PROJECT BLUE BOOK

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25. Where were you located when you saw the object?
(Circle One):

26. Were you (Circle One)

a. In the business section of a city?

a. Inside a building b. In the residential section of a city?

b. jIn a car ¢. In open countryside? _

c. Outdoors d. Near an airfield?

d. In on.airplane (type) e. Flying over a city?

e. At sea f. Flying over open country?

g. Other

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)

a. {North ec. East e. South g. West
b. | Northecst d. Southeast f. Southwest h. Northwest

28.2 How fast were you moving?____ smiles per hour.

28.3 Did you stop at any time while you were looking at the object?
(Circle One) | Yes ._ No

-

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

a. North c. jEast e. South h. Northwest
b. Northeast d. Southeast f. Southwest i. Overhead

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

g- West
a. ‘North c. East e. South h. Northwest
b. [Northeast_ d. Southeast f, Southwest i. Overhead

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

31.1 When it first appeared:

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a. From true North___/~___degrees.
b. From horizon oc ae degrees.

31.2 When it disappeored:

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a. From true North as, degrees.

b. From horizon ___4.5 °__degrees.

32. 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. Ploce a “B” on the same curved line to
show how high the object was above the horizon (skyline) when you last saw it.

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33. In the following larger sketch place an “A” at the position the object was when you first sow it, and o "B” at its
position when you lost saw it, Refer to smaller sketch os an example of how to complete the lorger sketch.

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

CLOUDS (Circle One) WEATHER (Circle One)

a. [Clear sky; a. |Dry
b. Hazy b. Fog, mist, or light rain

c. Scattered: clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow

e. Don’t remember

35. When and to eee did you report that you had:seen the object?

MON 1X p4. SEPT, /G6l
Day Month Year

36. Was i i else with you at the time you saw the object?
(Circle One) 5 Ne

>.
36.1] IF you answered YES, did they see the object too?
| (Circle One) iYes No

36.2 Please list their nomes ane

37. Was this the first time that you had seen an object or objects like this?

(Circle One) Yes | No .

IF you answered NO, then when, where, and under what circumstances did you see © other ones?
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38. In your opinion what do you think the object was and what might have caused it?

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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?

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?
41, Please give the following information about yourself:

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TELEPHONE NUMBERS

Age __ Sex ik

Indicate any additional information about yourself, including any education, which might be pertinent.
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42. Date you completed this questionnaire: | ee We" ERY: //6o/
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U.S. AIR FORCE TECHNICAL INFORMATION SHEET
(SUMMARY DATA)

In order that your information may be filed and coded as accurately as possible, please use
the following ‘space to write out a short description of the event that you observed. You may re-
peat information that you have already given in the questionnaire, 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 same size paper may be attached
if they.are needed.

NAME es (Do Not Write in This Space)
(Pleese Pr
SIGNATURE nigga Rrra,

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CODE:

RR LY LT eT mee Trey eens LL LL ELE “ :

26 Sevtember 1961

Dear Mr, aie

Your letter of September 17th addressed to the Navy Department
has been referred to this office. The U. S. Air Force has been

assigned the responsibility for the investigation and amalysis of
vaidentified flying object sightings as part of Air Defense
 +Yesponsibilities.

I am enclosing the standard ATIC questionnaire concerning
your sighting. Request you and your friend camlete the questionaire
and retum then in the enclosed self-addressed envelopes.

Your interest in this miter is appreciated.
Sincerely,

WILLIAM T. COLEMAN, JR.
Major, USAF

UBO Project Officer

Poblic Information Division
Office of Information

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Wed. Sent. 27th. 1961

Washincton B.C,.

To: Major William T, Coleman Jr.
U.F.O. Project Officer
Publin Information Division

Office of Information,

Dear Sirs

Enclosed is the questionnaire concerning the sighting
I renvorted, I am returning the other form unanswered ina
seperate envelope. because my frie: d does not whish to fill
it out. I have tried to fill it ovt exactly as I rembered

it. I hope you find this inforzation useful.

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U.S. AIR FORCE TECHNICAL INFORMATION SHEET

This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as possible concerning the unidentified aerial phenomenon that you have observed.
Please 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 name will not |
be used ‘in connection with any, statements, conclusions, or publications without your permission.

|
We request this personal information ‘so that, if it 1s deemed necessary, we may contact you for |
further details.

1. When did you see the object? 2. Time of day: ) 00 _—
7rd Hour Minutes

SuNDAY SepremazR _/96/

Month You (Circle One): or P.M,

3. Time Zone:

(Circle One): a. (Circle One): a.
b. Centra b. Standare

¢. Mountain
d. Pacific
e. Other

4, Where were you when you saw the object?

RAKE GH NoRTN CARMINA

Neorest Posta! ‘YS Sth ltr ‘State or Country

Additional remarks: _U a. RS RE | EE ea A ee

5. How long was object in sight?

Minutes Seconds

5.1 How was time in sight determined?

a. c. Not very sure
b. Fairly certain: d. Just o guess
6. What was the condition of the sky?

DAY

a. Bright
b. Cloudy

7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?

(Circle One): a. In front of you d. To your left

b. In back of you e. Overhead
c. f. Don’t remember

AT | C FEB 60 164 This form supersedes ATIC 164, 13 Oct 54.

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IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):

.@. None a. Bright moonlight
b. A few b. Dull moonlight

— ¢. No moonlight — pitch dark
d. "t remember d.

The object appeared:

(Circle One): a. b. Shiny ce. Dark d. Don't remember

If.it appecred as a light, was it brighter than the brightest stars?

No

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Did the object: (Circle One for each question)

a, Appear to stand still at any time? No
b. Suddenly speed up and rush away at any time? Yes CNo)

¢. Break up into parts or explode? Yes (No)
d. Give off smoke?

Change brightness? Yes
Change shape?
Flash or flicker?

Disoppeor and reappear ? wo

. Did the object move behind something at any time, particularly a cloud?

(Circle One): (No) Don’t Know.
it moved behind:

Did the object move in front of something at any time, particularly a cloud?

(Circle One): Don’t Know.

in front of:

- Did the object appear: (Circle One): a. (Solid) b. Transparent c. Vapor

- Did you observe the object through any of the following?

a. Eyeglasses Yes No e. Binoculars
b. Sun glasses Yes No f. Telescope

c. Windshield Yes) No g- Theodolite
d. Window glass. Yes No h. Other

Don't Know
Don’t Know
Don't Know |
Don't Know
Don't Know
Don’t Know

Don’t Know

Don’t Know

IF you answered YES, then tell what

IF you answered YES, then tell what

d. Don't Know

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16. Tell in a few words the following things about the object.
a. Sound N
b. Color

17. Drew a picture that will show the shape of the object or objects. Label.and include in your sketch any details

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

18. The edges of the object were:

(Circle One): o. Fuzzy or blurred
bi Like o bright stor”
c. Sharply outlined
d. Don’t remember

19, IF there was MORE THAN ONE object, then how many were there?

Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

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20. Draw a picture that will show the motion that the object or objects.made. Place an ‘‘A”’ at the beginning of
the path, a ‘’B’’ at the end of the path, and show any changes in direction during the course.

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21. How large did the object :appear:to. you as compared to an object.with which you are familiar?
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22. We wish to know the angular size. Hold.a match stick at orm’s length in line with a known object.and note

how much of the object is: covered by the head of the match. If you had performed this experiment at the time
of the sighting, how much of the object would have been covered by the match head?

23. Did the object disappear while you were watching it? If so, how?
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24. In order that you can give as clear.a picture as possible of what you saw, describe in your own words a

common object or objects which, when placed up in the sky, would give the same appearance as the object

which you saw.

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