PROJECT BLUE BOOK

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13 COACLLSICNs
10 lov 52
COVIIGTON OHIC
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EP.ISN .
10/1950.EST
20/2400.7 A
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Civiia 41941
31
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Brilliant blelsh Hght waich had a brbbing
1. Bourte cleins he his soon light alx
Mingion, Ohle
times in Jast txo monthn.

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In order that your information may be filed and coded as accurately as possible, please use
the followings space to write out a short description of the that you observed. You may re-
peat information that you have already given in the questionnai d add any further comments,
statements, or sketches that you believe important. Try to sent the details of the observa-
tion in the order in which they occurred. litional page er may be attached
if they are needed.
NAME (Do Not Write in This Space)
(Please Print)
CODE:
SIGNATURE
DATE
. Sycamore Bend,
Covington, Ohio. M
from his home, which is located on Route 48, just west of - Covington, Ohio. The
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be used for res search egarded as confidential material. Your name will not
be used in connection with onclusions publications without your permission.
We request this rsonal information so eemed neces contact you for
further details.
When did you see the object? 2. Time of da: 190
No 1952 Hour Minutes
10 a
Day Month Year (Circle One): A.M. or P.M.
3. Time zone: (Circle One)(a. Eastern
(Circle One): a. Daylight Saving
1 b. Central b Standard
c. Mountain
d. Pacific
. e. Other
4.Where were you when you saw the object?
Suca le Bend Ciroton 0410
Nearest Postal Address /City or Town State or Country
Additional remarks: :.
a. Certain c. Not very sure .
.Fairly certain d.Just a guess
(Circle One): a. Bright daylight d. Just a trace of daylight X
b. Dull daylight e. No trace of daylight
c. Bright twilight f.Don't remember
7. IF you saw the obje TWILIGHT where was located as you looked at
the object? .
(Circle One): a. I In front of you d. To your left
b.In back of you e. Overhead 3719-29
c. To your right f. Don't remember

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Page ?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
a.  None a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight - pitch dark
d. Don't remember d. Don't remember
Ws tt i than t acoun y
(Circle One): a. Yes . No c. Don't remember
(Circle One) a. A mile or more away (a distant car)?
b. Several blocks away?
c. A block away?
d. Several yards away? d. Several yards away?
e. Other. e. Other
Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes Na Don't Know
b. Suddenly speed up and rush away at any time? Yes No Don't Know
c. Break up into parts or explode? Yes No Don't Know Don't Know
d. Give off smoke? Yes No Don't Know
e. e. Change brightness? Yes Yes No Don't Know
f. Change shape? Yes Yes Noo Don't Know Don't Know
g. Flicker, throb, or pulsate? Yes Yes. No Don't Know
.Did the object move behind something at anytime, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answere then tell what
it moved behind:.
.Did the object move in front of something at anytime, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, than tell what
it moved in front of:. .
Did the object appear: (Circle One): a. Solid? b. Transparent? c. Don't Know.
15. Did you observe the object through any of t efollowing?
a. Eyeglasses Yes No e. Binoculars Yes
b. Sun glasses Yes No f. Telescope Yes No
c. Windshield Yes g. Theodolite Yes No
d.Window glass Yes No h. Other
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18. The edges of the object were:
(Circle One): a. Fuzzy or blurred
b. Like a bright star
c. Sharply outlined
d. Don't remember

and at about arm's length?
(Circle One): a. Head of a pin g. Silver dollar
b. Pea h. Baseball
c. Dime i. Grapefruit
d. Nickel i. Basketball
e. Quarter k. Other
f. Half dollar
22.1 (Circle One of
a. Certain c. Not very sure
b. Fairly certain d. Uncertain
How did the object or objec om view?

2. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the owing questions:
a. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
28.2 How fast were you moving? _ — miles per hour.
(Circle One) Yes No
2. What direction were you looking when you first saw the object? (Circle One)
31.2 When it disappeared:
a.From true North .. degrees.
b. From horizon _ degrees.

In the following larger sketch place an A at the position the object was when you first saw it, and a B at its
B
A 0
:

What is your pre
Age- Sex
Please indicate any specia ducational training that you have had.
Grade school e.e. Technical school
b. High school (Type)