PROJECT BLUE BOOK

25 July 53 Washin_ton, D. C.
3. SOURCE 10. CONCLUSION
aly rModeel (rzus & JUIrR)
Ln2 of o horvetlon id varliefroot oll inate pooainlll
NUM3 OF OBJECTS of ollood r W/e. Vant prtablsstrone iorl. Vaais & dunds
3
5. LENGTH OF OBSERVATION 11. SRIEP SUMMARY AND ANALYSIS
2 HAT56 lowas T. 1n eonbro1 totror onn 2ets1
6. TYPE OF OBSERVATION 1 1F 12
t. w1 lar 56 1in wt2
7. COURSE
3. PHOTOS 3. PHOTOS
Yos Y.s
9. PHYSICAL IOENCE ENCE V
a Yes
Z5N. X5N.
FORM
FTD SEP43 FTD SEP 43 0-329 (TDE) foru may be ueod.

EASTERN STANDARD BRIGHT OBJECTS ABOVE THE OTHER
THE LCWER OBJECT MUCH BRI3HTER THAN THE HlOHe: 935. APP
EARENCE OJJECTS OIJECTS LOCATE EASt EAST LRO.OME .0.0M EASTERN
STANI TIME FIME THE OBJE CT EASTERN STANDARD STANDARD
TIME THE SECON OJECTEE DISAPPEARE ISAPPEARE MENTIONE OBJECTS LOOKES OBJECTS LOOKE
LIKE STARS HOWEVER MUCH MUCH LOWER LOWER LAROER THAN ANY OF THE STARS LAROER THAN ANY OF THE STARS
IN THE SKYS THIS NI IN THE SKYS This N UNABLE TO TAK TAKE MORE DRE PICTUERS PICTUERS MALFUNCTION
OF CAMARA.
#
-08

informatien as soncerning the unidentified aerial phenomenon that you have observed.
Please try questions as you possibly can. T The information that you give will
be used for regarded as confidential material. Your name will not
be used in connection with any statements, conclusions, or publications without your permission.
We request this persanal information so that, if it i deemed necessar contact you for
further details.
I. When did you see the object? 2.Time oi day: - 0.3 - 09
Hour Minutes
25 Joll 1253
Day Manth Yoar (Circle One): A.M. or P.M.
3. Time xone:
(Cirele Ona) 1. Eastera (Circla One): a. Daylight Saving
b. Central b. Standard
e. Mountain
4. Pacifie
7. Other
4Where were you 41
Bolling Coit Tower Bollo A WSFDC
City or Town State or Country
Additional remarks:
b.Fairly certain d.Just a guess
(Cirele One): a. Bright daylight d. Just a trace of daylight
b. Dull daylight a. No race of daylight
c. Bright rwilight i. Don'tremember
Ilocated as you locked at
the object?
(Circle Onel: a. in front of you d. To your left
b. in back of you . Overhead
c. To vour right Oan't romember
PHOTOS SHOWED NOTHUSS
S

c. A block away?
d. Several yards away? +
. Other
11. Did the obinct: (Circle One for each question)
a. Appear to stand still t ny time? YoD No Don't Know
b. Suddenly speed u at any time? Yes No Don't Know
c. Break up into parts Yes Don't Know
d. Give off smoke? Yes Don't Know
e. Change brightness? Yes 399999 Don't Know
f. Change shape? Yas Don't Know
g. Flicker, throb, or pulsnte? Yes Don't Know
(Circle One): (Cirsle Ona): Yes Ye. (No Don't Know. IF you answered hen toll whet
it moved behind:
.Did the object mo ent at somerh thing at anyd
(Cirele One): Yos N Don't Know. IF you answ
it moved in front of:.
1 Did the object appear: (Cirele One): a.Solid b. Transparent? c. Don't Know.
failowing?
a. Eyeglasses Yas No o. Binocularz Yoy
b. Sun glasses Yas No F. Telascope Yes
c. Windshield Yes No 3. Theodalite Yes
d. Window gltss Yes No h. Other

Appeared
O
THS OBJECT Appeared Thave
O DISAPP
THE
18. The odgos of
(Cireie Onak
Lik =
e. Shorply sutilmed
d. Den't

_feet. NOT
22. How large did the abject or objects appear as compared with one of the following objects
and at about arm's langth?
(Circle One): d. Head of a pin 9. Silver dollar
b. Pea h Baseball) NTom OBFCT
C. Dime 1. Grapefruit
d. Nickal i. Basketball
B. Qugrter k. Other
.Holf dollar
22.1 (Circle One of the following to indicats how cartain you are of your answer to Question 22.
a.Cortaia c. Not very sure
b. Fairly certain d. Uncertain
23. How did the object or objects disappear from view? I ORIECTI
SEEN AETER IGHTER
?4. In order that vou eae would like ine that yoy could
S13EO STAR, AND THE
HAVE SEEN IN
ANY STAR , THAT I
TIME THERE L
HOWEVER AT THE BUT NONE WERG HS
STARS IN 7dE SKY,
FSW CAIGHT
OR AS LARGE, OR AS
a

28.1 What direction i
North C. East e. South West
b. Northeast d. Southeast f. Southwest Northwest
miles per hour.
l you were looking at the abject?
(Circle One) Yes No
What direction
direction), try to estimate the number of degrees the
from true North and also the number of degre upward from the horizon (elevation).
31.1 When it First appeared:
a.F From true North degrees.
b. From horizon degrees.
31.2 When it disappeared:
. a. From true North degrees.
b. 'From horizon egrees.

0309E$
33. In the following larger sketch place an "A
positian when you last saw it. Refar to smaller ske etch as an example of how to complet the larger sketch.
B
0 A
T

25 July 5
Day Month Yeur
(Circl One) Yn No
36.1 IF you answered YES, did they see the object too? .
(Cirel Ome) Y.a No
36.2 Please list their names and addresses:
I
38. in your apinion what do you think the object was and what might have caused it?
19c17

(Circle One) Yes (No)
IF you answered YES then how for
information about yourself:
NAME
Last Nama First Name Middi Name
ADDRESS 1NASH 20 D.C.
City Zone State
Ago 23 Sox 1116
a. Grade school ..
Hich ccbool (Type)
c. College -
d.Post graduate
is questionnaire: 25 fold -195
2Date you compl Day Month