PROJECT BLUE BOOK

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30. Please add here any further comments which you believe are important.
Use additional sheets of the same ones paper, if necessary.

; TENTATIVE ee:

SEES SSI - W959, 00

SECTION A

1. When did you ey BS, objects
1.1 Dates Thuas S 2 pt reve

1.2 Time of Day: Y - S&S or P.M. (Cirele One)

1.3 Time Zone: (Circle One):

a. Eastern Pacific )
be Central s Deke:

ce. Mountain

(Circle One): a+ Daylight t Saving)

2.4 Circle one of the following to indicate how certain you are of
™ your answer to the above question 1.2:

Car Cortet Ce Ce Not very sure
. Fairly certain ad. Just a guess

2. Where were you when you saw the a

ae or ao Siadiihonad shee
vi

3. Where were you located when you saw the object:
(Circle One): a. Inside a building d. In an airplane

b. In a car e. At sea
(€- Outdoors ) f. Other

3.1 Were yous

(Circle One): a Tn the iaatnene ahead of a city?

“In the residential section of a city?
In open countryside?
d. Flying near an airfield?
e. Flying over a city?

f. Flying over open country?
g- Other

LLLP LLL LAL ALLA LALA

he How did you happen to notice the object?

?
- : vA =
7 ‘ et £_2

y

5. When did you report to some official that you had seen the object?

SECTION B

6. What were you doing at the time you saw the object?

-
.
, : - * ”
ad
. _

6.1 What tad you been doing for the 30 minutes before you saw the object?

Try to list the activity or activities and the approximate amount
of time spent on each.

srw” o
\/ /

7. Were you moving at. any time while you saw the object? (Circle One):

s - @

IF you answered YES, then complete the following questions:
7ol What direction were you moving?

(Circle One): a. North @. South
b. Northeast f. Southwest
ce East g- West
ad. Southeast h. Northwest
7e2 How fast were you moving? miles per hour.

7-3 Did you stop at any time while you were looking at the object?
(Circle One): Yes or No

8. What direction were you looking when you first saw the object?

(Circle One): a. North e. South
b. Northeast f. Southwest

ce East West
dad. Southeast (bo orthwest By UWoest

a a a =

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8.1 What direction were you looking when the object disappeared?

(Circle One): ae North e. South
b. Northeast f. Southwest
c. East West
ad. Southeast Northwest Cy West

8.2 Circle one of the following to indicate how certain you are of
_— r to the above question and preceding question (8 and
@ >

Cae Certain > c. Not very sure
b. Fairly certain ad Just a guess

9. Were you wearing eye glasses when you saw the object? (Circle One):

=

10. How was the object seen?
(Circle One): a. Through window glass e. Through theodolite

b. Through windshield f. Through sunglasses
Chacke 662) Through binoculars Through open space
a i, Through telescope « Other
11. What do you remember about the weather conditions at the time you saw the
object?
11.1 CLOUDS (Circle One) _ 11.3 WEATHER (Circle One)
G.__Clear skp ae Dry
b. Hazy “be Fog, Mist, or light rain
ce Scattered clouds c. Moderate or heavy rain
ad. Thick or heavy clouds d. Snow
- @e Don't remember e. Don't remember
11.2 WIND (Circle One) . 11. TEMPERATURE (Circle One)
Ca. to wind> Be Cold
b. Slight breeze Cb. Cool
c. Strong wind ce Warm
d. Don't remember d. Hot

e. Don't remember

SECTION C

12. Estimate how 1 the object? Leva
8 ong you saw jec ; =

Page

12.1 Circle one of the following to indicate how certain you are of your
answer to Question 12:

é Certain ¢. Not very sure
> Fairly sure d. Just a guess
13. Did the object look: (Circle One)/ Solid } or Transparent

Uh. Did the object at any time: oe

(Circle One for each question)

1k.1 Change direction?
14.2 Change speed?
1;.3 Change size?

o
@

’ Don't know

yes No) Don't know

e \ Don't know

1.4 Change color? “Yes ) B Don't know

14.5 Break i parts or Yes Cio) Don't know

Wh.6 Give off smoke? Ye Cie Don't know

14.7 Change brightness? i (Yes » Don't know

1.8 “—s—e Shane mer Ciées) Yo n iW
sa a --

14.9 Remain motionless? (Yes » No Don't know

15. Did the object give off a light? (Circle One): Yes (ilo) Don't know
15.1 IF you answered YES, what was the color of the light?
16. Tell in a few wrds the following things about the object?
16.1 Sound MA AL.
16.2 Color : ke vr
17- IF there was MORE THAN ONE object, how i. were there?

Draw a picture of how they were arranged and put an arrow to show the
direction they were traveling.

iA / -
Cc

18, Did the object at any time:

18,1 Move behind something? (Circle One) Yes Cite) Don't know
IF you answered YES, then tell what it moved behind,

-
—

: Page 5

18.2 Move in front of something? (Circle One) Yes ( No | Don't know
IF you answered YES, then tell what it moved in front of.

18.3 Blend with the background? (Circle One) Yes (&) Don't know

19. Which of the following objects is about the same actual size as the object
you saw? (Circle One):

+ Pea f. Automobile
b. Baseball g- Small airplane
c. Basketball “ Large airplane
ad. Bicycle wheel Dirigible
e. Office desk C 3) Other chunk Ge /) aw ah J ee.

19.1 Circle one of the following to indicate how certain you are of your
cnawer to Question 19.

ae ee

+_Certatn > c. Not very sure
airly certain dad Uncertain

20. Try to tell the following things about the object:

20,1 How high above the earth was it? SOv?- 5, oof feet.

20.2 How far was it from you? eet or =z miles.

20.3 How fast was it going? o miles per hour.

20.4, Circle one of the follow t indicate how certain you are of your
answer to the above questions:

Qe " ce Not very sure
« Fairly certain d. Just a guess
21. How did the object disappear from view?
(Circle One): (a. Sudden c. Other
: ly d. Don't remember
SECTION D

22. In the following sketch, imagine your eye at the point shown. Place an "A"
on the curved line to show how high the object was above the horizon

(skyline) when you first saw it. Place a "B" to show vhere it was when
you last saw it.

Overhead

Horizon:

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23. In the following sketch place an "A" at the position the object was when
you first saw it, and a "B" at its position when you last saw it.

Overhead

Horizon

2h. Draw a picture that will show the motion that t!- object made. Place an
"A" at the beginning of its path and a "B" at tne end of its path.

~
— ——— ee ee ee ee ee ——-——={ ;

25. Draw a picture that will show the shape of the object. Label and include
in your sketch any details of the object that you saw and place an arrow
beside the draving to show the direction the object was moving.

eS eee

Regattas EK

prams deck ak parte

oes te nw cL TT | ar buir,

x<-F cths

SECTION E
26. Was this the first time that you have seen an object like this?

(Circle One): (xs) or No

26.1 IF you answered NO, then when, where, and under what conditions did
you see other ones?

27- In al opinion what do you think the object was and what might have caused
i

re ecfagnr

28. Give the following information about yourself:

a.

29. Was anyone else with you at the time you saw the object?

a

(Circle One): (Zee) or No

29.1 IF you answered YES, did they see the object too?

(Circle One): (zea) or lo
29.2 Please list their names and addresses?

hb #