PROJECT BLUE BOOK

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Ul 8. AIR FORCE YFYECHNICAL INFORMATION SHEET

This questionnaire has been prepared so that you can give the U. S. Air Force os much
infermerion as possible concerning the unidentified aerial phanomenon that you have observed.
Plocse try lo answer as many questions as you possibly can, The information that you give will
be osed for sssearch purposes, and will be regarded as confidential material. Your name will nor
ba used in connection with any statements, conclusions, or publications without your permission.
: We request this persona! information to thet, If it is deemed necessary, we may contact you for

further datails.

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1, When did you see the object? | 2, Time of dey; — ee ee
Hour Minutes
Day Mant’ Yeor (Circle One): A.M or P.M.
4
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3, Time sone
‘Cieale Orel: oc. Eastern (Ci-cle One): a, Daylight Saving
b, Caniral b, Standard
¢. Mountain
d. Pacific |
a, Other
4, Whera were vou when you sow the object?
at ‘ ‘
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, * Menteast Psats! Addrase City or Towa Stcte or Country i
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3. Estimate row long you sow the obiect, Soe ~
su Minutes Seconds
BY G3 og of ine follosicg to indicate new certain you ore of your answer to Question 5,
c. Certain c, Not very sure
>. Foirly certain d, Just a guess

4, Who? wos °56 sc 3 rom oO. ine cy?
(Circle C s, Bright caylight d. Just a trace of dayligh
b. Dull daylight e. No trace of daylight
¢. Bright twilight f, Don't remember

7, 'F you saw the oblect during DAYLIGHT, TWILIGHT, of DAWN, where was the SUN locoted as you looked o*

tha obisct?

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(Circle Gnei: a, im front of you d, To your left
b. In back of you e, Overheod

c, Te your right f, Don't remember

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8, IF you saw the ovject ct NIGHT, TWILIGHT, or DAWN, what did you notice concerning the STARS and MOON?

9.) STARS (Cirelea Ona): 8.2 MOON (Circi/e One):
oc. None a. Bright moonlight |
db. A few b. Dull moonlight
c. Many c. No moonlight —~ pitch dark
4d. Don't ramember d. Don't remember

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9, Wes the object brighter than the background of the sky?

(Circle One): co, Yes bd. No ce. Don't romember | |

- — — —_ -_—-_ — - —_--—

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

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

—-—- + --.
a —

b. Several blocks away?

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e. Ablock away?

|
d. Several yards away? ;
e, Other |
11, Did the odiect: {Cirele One for each question) |
6. Appeor to stand still at any time? Yes No Don’? Know |
b. Suddenly speed up and rush away et any time? Yes “No Don't Know
¢, Break up into perts or explode? Yes No Don't Know |
d. Giva off smoke? Yes No Don't Know
@. Change brightness? Yes No Don’t Know
; |
f, Chsnrce shane? Yes No* Don’? Know
g. Flicker, threb, or pulscte? Yes No Don't Know
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12, Did the =siecr move behind something af anytime, particularly a cloud?
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(Circle One): Vi. Nis Don't Know, IF you answered YES, then tali what |
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13. Did the obiect move in frert 2° something of anytime, particularly o cloud?
(Circle One): Yas No Don't Know. IF you answored YES, than toll wher
it moves in front of: Losraiehaiok 2 = ae hs Se tA de
14, Did the object cpoear: (Circe One): a. Soild? b. Transparent? c. Don’t Know.
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15. Did you observe the object through any of the following?
: a. Eyeg!csses les No ®. Binoculars Yes No
b. Sun glosses Yas No ff. Telescope Yes No
, ce, Wingshield Yes No gq. Theodolite Yes Neo
d. Window giess Yas No He OMeE rote a pete en eee 8

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76. Tell in @ fow words the fol'owing things cbout the object,

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Drow « picture tha? will show the ahape of the object or objects.. Lobel and include In your sketch ony details
of the oblwst that you saw such as wings, protrusions, ate,, and especially exhaust? trails or vapor trails. Place
wn crrow beside the drawing to show the dirastion tha object waa moving,

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18, Tha edges of the object were:

{Circle Ona): o. Fuzzy or dlurred @. Or
b; Like a bright stor
g. Sherpiv outlined
4, Don't remember

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19, IF thers wse MORE THAN ONE object, then now mony were there? :
Draw < s chore of how thay wore crronged. ane pu? en arrow te show tha direction that thay ware traval ing,

——-—.-e ——

25. Where were you lucated when you saw the object?

(Circle One):

@. inside a building
b. Ina car

c. Outdoors

d. in an airplane

e. At sea

f, Other

_——_——_—

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|

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26. Were you (Circle One)

o. In the business section of a city?
b. In the residential section of a city?
c. In open countryside?

d. Flying near an airfield?

e. Flying over a city?

f, Flying over open country?

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27. What were you doing at the time you saw the object, and how did you happen to notice it? :
f ; sate of Pe , |

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

28,1 What direction were you moving? (Circle One)

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a. North c. East e. South g- West |
b. Northeast d, Southeost f. Southwest h. Northwest
:
28,2 How fest were you moving? __. miles per hour. |
28,3 Did you stop ct any time while you were looking at the object? |
(Circle One) Yes No
EEE _— ———S — — — -_
29. What direction were you looking when you first sow the object? (Circle One) | |
c. North c. East e. South g. West
| b, Northeast d. Scoutnecs? f, Southwest h, Northwest | |

30. What c rection were you ‘coxing when you last sow the object? (Circle One)

g. West
h. Northwest |

ec. Eost e. South
d. Southeast f. Southwest

| s. North _
| b, Northeast

— ——-— -—- - —

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—-——_  —  —

31. If you cre familiar with becr =g terms ‘sngulor direction), try to estimate the number of degrees the object was |
from true North ond also th= number of degrees it was upward from the horizon (elevation). |

31.1 When it first appecrec: | |

a. From true North . degrees. :

>. From horizon a” degrees.

|

j 31.2 Ynen it discppeared:
a. From true North __ degrees. |
b. From horizon degrees. |

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34, What were the weather conditions at the time you saw the object?

34.) CLOUDS (Circle One) 34.2 WIND (Circle One)
a. Clear sky a. 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, Dry a, Cold — |
b. Fog, mist, or light rain b. Cool
c. Moderate orheavy rain c. Warm ;
d. Snow d. Hot |
e. Don't remember e. Don’t remember

——— —_—-— => -_———_—___ — ——-_—_—__——_ _-- —_—_e-_ __—o —_—-

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

on

= —— -

Day Month Year

| 36. Was anyone else with you ot the time you saw the object?
| (Circle One) Yes No
36.1 IF you answered YES, did they see the object too?
(Cirele One) Yes No
36.2 Please list their names and addresses:
j

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 ones?

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38. In your opinion whet do you think the object was and what might have caused it?

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Page 8
39. Do you think you can estimate the speed of the object?
(Circle One) Yes No
| IF you answered YES, then what speed would you estimate? A ta SSR PF
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40. Do you think you can estimate how far away from you the object was?
| (Circle One) Yes No x
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IF you answered YES, then how far away would you say it was? / AL feet.
41, Please give the following information about yourself:
NAME So
Lost Name First Name Middle Nome
ADDRESS AM iS oS Re a
Street City Zone State
!
TELEPHONE NUMBER
What is your present job? = IRR oe lt SO ee a
Age Sex
Please indicate any special educational training that you have hed.
a. Grade school e,@. Technica! schoo! __
b. High school aay) C7 | anes sel <=
c. College f, Other special training ae
d, Post graduate ae
| 42, Date you completed this questionnaire: = per va

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