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8. 1F you sow the object at NIGHT, what did you notice concerning the STARS ond MOON?

#7 STARS (Circle One}: 8.2 MOGN (Circle One):
a. None a, Bright moonlight
b. A few

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. Dull moonlight

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» No moonlight -- pitch dark

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d, Don't remamnber p-” . Don't remember j.--

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(Circle One}: (a. As a fight b. Shiny c. Dark d. Don’t rememb

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10, YF it appeeored as a light, was it brighter then the brightest stars? | ' )

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1], Did the object: (Circle One for each quostion)

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+, Appeor to stand stil! at cny time? “7: Yeas No Don’t Know

>. Suddenly speed up ond rush away at any time? { Yes) ° Don’t Know
c. Break up into parts or explode? Yes ‘No Don't Know
J. Give off smoke? ay ~ oO : Yes No Don't Know

No Don’t Know

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Charge brightness? Yes

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Change shape? Yes cite Don't Know

Flash or flicker? Yos “No Don’t Know

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Disappeor.and reappear ? Yes ( No Don’t Know

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12. Did the object move behind something at any time, porticularly a cloud?
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(Circle One): Yes’ ' (No) Don't Know. IF you answered YES, then tall whol
: it moved behind: 7° ee. Ae eS ee ee ee a ee os. EE SESS See et oo ae ee ee |
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13. Did the ob'ect move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don’? Know. IF you onswered YES, then tel! what
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. VW. Did the object appoar: (Circle One): a. (Solid b. Transperent c. Vapo: d. Don't } ‘ |

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; ield Yes No Ue fheodolite ies No

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16. Tell in a few words the following things ebout the object.

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17. Drew o picture that will show the shape of the object or objects. Label and include in your s!

of the object that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails,
Place on crrow beside the drawing to show the direction the object was. moving.

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18. The ecges of the object ware:
| (Circle One): a. Fuzzy or blurred ; ee eee ae OS ae ae ee
b. Like o bright star Be. ae eee at ae ee ae
{ c. Sharply outlined oe A
d. Don’t remember
19. IF there was MORE THAN ONE object, then how many were there?
Draw ¢ picture of how they were orranged, and put on arrow to show the direction that they were traveling.
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20. Draw a picture thot will show the motion that the object al objects made, Place an “A” at the vegiining of
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| the poatn, a “5 et the end of the natn, ond show any changes tn direction during the course,
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| 2}. ,How forge did the object appsur.to. you os compared to an object with which you are familiar]
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22, Wa wish to know the engulor size, Hold a match stick of orm’s length in Hne with a known baject ond note
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| how mucn of the object is covered by the head of the match. If you hed performed this experiment at the time
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| at the sighting, how much of the obfect would have bean covered by the match head? = y
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common osject or objects which, when placed up in the sky, would give the same cppeorance os the object
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high the object was above the horizon (sky
| show how high the object was obove the horizon (skyline) when you lost saw is

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wr PT? FRO TO owing larger sketch sicce an “A” at the position Me Gb scl was when you iii Psaw i, GaGa i 17 its

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TECHNICAL INFORMA
(SUMMARY DATA)

tion in the order in which they occurred. Additional pages of the

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Location _ soothe i. artnet

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+. <-o —— om - o- —sS —.. oe -_—_—-— _e ———— were ee ee oe eee”

Date (Local) 30 “Nov 40 Hour (Locnl)

oe Oe re 0 ee ES Oe Oe eS erm ae et eee ee ee ee ere ot —_ .- ——_— ——— Wm “or — -— cee “eee os

Hour (Z Time Group)

ot ee 6 ee Oe OE ES OO CO owen

Satellite: (Det 5 ATIC, Ext 3279) ----------

— 8 Oe eee - —————E—— «eae eS ere OU

—_— ——- ——a —! -— a —_— -—— ~SO-we = ee Oe me ee On ee Ge Oem SO Oe

ea eee ee

-

Astronomical Phenomena (Meteor, Comet, Planet, etc) ---- --

2 — oo enmtee Oot Se Se ee Ge eer Se oe

—.

KOSS1%sY REFRACTION OF CX pemaa f Ca%i464 ) ania t, 2. &
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Radar Analysis (AFCIN-EL) j;
Owe eee ee me ee re De ree mee Oe ee ae - = -——
Omer eee! Se So ee Fee ee SE eS FO cee Ce er + oe : -— 2 « Ot + 1 ae rege eS: 0 ee OO

Natural Phenomena (Ball Lightning, etc) -------

oo — © Oe OO ee ee we em a OD Oe | a ee Orem <8) Oe SB 6S ee tena

ee on we OR oe Ome em eS me. + = OD + + oe ee Oe ee Oe ee ll

——-<- =—

Fy

Aircraft, Balloons, Airsnips, ete 7 ~ ¢

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~—— ————. Pe ee ree te Oe mH ee Or et Oe wee Oe ee Oe we - 1 te} + ee OS Det + 6 a es Owe me

Other

i eee nn en ne, ee ee eee

_—— —_-:... me 06 er ae + Oe OF ae ee — Oe eee eee oem -o.- - ee - ~— oe -- 3 Oo ee Oe ee AK ee SK UFOS OO ee

Evaluation of Source FPeltability Grapes:

orrsSs—-—— — - ES es DO OO Ow Se PS 2 Se SD

Analysis end Conclusions:

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U.S. AIR FORCE

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This questionnaire has be
information as possible
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forthor details.

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“1 prepereéd ‘so that yeu con
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concerning the unidentified ceria! phenomenon inal you have opserved,

many questions as

be vacd in connection with ony stuter

2 request this personal informotion so het,

ore woo y= a ee wes oO ee + ew Oe e+ = of —_ «= « “se ~~. — ~- * - —s=<— o~ ete ~c08
age we see , ~ . Ms mata s ad +s . "y -
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oive the WS. Air Force gs much

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vou possialy can. The information that you give will

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for research purposes, ond will be regarded os confidential material, Your name will not

sents, conclusions, or publications without your permission.

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if it Is deemed necessary, we may contact you for |

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: |. When dis yousee the object? | 69, Time of day: .4f 7 asa
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1. Whore were you when you saw the object? |
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| 5. How lone was object in sight? ibe summa A bay _—
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