PROJECT BLUE BOOK

\ PROJECT 10073 RECORD

y Ba A TIME GROUP 2. LOCATION

12 Not 19524 ;
Oe 13 {921 Z, Barberton, Ohio
3. SOURCE 10. CONCLUSION

Ci- lian PROBABLY AIRCRAFT

4, NUMBER OF OBJECTS
1
5. LENGTH OF OBSERVATION /|11. BRIEF SUMMARY AND ANALYSIS

5 Minutes Cigar shaped object ancpeared and traveled into the West
withovt sound. Sma it object wes seen leaving lereer one, It

6 TYPE OF OBSERVATION <dikcat hile Sens AOS .
vraveled into.the east, while larger object went west, Object

b/¥inat4s/ Ground Visue oserved at night time. Very rapid speed. stimated altitude

7, COURSE

See Case File
8, PHOTOS

O Yes
tr Noe ‘

9. PHYSICAL EVIDENCE

oO Yes
“OO No

FORM
FTD seps63 0-329 (TDE) Previous editions of this form may be used,

a

ae —- -— — ———_ + - - -- = - ——_—_- -——

U. S. AIR FORCE TECHNICAL INFORMATION SHEET
(SUMMARY DATA)

| In order that your information may be filed dnd coded os ocevretely os possible, please use
the following space to write out o short description of the event thet you observed. You may re-
peot Information thet you have alreody given in the questionneire, and odd any further comments,
statements, or sketches that you believe ore Important. Try te present the details of the observo-
tion In the order in which they occurred, Additional pages of the seme size poper may be attached

if they are needed,

WC ne, (De Not Write in This Space)

(Please Prim)

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U.S. AIR FORCE TECHNICAL INFORMATION SHE

This questionnaire has been prepared so that you can give the U. S. Air Force aa much
Information os possible concerning the unidentified cerial phenomenon that you have observed
Pleose try to answer as many questions as you possibly can, The information that you give will
be used for research purposes, and will be regarded as confidential material. Your neme wil! nor
be used in connection with any statements, conclusions, or publications without your permission.

‘
YOU ror

We request this persona! infermation so that, if it is deemed necessary, we may contact 5
further details.

—————————————— SSS ———— SS ——.-— eS SS See
| 1, When did you see the object? 2. Time of day: #4 Lo
) ovr Minutes
) eee LIEL, :
Day Month Yeor (Circle One): A.M or P.M,
== L
3, Time zone:
(Circle One): a. Eastern (Cirele One): a. Daylight Saving
b, Central b, Standard <——
¢. Mountain
d. Pacific
e, Other __ iabiciomnianiaian

—

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4, Where were you when you sow the object? eee
Lob biehonm State of Couniry

Neorest Postal Address City or Teun

Additional remarks: wil

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me

5. Estimate how long you saw the object, __=

Hours Minutes Seconds

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

_
ec Certain SQ Not very sure

- airly certain d. Justa guess

——-

6. What was ine condition of the sky?

(Circle One): a. Bright daylight d, Justa trace of daylight
b. Dull daylight S No trace of dsylight
¢. Bright twilight Don’t remember

7, !F you sow the object during DAYLIGHT, TWILIGHT, or DAWN, where was the SUN located as you looked
the object?

(Circle One): a, In front of you d. To your left
b, In back of you e. Overhead

c, To your right f, Don’t remember

Pose ?

om —— — —_—— —_— <2 —_—_ “y

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

B.} STARS (Circle Ona): 8,2 MOON (Circle One):
: a, None Co. Bright moonlight

) b. A few b. Dull moonlight
'

c, Many c. No moonlight — pitch dark

d. Don’t remoamber d. Don't remember

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|

9, “ias the object brighter than the background of the sky?

| (Circle One): al Yes) b, No c. Don’t remember

_

10, iF it was BRIGHTER THAN the sky bockground, was the brightness like thot of an automobile hendlight?:

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

b. Several blocks away?

c. A block away?
d. Several yards oway?

lime

ie - iF ee e. Other 2 7

1}, Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes —~ Don’t Know
b. Suddenly speed up and rush away at any time? Yes Don’t Know |
c, Breck up into parts or explode? Yes Don’t Know
d. Give off smoke? Yes Don't Know
2, Change brightness? Yes Don’t Know
f. Change shape? Yes Don't Know
g. Flicker, throb, or pulsate? Yes Don’t Know

7 = 7 peacisentncnamneitinel

12. Did the object move behind something at anytime, particularly a cloud?
( Circle One): Yes Don’t Know. IF you answered YES, then tell whe?
it moved behind: = a RE nite te a ee ee ee

_ — —~ ~-
-_ —_ _— —_— _ —— —-

13. Did the chject 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:

a

——

14, Did the object cppeor: (Circle One): a. Solid? b, Transparent? ¢./ Don't Know,
- = ery
15. Did you observe the object through any of the following? .
os, Eyeglasses Yes No e. Binoculars Yes) No
b. Sun glasses Yes No f, Telescope Yes No
c, Windshield Yes No g. Theodolite Yes No
d.

Window glass Yes No h, Other _ |

J jy .
| b. Color WV ——) ~~ ete i E.

Poge 3

_—_ — a ———~
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| 16, Tall in a fow words the following things about the object.

—-— ——— a OS ee ——_—— — -_—— — —

——— + --- — —

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17, Drow a picture that will show the shape of the object or objects, Label and include In your sketch ony details
of the object that you sow such os wings, protrusions, ete., and especially exhaust trails or vapor trails, Place
on arrow beside the drawing to show the direction the objact was moving,

Cac. Cast. fre. tou
Liha oe Gren Led

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18, The edges of the object were:
(Circle One): a, Fuzzy or blurred e. Other _
b, Like a bright stor
(ey Sharply outlined
d. Don’t remember
19, IF there was MORE THAN ONE object, then how many were there? 2,

Draw o picture of how they were orranged, and put an arrow to show the direction that they were travel ing,

*

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20. Draw eo picture that will show the motion that the, object or objects made. Place an “A® at the beginning

j
| of the path, o "B® at the end of the path, and show ony changes in direction during the course. |
| ey

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sei wasn sniee of
2). IF POSSIBLE, try to guess or estimete what the real size of the object wos in its longest dimansion.
eee ee
22, How large did the object or objects appear as compared with one of the following objects held in the hand
and ot about arm’s length? ;
(Circle One): a. Head of g pin g. Silver dollar )
b} Peo psy pro— h, Baseball '
c. Dime i. Grapefruit |
d. Nickel j- Basketball
e. Sele ria al ony k, Other Coase hagaan
. Half dollor
22.1 (Circle One of the following to indicate how certain you are of your answer to Question 22.
a, Certain c. Not very sure
yb. Poorly certain d. diene a
23. How did the object or objects Hewat from view? Ll é aE”. oe a
a waa! dd nattions Tid or stk tte H—
, 24. In order that you can give os clacr o picture os possible of what you sow, we would like for you te Imagine that you cou!
construct the object that you sow. Of whot type material would you make it? How lerge would It ba, and what shape
. would it have? Describe in your own words o éommon object or objects which when placed up in the sky would give ths
tome Oppecrance as the object which you sow.

te

chy Loach k tka we Puta?

AA OFS,

Page

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“Vheara were you located when you saw the object? 26. Were you (Circle One)

25.
(Circle One):

a, Inthe business section of a city?

a. Inside a building b. In the residential section of « city?
b, Ina car Ze.) In open countryside?
(cy) Outdoors 7 Flying near on airfield?
d. In cn oirplune e, Flying over a city?
2. Alsea f. Flying over open country?
f, Other g. Other

—_—— a ee ee —— _—-

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

—Etezcssssang This po “ae

———
—_———- _ — — ----- - > -- CS S> LSS — -_——_—_ — — —_—- —

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——_

—

28. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions:

— «Beme

28.1 What direction wers you moving? (Circle One)

@. North ec, East e. South 5. West
b, Northeast d. Southeast f. Southwest h. Northwest
28.2 How fost were you moving? Licsariitbiniiieninaaia WAS DOT NOUR

28,3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No

~_— -—_— _——

7 ——_——- —

29, What direction were you looking when you first saw the object? (Circle One)

. North c. East e. South g. West
Nertheast d. Southeast f, Southwest h, Northwest

—-

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

a, North c. East e. South g. Wost
b, Northeast d. Southeast f. Southwest HD Northwest

— —_—_——— — ee — — —— |

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

31,1 When it first oppeared:

a. From true North degrees.
b, From horizon degrees.

31,2 When it disappeared:

a. From true North degrees.
b, From horizon _ degrees.

——+-

33. In the following larger sketch place an “A” at the position the object wos when you first saw it, anda "B” of its

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rage &

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32, In the following sketch, imogine that you are at the point shown, Place aun “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 some curved lies to
show how high the obiect was above the horizon (skyline) when you fost saw it,

-__

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——— ewe wee

position when you /ast saw it. Refer to smaller sketch as on example of how to complete the larger sketch.

Paaileci
BS Me ates

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+7 hme

——— ee

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34. What wero tho weather conditions at the time you saw the object?
$4.1 CLOVOS (Circle One) 34,2 WIND (Ciclo One)
(a) Cloer sky a. No wit
b. Hazy (5} Slight breeze
¢, Scattered clouds c. Strong wind
d, Thick or haavy clouds d, Don't ramamber
e. Don't reimnember
34.3 WEATHER (Circle One) 94.4 TEMPERATURE (Cirele Ono)
CS Dry a, Cold
. Fog, mist, or light rain b, Cool
c. Moderate orheavy rain ()) Warm
d, Snow d. Ho?
e. Don't remember @, Don’t remember

35. Yhendid you report to some official that you had seen the object?

1/3... ew: LIS 4, of SOS ee, nee

Sinith eee coe

Doy Month

—

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

(Circle One) No

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

(Cirele One) (ves) No

34.2 Please list their names and a

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37. Was this the first time that you had seen an object of objects Jiks this?

(Circle One) Yes

37.1 IF you answered NO, i when, where, and under what circ umstances did you see other ones?

38. In your opinion what do you think the object was and what might heve caused it?
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ef CL renee fdait. Corte oe
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= aa vit’ CLL i Cc z- AZT CHYYty ar Ze i.e

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— —_

39. Do you think you can estimate the ane of the object?
(Circle One) Yes (No
IF you answered YES, than what speed would you estimate? m.p.h.

‘e—-_---- —

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

{Circle One) Yes No

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

41, Please give the following information about yourself:

Last Nome First Nome Middle Nome

. fi
ADDRESS Dalit ee Barckitir WE
ree? City Zone Stote

TELEPHONE NUMBER VU 42- 3450

-beccrunlaxt

What is your present job? = ae a _—_

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a ee
Age _.2 Ah Sex 77

Please indicate any special educational training that you have had.

a. Grade school _~ e, e. Technical school ____ “
b. High school _A—— (Type) ___ ee
c. College <a f. Other special training ee
d. Post graduate saitialeeeplliaaaaeactloalibscdimessiindeistng a
ek ee 34 WE (hol
42, Date you completed this questionnaire: oe “= = “fs

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