PROJECT BLUE BOOK

2. LOCATION

3. SOURCE 10. CONCLUSION

M4 > » | > af "eer 4 TTF rr | -
Civilian 7% LIU SSLOCLISNT Da

4. NUMBER OF OBJECTS

Acecae@ar! mot? ; } —F 4°24 + >
SS8a0.2 Calloon, Nowever insurficien

—

5. LENGTH OF OBSERVATION

5. TYPE CF OBSERVATION

3. PHOTOS

oO Yee
TX Ne
9. PHYSICAL EVIDENCE

Oo Yes
xX Ne

FORM
FTD sep 63 0-329 (TDE) previous cdittons of this form may be used,

Page 7

34. Whet were the weather conditions at rhe time you saw the object?

34.1 CLOUDS (Circle One) 34.2 WIND (Circle One)
<a “Clear sky ) c. No wind.
b. Hazy b. Slight breeze
c. Scattered clouds c. Strong wind
d. Thick or heavy clouds d. Don't remember

e. Don't remember

34.3 WEATHER (Circle One) 34.4 TEMPERATURE (Circle One)
a. Ory a. Cold
b. Fog, mist, or light rain b. Cool
c. Moderate or heavy rain c. Warm
d. Snow d. Hot
e. Don't remember e. Don't remember

— — ——— —_ oe — ee

—-+---4-

35. When did you report to some otticial that you had seen the object?

Day Mort» a. : Yeor

_—- - -_——_—— — or _

26. Was anyone else with you at ‘he time you saw the object?

(Circle One) Ves No

36,1 IF you answered a did they see the object too?

(Circle One) Ces) No r

36.2 Please list their names and addresses: » thé, PEA 16

37. Was this the first time that you had seen an object or objects like this?

(Circle One) Yes (No)
37.1 IF you answered } NO, then when, where, and under what circumstances did you see other —
AYYL VTriw % rr, were 2h ae ChAL> Le ‘ phon? / r & > y. ous ae , “LAU
' = P
PF B06 Le mers Bite 17 / Bor tiie 4 ing as A ad “3 PW
m —_ é s ; >) . —, } . — — i bd
er é fA a0 Lag ZL  s Fs al ~ ee: Foe ort? Pas Lett A J a ee Oa,
© Avil 5 +se* a t4 ‘i tA, then ct a *

———- — » . ee ee —— -_ - — — ——————

3. in your opinion what do you think the object was and wnat might have caused it?

Page 2

USAFTIS

—-——

—

. é
oe pee AIR TECHNICAL INTELLIGENCE CENTER
~ \ WRIGHT-PATTERSON AIR FORCE BASE
\* OHIO
21 April 1953
~~
\
.
A )
a
d A (
oe \U
Wy
\
- © /
tamptomville S
liortn Carolina
~\

Dear Mr. Felts: >

Your recent revert Of unidentified aerial phenomena has been
received by the tir Te cal Intelligence Center. iInclosed is a
questionnaire, which, when‘completed by you and raturned in the
inclosed, self-addressed envelope, will aid in standardizing the
data and will provide a complete.record of the occurrence.

Your interest in reporting the matter and your public spirited
Gesire to be of survice are greatly appreciated.

Sincerely yours,

2 Inels ~ ° 2
a/s Major, USAF
Air Adjutant General
re (Brewer ae ie, q.
, o ——— oo Abd theo ? ne "
Mi pas “to ’ = tet a. vt .

Form A

——_——_————=====S=—==———— SS =e ee —————

U. S| AIR FORCE TECHNICAL

INFORMATION SHEET

This questionnaire has Seen prepared so that you can give the U. S. Air Force as much
information as possible concerning the unidentified aerial phenomenon that you have observed.

Please try to answer as many questions as you possibly can.
be used for research purposes, and will be regarded as confidential material.

The information that you give will
Your name will not

be used in connection with any statements, conclusions, of publications without your permission.
We request this personal information so that, if it is deemed necessary, we may contact you for

further details,

1. When did you see the object?

—

Day

/
weil **"
ot

Month \

ee ee

3. Time zone:

(Circle One):

anos

= —

Time of day: __

eee

PM,

Hour
l¢SsZ
Year Circle One} A.M,
|

= astern (Circle One): a. Daylight Saving
“satral -b. ._ Standard)
“ovurntain
Pacitic
Crher

4. Where were you when you saw the object?

\

ad

Additiona
fen. af

"9 ’

Nearest Posto! Address

el

orks:
A, Ae

= all

_ he, seer

'
(PUALA

-

5. Estimate how long you saw the obiect.

At aa _~ he

—

GG. ae"

City,or Town

Ade: TPL the ‘
— Se a >
- Minutes Seconds

Hours

5.1 Circle one of the following to indicate how certain you are of your answer to Question 5.

6. What was the condition of the sky?

(Circle One): Ca. Bright daylight.

ob. Dull deylignt
c. Bright rwilight

’

c. Not very sure
d. Justa guess

—

—_-

d. Justa trace of deylight
e. No trace of daylight
t. Don't remember

2 3$0w

‘se > art?

= | 7
i ase =

—--—-

the object during |.

45

-
“ese

LIGRT Tw

In front of vou

—— pore ee -- =

>. 'm oack of vou”
————————
To your rignt

LIGHT,

wrere was the oUN

or DAWN.

) Cur err
eo. § verneca

on t remember

Scated

:s
el

you 'oo«ed ar

Page 2

— _ —-

8. IF you saw the object at NIGHT, TWILIGHT, or DAWN, what did you notice concerning the STARS and MOON?

8.1 STARS (Circle One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
2. Many ¢. No moonlight — pitch dark
d. Don’t remember d. Don't remember

9. Was the object brighter than the background of the sky?

(Circle One): a. Yes b. No ce. Don't remember

— oe ae oe —<- ee ee ee

(oF licker) throb, or pulsate?

10, IF it was BRIGHTER THAN the sky background, was the brightness like that of an automobile headlight?:

(Circle One) a. A mile or more away (a distant car)?

b, Several blocks away?

c. Ablock away?

d. Several yards away?

ee a eS ee + oe ee ee

z e. Other... = u
11, Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes (No) Don’t Know
b. Suddenly speed up and rus away at any time? Yes No) Don’t Know
c. Break up into parts or exo/ode? Yes Don’t Know
_d. Give off smoke? Yes Don’t Know
e. Change brightness? Yes Don’t Know
f, Change shape? Yes Don’t Know

Yes) No Don’t Know

12. Did the object move behind something at anytime, particularly a cloud?

(Circle One): Yes (Ne) Don't Know. IF you answered YES, then tell what
it moved behind:

— _

= —_— —- — — oo .

—_

sa — -

13. Did the object move in front of something at anytime, particularly a cloud?

(Circle One): Yes (Ng Don't Know. IF you answered YES, than tell whar

it moved in front of: —

——- - = ee

_—— ---

a
14, Did the oziect apcear: (Circie One): (a. Solid? >. Trensparent? -. Don't Know.
: —- —— . ~~ ————s —s =

‘2

15. Did you coserve the object through any of the following?

21 43345 *s NO . S eeeviers 2

a. Un J1¢s8es 4 Noe) “2 #sco0e fas “Oo
. = . a

c. Winasnield Yas Ne. Jj. 'mecdolite (as NO

d. Window gicss’ Yes Ne nh. Other ___ — —_—_—

—_-—--—_---eneeeeeeeee> se - ---+- —_——- — ——_—_- --— ——_ -—- ——_—-

—_—- +e

—_—

~

16. Tell in a few words the following things acout the object.

' a. Sound

Me
b. Color Voie

-—- —

—

—

17. Draw a picture that will show the shape of the object or objects. Label and include in your sketch any details

of the object that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place
an arrow beside the drawing to show the direction the object was moving.

——-e-- » = —- . «9
A+
-~/ ut —— F -

18. The edges of the object were:
(Circle One): a

or brurred

ike a bright star)

Ce ply outlined
d. Don’t remember

rs

19. IF there was MORE THAN ONE object, then how many were there?
Drow a picture of how they were orranged, and put an arrow to show the direction that they were travel ing.

Page 4

om: —— Se ere ~ =
20. Draw a picture that will show the motion rnat the object or objects made. Place an “A” at the beginning’
of the path, a “B” at the end of the path, and show any changes in direction during the course. i

- ceueeiees a
:

21. IF POSSIBLE, try to guess or estimate what the real size of the object was in its longest dimension.
a sleet

—

—— —— — a _—

22. How large did the object or objects appear as compared with one of the following objects held in the hand
and at about arm's length?

| (Circle One): a. Head of a pin g. Silver dollar
' b. Pen h. Baseball
c. Dime G. GrapefruiD '
d. Nickel j. Basketball

e. Quarter k. Other 7

f. Hait doilar

22.1 (Circle One of the following to indicate how certain you are of your answer to Question 22.

OO a,
G6. Certarn) c. Not very sure
b. Farrly certain d. Uncertain
= a as = eras = mer a oo a
e 4: al/ a Ye * Ao oe Py,

_ _— = — —_—_s- —

24..1n order that you can give as clear a picture as possible of what you saw, we would like for you to imagine that you could
construct the object that you saw. Of what type moterial would you moke it? How lorge would it be, and what shape
would it have? Describe in your own words a éommon object or objects which when placed up in the sky would give the

same oppearcnce as the object which you sow.

aR)

Page 5

- = — =- =

oo OO eee Ss OFM mer ot

25. Where were you tucated when you suw the object? 25. Were you (Circle One)

(Circle One):

a. In the business section of a city?

- ~~“ at ere

| a. Inside a building b. In the residential section of a city?

| b. ina car \c._In open countryside?

| é. Outdoor d. Flying near an airfield?
d. In an airplane e. Flying over a city?
ae. At sea f. Flying over open country?
f. Other g. Other a

-_ ~ —_

27. What were you doing at the time you saw the object, and how did you hoppen to notice it?

4 -_ - |
wo =
ee - os - —_——_- o-_-_ = —_—- _>- ————— _ P<
g Pa (Ln a, | ? - a i ? Wd
—_— —« A ce Mt -_ —™ es —_—— —— ~ a —— — ——
—_ * L- ° ‘. a - : _
~
Y Ss i Bitinainat wait a —"

| 23. IF you were MOVING IN AN 4.) TOMOBILE or other vehicle at the time, then complete the following questions:

28.1 What direction were yow woving? (Circle One)

a. North c East e. South g. West
b. Northeast 4. Southeast f. Southwest h. Northwest
28.2 How fast were you moving? _ —________ miles per hour.

28.3 Did you stop at any time while you were looking at the object?

(Circle One) Yes No

29. What direction were you looking when you first saw the object? (Circle One) ( SLrexgpq- Uf
ee we :
a. North c. East e. South g. West '
b. Northeast d. Southeast f. Southwest h. Northwest

30. What direction were you looking when you last saw the object? (Circle One)

a. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest

—_— —_—— —_—-+-—-—--+- -- *

31. If you are familiar with bearing terms (angular direction), try to estimate the number of degrees the object was
from true North and also the number of degrees it was upward from the horizon (elevation).

11.) When it Sest apcecred: A
“rom true North os ss degrees.
<3" 2orlzoen ; eqrees.

. ‘780 (t adisaopecrea:

From true Norm degrees.
>. From herizon decrees.

; Page 6

—

| 32. In the following sketch, imagine thar you are at the point shown, Place an “A” on the curved line to show how
high the object was above the hor:zen (s«yiine) when you first saw it. Place a “8” on the same curved line to
show how high the object was above the horizon (skyline) when you last saw it.

— _ _ - — —_—_——_—_— —— _— —

33. In the following larger sketch place an “A” at the position the object wos when you first saw it, anda “8” at its
position when you last saw it. “sree to smaller sketch as an example of how to complete the larger sketch.

—-— «96s + +o

ous oe

a —o- —_—<$ mm

—

= ee oe ee

a

-— ---y-

ee ee

Page &

39. Do you think you can estimate the speed of the object?

(Circle One) Yes No
IF you answered YES, then whar soeed would you estimate? Zio fe 1220 m.p.h.

_ —_ - . a — ee -—— — = ————

—_<---— -+- - es --- —_ - —_

40. Do you think you can estimate how far away from you the object was?

(Circle One) Yes No

*
Pad
~~ L4

IF you answered YES, then how far away would you say it was? i feet.

11, Please give the following information about yourself:

Last Neme ‘vi '  Fiest Nome =e ta Middle mx "7

ADDRESS L. a NENA VL [MSTA Liverhena.
Street i City Zone State
TELEPHONE NUMBER __._-
7 *. 7
t é wy uf _
What is your present job? ea ee er
A Ww
Age O / Sex Pak fn
_ Please indicate any special educar onal training that you have had.
a. Grade school i> iow e. e. Technical school rt he
b. High school _____ el (Type)
c. College ____ f. Other special training
d. Post graducte saint line dite —_

—_ --——— ——--__— _

/ 2 VPLS LISS

42. Date you completed this questionnaire:

Day Mapth Y eor