1 iO. CONCLUSION , r.~.GTH Of C ..... _i<VATION 11. ORIEF SUMMARY AND A . ALYSI:; Ql)!J~r.:c:r st.:n:.~d t:.:..:. t.": c ob juct nppeur cc. -.s U. S. AIR FORCE TECHNICAL INFORMATI01~ Th questi onna ire ha a been prepor"d ao that you can uivo th a U.S. Air F o rce as much inform~lto:;n os pouiblo concerning the unidentified oer1o l phenoonenou tha t you hovu oLn.,rv~ti. Please ~;.-to onswer as many que:~tlona as y ou pC'Issibly c an. T ho informati on that )'C:U givo w:l l b$ uud i :;( ruearch purposes. Your nom. will not be used in connec.tion with any st~teruani:J, c on:!us i~ns, or publications without your permission. We request this pt)rsonol lnfo rmotion ~c thot rf 11 11 deemed neceuary, we rnay c ontact you fo r further details. 1. When d id y-,o.~ s:H' the obj~ct? 'i. f i me of -lo ' A.M. CJr (PM. i Crc/o One): 3. T ime Zone. (C~rcl<-vne): a,r"Ooyli\)ht ~c:tn~ b . ~ta1dard ( Clrclo One): .a, Eastern' b. Centra l d. Pociflc 4. V!horo wer~ yt>J when you saw t he object? C i t y ot T o"'n Sro 'A Col.,t 5. How lot--; .,..o, o b ject in alght? (Tot,l 01.1rotlon) inute a Sacoroda e. Cer:oin c. Not very sure h. Fa1ly c~rtoin d. Justo guess .)0 of rho s l<1? ~ C ' c udy ( o;" Br iolit" 7. IF you s~ :!"'!z _,,,ct during DAYLIGHT, ~h.,ra was tho SUN locotod os you loc.k~J c! tho ol;t<r~t? (Circle Ona): o. In front of y ou In beck of you c. To your rig,t d. T o your l~ft e. Overhead f. Don't ru m.,mber T ht. fmm ouporoodoo Pm 164, J u l 61, whic h lo oho'>lot~. a. IF you sow Jho ob tec t o l NIGHT I what did yov no!IC.t! concotning thl'll STARS and MOON? o .J:3r~r/!t moonlight: .... b. DCII-moonl ioht . c. No moonl ight -pitch dar\( d. Don' t remtmb.r 9 . What .... .,,.~ : ~ ... oother londstiona ot tn~ tim-. you aow the obj~c-t? CLOUDS ' ( n lc Ono): c. ~CCitll:-c :lO\o'~ WEATHER (Circ Itt One): L. Fog, m1Sf, Of luht roltt c. Modoro to or heavy rain o. Don' t re~membor 10. The :lbt~c-1 v,>peorod: ( Circl& On~}. b. T r urupo ~Il l o . Doo't r rnlar 11. If 11 cppeord o s a li ght, wo a it brightor then the brlghtft~t stars? (Circii!J On:t): c. About th s ame d , Don't know 11. 1 Co.-per~ ~ightnn to 1101'1\ir c:~,..rrton obJ~ct: 12. Th od~u c.i n~ object were: : . L ske a brl~ s~ c.. Sl-orply ou!lire= ::. Don ' t romemb~r (Circlo On~ few oach que:.lion) Don ' t know Dcn't know o . Appeor IQ ''o "'d still a t any t ime? b. Sudd~nly ';>e~ up ond ru 3h away ot a ny tim~? c. Br.,ol< L;> ,rr:. ~arta cw e x p lod. ? Yo a Don't tmow d. G11~ off l-:~lc<!? Ytu ( N o Don' t kno* o, Chonptt ~!]1tneu? ( Yos I No D::#t't know f. Change lhJ~? Yu No (.Don't !mow g . flo)h cw flic~er? Don' t ltnow h. Daop~or ond roop~or? Dcn' t know 14. Did tho ob1oct disoppoor whi lo you were. totc h ing 1t? II :.o, how? 15. Did tho ob;e m~ve boh ind someth1ng ot ony time, porticul,uly o cloud'? (Ctrcle c --,J: it movbd ~hind: N o Don't Know. 16. Did tho ob tc:t move in front o f ~opm:tthing atony tr rne, p()rtic ularly o cloud? Cio n 't Know. IF you answerod YES. t~'!!., -: \I w:a:JI 17. Toll in o fe., words tho following th ings obout tho objt!c t : We wish to know the ongulor sixe. Hold o match stic k o t arm's length in lin~ with o k1rown tJbjo:t ond1:; r of th ~ objett is covered by th e hood of tho match. If y ou had pttrformod this oxper imeut o t th& t i ..... ,i :ligi,lrng, h~.,.. much of th e ob;oct would hova bea n covorod by tha matc h hood? 19. D:ow c ~!::..,, ""'lot w ill show th~ ~h!l;:;e o f tha object or objocts. Lobel and include in y our a ketch ony deto:l:. of th =') ~ .. ,~, y~u saw such os w i- gs, protru&ions, etc., ond oapacially exhaust troilt or vapOi' trolls. Plac..t c , ::::..-;,e1d e th o drowirt1 to s~=.~t tho direction the objoct was moving . 27. In tha followlna o!c~teh, lmc9ln thot you are at tin point !Shown. Ploc: (.1., "J..." on \ ho r:urv: lm1. t o ohow ho .... h igh th~ objec:t was obov th horiz on (kylln.t) whotn yc.u first JOW lt. P locu 'I " B" l)n the I:Jtne t..Ur< d line :c ahow how high th obict was obov the hori:zon (Gkyllne) when you last ~uw rl. Place .:.~n ' 'A ' on the compra : wh_,n you f/Jf sow It, Ploc o ''B" on th 'ompon whr~> you lost ilaw tft<.t oh1" c t. r 2o . Draw o plcturo tha t will ahow th~ mot;on t hat tha object or objects modo. Place on ' ' A ' a r rho boolnrsi.'IR o t path, o " B o t the ond of th~ path, e nd Ghow ony chono"' in direct ion during the .;.'lur~e. t hn how mony w~ro thare? ------------ Ora "" c ;:-::.~ ::>f h:l~ th,y w~r~ ~r-or;~, and put on arrow t o ahow tho diroctton t hat thoy w:sut tr ovvlin1,1. 31. Wo; oryo-.., ls with you at ~e ti ma you sow the object? (Circle One) 31.1 lr ~:.v ""' wr.,d YES, did t hty see t he objct too? (Circ/o Ono) 31.2 Pl~cu l iat t he ir namu tnd oddr~uu: 32. Ploou giV't the following lnf~matlon about yourulf: f' I rat Nom TE LE PHOr,; ~lUMBER ndloa -.... :~ddltionol lnforiT*tlon ~bout yourulf, lncludlnu any opKiol oxprl nc~, whlc:h mioht b > JV)Ointnr 33. Whe n and to wl-1~ d id you re~t that you hod aun th object? Day Month Year 34. Oat you complt~d thi!J qu&IStlonnalr": lnf~moticn whi::~ y~ fl pertlnnt and which Is not od~quot&ly covl'tr~d in tht a~clflc polnta of the qu.,ltlonnair~ ~ a narrative oxplonotion of your alghting UFO Obee~ration, 19 April 1967 ~lev Rochelle, New Yor k lo80 1 ~!.s replies to you:: ~cent letter of May 3 , 1967 in l-lhich you me ioned your unidentifie d observatio~s sine~ April 19 , 1967. Request you c omplete tbe inclosdd FTD 7o=m 164 and resubcit the 1m oxmat:ton. This will enable our ana lysts to study the information and ~rform a pro,Per in'lestigation. ~f the unidentified object has ap a d night at~er night , I suggest you contact the local pol~ce d epartment. It i s possible that so~one could c ome out t o you:: nome and observe t h e UFO. Sincl!rely, "iitcTOR QUDITA)JILLA Jr, Ha jor, USAF et, Proje c t Blue Book l'TD ?orm 164 v/envelcpe