PROJECT BLUE BOOK

11
*
DATE ·TIME GROUP LOCATION
Hove dbor'53 02/014.52 Gudaloupe Ial
3. SOURCE 10. CONCLUSION
Civilian wnoded (T)
NUMBER OF OBJECTS
One Eveletod Iptoor obsarvation.
S. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 11. BRIEP SUMMARY AND ANALYSIS
1d S-con's 1d S-com's Very bed Jit obgoot CAke Very brd jit objeot CAle ofar or con. Cloved in doten rd o1f o" con. Goved in dotnr rd
TYPE OF OBSERVATION direotlon ani disempetred Anto ceon.' direct.onrmi diseppetred Linto ceon. Govu of rarilel Govu off rerilel C.C
6. it descendad.
Ground-Visuel
7. COURSE . COURSE
Descendia" Descendia .
. PHOTOS
D Yes Yes
KXN.
9. PHYSICAL EVIDENCE
Yes
Ne
FORM
FTD SEP 63 0-329 (TDE) Provious 0dMomo
.
-

(Circle One) Yes (No)
IF you answered YES, then what speed would you estimate? .m.p.h.
(Circle One) Yes No
IF you answered YES, then how far away would you say it was? foot.
NAME 2
Lest Name Middie Nome
ADDRESS SOUTBERNRNES N
City Zone
TELEPHONE NUMBER
HorEfE
A_go 2t A_go 2't Sex _F Sex F
Please indicateany special educational training that you have had. Please indicate any speci I educational training that you have had.
Grade school Grade school_ . •. Technical school Technical school
High school (Type) _
c. College f. Other special training —
d.Post graduate
42Date you compl I this questionnaire: Month
.

peat information that yeu have already given in the questionnalre, and add any further comments,
statements, or sketches that you believe are important. Try to present the details of the observa-
tion in the order in which they occurred. Additional pages of the may be attached
if they are needed.
NAME (Do Not Write in This Space)
CODE:
SIGNATURE
DATE 6 D2c2ukan 1953
2R0C2 101 C4 nusoand
ard col and He. on Gand
is
Bland od
-
Guad.
and re said tecidrit Knoxd bout it - was not
aas about S:4 and nor c2t daik. th2
.

peha A1
.

147 APISKE
SOUTHERN PINES ARALU (
Matli NORTH OLIN
15 Nouzuber
DzaR Suis:
- would like to
22po2t a
B2
uland o Co
-
fl are interiled
fou please sond m T aTsr .
Gustionnaire
plt 1ll53

Please try to answer as many questions as you possibly can. The information that you give will
be used for re purposes, and will be regarded as confidential material. Your name will not
be used in connection with any statements, conclusions publications without your permission.
Wo request this personal information so that, if it deemed necessary, may contact you for
further dotails.
I. Whon did you see the object? 2.Time of day: 5 40
Hour Minutes
Sung 1953
Month Year (Circle One): A.M 8 P.M.
3. Time zone: Eastern (Circle One):
(Circle One): a. Daylight Saving
b. Central Standard
c. Mountain
d. Pacific
4.Where were you when you saw the object?
GRANd TERRE Pointa PitRe Guadaloupe bland
Nearest Poatal Address City or Town Stote or Country
Lwas near on ead Lwas neaR one
5.Estimate how long you saw the object. Estimate how long you saw the object. 18 App 18 APp .
Hours Minutes Seconds
IMoy have IELn mOSE,
Question 5. t Ndi
a. Certain Not very sure
.Fairly certain d.Just a guess
What was the cond
(Circle One): a. Bright daylight d. Just a trace of daylight
b. Dull daylight e. No trace of daylight
Bright twilight .Don't remember
7.IF you saw the obj located as you looked at
tho object?
d. To your left
b. In back of you e. Overhead
To your right f. Don't remember
4

Page ?
IF  sa  NIGHTTWILIGHTDAWN,ha   STARS  MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
a. None .Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight - pitch dark
dDon't remember Don't remember -⊥ duaint 22
it was Too liqat
.Was the object brighter than the background of the sky?
(Circle One): @ Yes b. No c. Don't remember
Several blocks away?
c. A block away?
d. Several yards away?
. Other Other
Did the object: (Circle One for each question)
a.Appear to stand still at any time? a. Appear to stand still at any time? Yes Yes No Don't Know
b. b. Suddenly speed up and rush away at any time? Yes Don't Know
Break up into parts or explode? Yos Yos Don't Know
Give off smoke? Yes 222 22 Don't Know
e. Change brightness? Yes Yes Don't Know Don't Know
f. Change shape? Yes Don't Know
g. Flicker, throb, or pulsate? Yes Don't Know
Did the object move behind something at anytime, particularly a cloud? .Did the object move behind something at anytime, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answer YES, then toll what
it moved behind: ..
(Circle One): Yes No Don't Know. IF you answer ES, than tell what
it moved in front of: .
14.Did the object appear: (Circle One): a. Solid? b. Transparent? Don't Know.
15. Did you observe the object through any of the following?
a. Eyeglasses Yes •. Binoculars Yes
b. Sun glasses 9889 f. Telescope Yes
c. Windshield Yes g. Theodolite
d. Window glass Yes h. Other
IT

of the object that you saw such as wings, protrusions, ete., and especially exhaust trails or vapor trails. Place
an arrow beside the drawing to show the direction the object was moving.
As it f=1l .7 Seamad ts$ shoot
LiT2it2ings out-
P a
7
18. The edges of the object were:
(Circlo One): a. Fuzzy or blurred .Other_.
6. Like a bright star
c. Sharply outlined

._feet.Icantimegine ho aux
22. How large did the object or objects appear as
and at about arm's length?
(Circle One): a. Head of a pin g. Silver dollar
b. Pea h.-Basebull
c. Dime I. Grapefruit
d. Nickel I. Basketball
•. Quarter k. Other ONG
f. Half dollar
2. (Circle One of the following to indicate how certain you are of your answer to Question 22.
a. Certain c. Not very sure
Fairly certain d.Uncertain
23. How did the object or objects disappear from view?
su2ei wantamde2.

ing?(Cirele One) -
a. North a. North c. C. East .. .. South South g. West West
b. Northeast d. d. Southeast f. Southwest h. Northwest Northwest
28.2 How fast were you moving? miles per hour.
(Circle One) Yes No
a. North North c. East East South South a. West West
b. Northeast d. Southeast 6 Southwest Northwest
a. North c. East South ai West
b. Northeast d. Southeast Southwest Northwest
31. If you are familiar with bearingt terms (angular direction), try to estimate the number r of degrees the object was
from true North and also the number of degrees it was upward from the horizon (elovation).
31.1 When it first appeared:
a. From true North degrees.
b. From horizon. degrees.
31.2 When it disappeared:
a.From true North degrees.
.From horizon ._ degrees.
.

Poge 6
3. In the following sketch, imagine that you are 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" 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 was when you first saw it, and a "B" at its
position when you last saw it. Refer to smaller sketch as an example of how to complete the larger sketch.
I
I

Pago 7
What were the weather conditions at the time you saw the object?
34.1 CLOUDS (Circle One) 34.2 WIND (Circle One)
Clear sky 6 No wind
b. Hazy Slight breeze
c. Scattered clouds c. Strong wind
d. Thick or heavy clouds d. Don't remember
8. Don't remember
34.3 V WEATHER (Circle One) 34.41 TEMPERATURE (Circle One)
Dry a. Cold
b. Fog, mist, or light rain b. Cool
c. Moderate or heavy rain Warm
d. Snow Hot
Don't remember e. Don't remember
When did you report to some off a that you had seen the object?
Day Month Year
(Circle One) Yes No
36.1 IF you answered YES, did they see the object too?
(Circle One) (Yes) No
36.2 Please list their names and addresses:
PNenurst,
North CoCOna .
but thi sbect - 1 dedit thik
tol ME
should 22part it.
.