~O>~CL~SION .:)3SERVATION 11 B RI E P SUMMARY A ND ANALYSIS ?r11v~ -~ d!t. ona o f thia f orm may b e uaed. t UFO form continued Do [OU think you can estimate the speed of the object? (C ircle One) 1?-you on~w~red YES, then what speed would you estimate? ::o fOu thin~ you con e~timote how for away from you the object was? (Circle One) SJ. No ;: you answered YES, then how for away would you say it was? 22. ,_.,,.~,~re were you located when you saw the object? 23. Were you (Circle OntJ) a. In the businen section of a city? c Inside a building b. In the residential ~ection of a city? c Outdoors c. In an airplane (type) e . At sea (:ijln open countryside? d . Near on airfield? e: Flying over a city? (f) Flying over open country? 2- . = ;'~V were MOVING IN AN AUTO,.~OolLE or other vehicle ot the time, then complete the following que~tions: 2d. l What direction were you movi,.g? (Circle One) a. North @ Eo$1 e. South ortheast c. Southeast f . Southwest How fast were you moving? . :.../_l~'_miles per hour. 1~ 3 Did you stop at any time while you were looking at the object? (Circle One) 25. Dc! you ooserv~ the object througn '=lny of the following? c . Ey~glosses b. 5~,. n g lo,s.es /~ \Nil"'dshreld e . Binoculars f. Telescope g . Theodolite h. Northwest .-:. N c'1oow gioss !f'! cr=~"' ~-:: vou con g ive oos cleor o oi cture Q.s possible of what you saw, describe in your own words a common object or ob-- i::=-: ,...--:- .... ~A., placed up in the slcy, would give the some appearance as the object which you saw. . OffiCial U.S. Air Force 27. !n l'!e following sketch, imagine that you are at the paint shown. Place an " A" an the curved line to show haw high the object we~ -::bove the horizon (skyline) when you first saw it. Place u " 8" an the same curved line to show how high the object was o~o" th~ horizon (skyline) whe n you last saw it. Place an " A" on the compan when you first sow it. Place a "B" on the com ou when you last saw the object. 0~ a picture that will sh ow th~ motion thot the object o r objects mode. Ploce an A" at the beginning of the path, a "8" at th<e end of the path, and show any chor.gas in directton during the course. 29. ;;: ~r~ ...,os MORE THAN ONE ooiec, th en how many were there? _ Or":lw o pictwe of how they w~re crronged, and put an arrow to show the direction that they were traveling . UFO form continued 30. Have you ev~, .;~e., this, oro similar abject before. If !>O give date or dates and location . 31. Was onyon .. ~1 wirh you at the time ycu sow the object? (Circfe One) 31.1 1;: you .::nswered YES, did they see the object too? (Circle One) Yes 31.2 Plecse :,sr their names and oddreues: 32. Please gi ;net following information about your~elf: lndtcote ~ny ::ccitional informotio11 about yo1.r~elf, including any spectolexperience, which might b e pertinent. 33. When ard o ...,.,o,... 01C you report that you ned seen the abject? / ' ' 1Yl Y W ( I~ R Official U.S. Air Force 34. Dote you 'ompleted this questionnaire: 35. Information which you feel pertinent and which is not adequately covered in the specific points of tne oue~tionnoire or a narrative explanation of your sighting. /J c{S f+Lt_ A-P-c "'"" (;_ 1;r Tlfi! {s ,,.rr G ll.f I~LL t-v tf, r E --/fg (l 1 :Tfi.C.# 5'f-c p tv ff!'iAf. I' W i) s. C.. OtiJt' N '-J) 0 WJ..I 'TI+ t!.lh LL UFO form continued U.S. AIR FORCE TECHNICAl INFORMATION This questionnain' has been prepared so fhat you can give the U.S. Air Force os much information os possible cbncerning the unidentified aerial phenomenon that you have observed. Please try to onsw~r as many questions as you possibly can. The information that you give will be used for research purposes. Your name will not be used in connection with any statements, c.onclusions, or publications without your permission. We request this personal information so that if it is deemed r~cessary, we may contact you far further details. 1. When did you see the object? 2. Time of day: , (Circle One): or P.M. 3. Time Zone: (Circle One): a. Eostern b. Central c . .M.ounta in d. Pocific (Circle One): a. Daylight Saving b . Standard ~. W'r.ere were you when you so"" ne object? N~orest Po~tol Add~u City or Town 5. ~::Jw long was object in sight? (Total Duration) .. -. Hours Minutes o. Certain f c. Not very sure b . Fairly certom d . Just o guess I ( w~ obj~ct in sight conti:'luously? b . Cloudy 7. IF you so w ihe o b ject during DAYLIGHT, where was the SUN located as you looke d at the object? [ Ci r cle On9): a. In front of you d . To your l eft b. In bock of you e . Overhead c. To your right f . Don't remember State or County FTD OCT 62 164 Th1s form sup~rsedP!' FTD 16_., jut 61, which is obsolete. 8. If you sew ~"e object at NIGHT, what did you notice concerning the STARS and MOON? d. ;Jon' t remember 8.2 MOON (Circle One): o. Bright moonlight c. No moonlight-pitch dark d . Do n't remember 9. What w:er<t 'ne weather conditions at the timt~ you saw the object? CLOUDS fCi:de One): o. C lear sky ~-&-aft!''ed clouds d. Th icl< or :,eovy clouds WEATHER (Circle One): !(.,...Fog-, m-'fit,orfigfirroin) c. Moderate"Or'lieovy rain e. Don' t remember 10. ;:..-e ?biec: :!opeored: (Circle Oneh b. TrcnsFor~t"t e. Don'trem""mber c:) (. f'C't; f.._';~') \l\1~ \ .\ 11. If ir cppeor!'e :s a light, was it brighter tncl"t tne brightest stars? (Circle One): o . .:>flCM ter c. Aoout the same ~-:--"~ i JT'I tT- e d . Don't know 11.1 Compare '::>rig~tness to some common object: 12. The <tdges oi TT'!!" eo!ect were: , ::J. !. Koto ort ntstor Did the o b ject: (Circle One for eoc:h question) Appear to itond :;till a t any time? Ye s Don't know b. Suddertly speed up and rush away at a ny time? Yes Don't know c. Break u p 1nto ?arts or explode? Yes Don't know d. Gi 11e off s!"'lok e' Don' t know Chonge brigntnem~? Yes Don't know Chong~ !>hope? Don' t know Flash o r rlic ker? Don't know Disappear and reappear? No Don't know . OfficiaiU.S. Air Force 14. o;d rne object lisappear while you were watching it? If so, how~ tJ d t (/V fl A Jt:>.fJ.flD.'Lill{ Did the object move behind ~omething at any time, particularly a cloud?. Don't know. IF you answered YES, then tell what 16. Did the object move in front of something at any time, particularly a cloud? (Circle One): Yes ~ Don't know. IF you answered YES, then tell what T ~II in a few words the following things about thj'j object: We w ish to know the angular siz~. Hold a match stick at arm's length in line with a known object and note how much of the :::>bject is covered by the head of the match. If you hod performed this experiment at the time of the sighting, how mych of th~ object would hove been cover!d by t~e p1atch head?" i),.ow a ?ic:ture that will sho..., ~he shape of the object or objects. label and include in your sketch any .details of the object met you saw such as wings, ?rotrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing t~ snow :ne direction the obiecr was moving. UFO form continued 20. Do you : hink you con estimate the speed of the object? (Circl~ o,e) <f=y No !f you onswered YES, then what spe~d would you estimate? 21. D ::> vou think you con estimate how for away from you the object was? (Circle One) 1c. ;.--::u answered YES, then how for o""'oy would you soy it wos? -::...:."i"";,.. ...:.!Yh-'-.:...:.:IV:-= 22. Wn~e .yere you located when you sc .J fn e object? o kside a buildin g b 1,, a cor d. bon airplane (type) e . At sea 23. Were you (Circle One) a. In the business section of o city? b . In the residential section of a city?;> c. In opericoV'ritry;iJe"? d . Near on airfield? e . Flying over o city? f. Flying over open country? 24. iF you were MOVING IN AN AUTO/v\OSILE or other ve h:cle a~ the ti-ne, th e n complete the following questions: What direction were you moving? (Circle One) S. N ortheast d. Sourh~ost f . Southwest H:Jw fast were you moving? miles per hour. 24.3 ~;d you stop at any time while you were looking at the object? (Circ/9 One) D id you obser'le the object througn Cf'.y or the following? c. = glosses Binoculars ;:,un ';ICSieS f. Tele~cope ,y:,.,csh;~Hd Theodolite h. Northwest !lr ltY! z nJ d. 'IVnco'-::le u Yes 26. i:1 :.:rc!-' :-:c 'CV :::n give cs dee r o picture as possible of what you sow, describe in your own words a common object or o b - jecrs w-c~ "'"'-:!1 placed u p i n th e ; ky, would give the same appearance as the object which you sow. Official-U.S. Air Fore , 27. 111 the following ~ketch, imagine that you are ot the point ~hown. Place on "A" on the curved line to show how high the CJbject was above the horizon (~kyline) when you first sow it. Place a "8" on the some curved line to show how high the objed wo' o!;)ove the horizon (skyline) when )'OU fast saw it. Place an "A" on the compass when you first sow it. Place a "8" on the kom- ?em ~hen you last saw the ob1ect. 2a. C~"" o picture that wilf show the motion 1hat the object ~r objech made. Place an "A" at the be3inning of the path, a "B" at .:.. ~ ~.,d of the path, and show any changes in direction during the course. 29. !F t;, '!r8 was MORE THAN ONE obi~. then how many were there? , _ Dr::-a picture of how they were arranged, and put an arrow to show the direction that they were traveling, DEPARTMENT OF 'fHE AIR FORCE HEADOUA .. TERS ~'FOREIGN TECHNOLOGY DIVISION f A,SC) WRIGHT-PATTERSON AIR 'ORCE IIASK, OHIO 45433 TDE'.i.'/UPO UFO Observation, Mar 67 Refe~=nce your unidentified observation. The information vhich we ':.2.-re received is not sufficient for a scientific evaluation. Re~-.est you complete the attached FTD Forrn 164 and return 1 t in the envelope provid~d. Thank you for reporting your observation to t~e Air Force Jftlv83 c. MANA'Pr, Colonel, USAF of Technology a nd Subsystems FTD Form 164 v/envelope UFO form continued 30. Hovs you ~ .. !!. sc!~n this, or a similar object before. If so give dote or dotes and location. 3 1. w,.,s OI"")'O"" el se with you at the time yoJ sow the object? ( C ircle One) 31.1 If fOU -:~nswered YES, did they seo? th~ object too? ( C ircle Ono:1) No 3 1.2 ? '!!c!oe lst tneir names ond addresses: 32. Please 3'"~ !he following information about yours:!lf: Fi r $1 Name C ity Zone M iddle Nome !nciicate on~ additional information aboJt y