PROJECT BLUE BOOK

Page 7
‘a? Were the weather “onditions ct the time vou saw the sopect?
’
> (Circte = =2 fC ives -
sor 3
/ - nis , a wf re
sttered clouds > modercte or neovy rain
i hick or heavy clouds 1, Snow
. + ene >
id. When and to whom did you report thet you hed seen the object?
Doy Month Yoor =)
: = ae 5
16. Was anyone sise with you at the time you saw the object? j
(Circle One) Yes No “i A
-_ «
26.1 IF you answered YES, did they see the object too? ’ . |
(Circle One) Yes No ae _
f - Z > - , - ;
34.2 Please list their nomes ond addresses: -
= > :

. Was this the first time thet you had seen on object or objects like this?

(Circle One) Yos “No

-~— +

57.) |F you answered NO, then when, whore, and under what circumstances did you 200 other ones?

. o
*
ieee — — — = ——— oe ee oe —
% Mie . tae ’ Ma yi ah me ry as lee fee aa "7 TF a sere SO Pa ea 9 SP EL eee ee atelier tall ees ee ee o>
“" . MAS , a ae, .

ran es - .

>

Dear <> Amaia

This is to acknowledge your letter of 6 September 19£9
concerning the sizhtinz by you ef an unidentified flying coject
on that evening.

Your letter contained insufficient inforzeticon ier a yalid
conclusions. Therefore, we ask that you fill cut She attached
Air Force cuestionnaire and send the completed document to the
Aerospace Technical Intellizence Center st Wright-Patterson Air

Force 5ise, Ohic for their analysis and evaluation.

Sincerely,

Inelcosure LAWRENCE J. TACKZER
Lt. Colonel, JSA:
Public Information Division
Office of Inforzation

oo rr ee eee weer ee

ruse

340 tor research purposes, and will be regarded as conticentia) motericl.

> -~ _ —-—— ‘ . na - . ~~ —-—
y 2 FORCE TECHNICAL INFORMATION SHEET
" = naire has heen Srevored of you can sive 12 WU.o ' ~wce cs mucn
on cs possidre concerning the unicentitied aerial pnenomenon thot yOu OV® ooserved.
1.7 .s . t " .
Iry to answer os mony questions cs 0S8iDly can. ine information thot you give will

as :
four name will nor

s@ used in connection with any statements, conclusions, or publications without vour permiasion.

‘2 request this personal information so that, if it 1s deemed necessory, we may contact you for

‘urther details.

eee eee = = = = = === - = = ——=nvaooeses = i .
1, When did you see the object? 2. Time of day: 7 Es a i ee
riour Minutes
|
. =, . :
Oey Manth Yeor (Circle Une): ~A.M. or | P.M.
a }
). Time Zone: CBR,

(Circle One): a. Eastern

b. Terral
c. Mountcin
d. Pacific

(Circle One): a.’ Daylight Saving
b. Stenderd

e. Other See) ee
a, rere were you wnen you sow the object?
7 = - — 7

Necrest Mosta!l Address

State or Country

Additional remarks: -— a ~ - —— —~—-~-—-—-- —__ -—_—_—_-- -- i
2. Plow long was object in sight? _ —— _ |
Hours Minutes Seconds ’
’
,
3. “ow was time in siagnt determined?
!
’
= ’
ea. Cartcin Not very sure
2+. Fairly certain gd. Just o quess
| |
Not wes the condition of the sky?
i
LY Nj eo hs j
i
3 ent 5 rian?
voy . et cy
—_ ——EE — _ —_ —— —_— ————e ee - —- 7
2w tre object during DAYLIGHT, where was the SUN located cs you looked at the object?
- ant or ' r er
- . ser-end
° =~“? rorrer” as
Te re oe. : OTS? ES he
> aad o “s ass ‘\ in S. > ~

_

.

.

.

ak i al, Beltre A te hs ate

i gel Vee Qayewrse ewe i be roe «>

————— — - - shall
3. IF you sow the object at NIGHT, wher did you notice concerning the STARS and MOON?
G.1 STARS (Circle One): 8.2 MOON (Circle One):
oc. None e. Briaht moonlignt
b. A faw b. Dull moonlight
ec. (idany c. No moonlight — pitch dark
d. Qon't remember d. Don’? remember

9. The object appeared:

(Cirele One): a. Asa light b. Shiny c. Dark d. Don't remember

—

—

; ,

10. If it appeared os a light, was it brighter than the orightest stors?

j Ci 127) A —
11. Did the object: (Circle One for each question)
oe. Appeor to stand still at any time? Yes No Don’t Know
| >. Suddenly speed up ond rush away oat any time? | Yes No Don’t Know
c. Break up into ports or explode? “Yes No Don't Know :
d. Give off smoke? Yes No Don't Know
2. Chenge brightness? Yes No Don't Know
§. Chenge shape? Yes No Don't Know
;
g- Flash or Hicker? Yes No Don't Know
h. Diseooecr and recovecr ? Yes No Don't Know
12. Did the object move behind something at any time, particularly a cloud?
Circle One): Yes No Don't Know. |F you answered YES, then rel! wnat
it moved behind; : : - —*

to

Sid the object move in front of something at cny time, particularly 2 cloud?

—_——

Circie One): Yes Neo Don’t Know. r you answered YES, then teil whet
in front of: | : iO acd ors " — a be ee a
/
Na — ee ——— :
rs " ‘ - ; . a - j ; b oo ansoarent 9 -or + Den’: <now
be id 're corec? 350e¢cr: (Circle One): “ae wo 1G . 1 otek Peiris * * =

J'd you observe the object through any of the following?

% Eyechasses Yes No * Binocyulers "s No
S Sun gi csses {es No * Telescone "95 No
ed jes No >, ineoedolite ‘* No
lincow olass Yes No 1». Other wi ; )
7 aa
- —— — ——— += _— —_ as shee ee

eo 4
- — _ -
}. Draw 2 olcture that will show the motion that the object of objects made. Place an "A" at the beginning oF
¢ path, a “'B"’ at the end of the oath, and show any changes in direction during the course,

. How lorge did the object apoecr to you cs compeored to an object with which you are fomilior?

= »
é ;
+ - ; -
—- -_— —- _—— -

22. Me wish to know the onguler size. Hold a match stick at arm's length in line with a known object and note
how much of the object is covered by the heed of the match. If you hod performed this experiment at the time |

of the sighting, how much of the object would have been covered by the match head?

7

|
e

id the oblect disappear while you were watching it? |f so, how?

= _
‘
‘ 4. gs -
—— att

Oe
7
|
oe be ee

‘4. | order thet you con give os clecr a picture as possibie of whet you sow, describe in your own words o

-ommen object of cbjects which, when ploced up in the sky, would give the same cocecronce os the obiect

7

“m you tow.

~Yh

ant ST rE ~~" We SOTEP err rs s47er . .- ha -~-

Pane 5

25. ‘here were you located when you saw the object? 24. Were you (Circle One)

(Circle One}: co :
Oo. in ihe DuUsINeSssS Section oF a City?

“sice a building b. In the residential section of a city?
9. ind cor c. In open countryside? i
-. Outdoors Gc. Near an oirtrsid?
in an airplane (tyoe) e. Flying over a city?
e. At sea *. Flying over open country?
f. Other g- Other ss a A; a: =
27. Whot were you doing at the time you saw the object, and how did you happen to notice it?
7 P 1 ae ’ ; 7 of 4 . 7
LAS tees | Lgi“eu —-t . (ATE a fish 5 j Ab atin : ™ ~~ a 1 “ , " st
’ :
° Re wt ,'| rd Tf SS pret” Bove ‘ ~- =< £ ¥ 7 — ‘ ——\ f '
ee ee _ . —_—_—
of — . /
7- | , yd 7 ‘ LAA ‘iy : y / — { ~ — ’ 4!
“ — os : Z = - an a. ee ra fats = ————

3. 1F you were MOVING IN AN AUTCMOBILE or other vehicle at tho time, then complete the following questions:

it

23.1 What direction were you moving? (Circle One)

a. North c. East 2. South ¢- West '
b. Northeesr d. Southecs? f. Southwest 4. Northwest

23.2 How fost were you moving? miles per hour.

23.5 Did you stop at ony time wnile you were looking at the obiect?

(Circle One) Yes No
29. What direction were you looking when you first sow the object? (Circle One)
3. West
a. Nerth ce. East e. South bh. Novthwest
o. Northeost d. Southecst f. Southwesr i. Overheed
30. Wher direction were you looking when you lest sew the object? (Circle One)
9g. West
s. North ce. Eost @. South h. Northweat
>. Nertheost 3d. Southecs? #, Southwesr . Overheed

——— — S| —_—

—_

|f you ore familicr with beering terms (enguler direction), try to estimate the number of decrees the cbiect wes
‘rom true North (they east) ond also the number of degrees it was upword from the horizon (elevation).

| .

toon it firet covecred:

From true North deqrees. |

Prom serizon _ ceorees.

ven it cisopcecred:

“rom true Nerth sqrees.

Prom horizon _ Jeorees.

a at ee eee