PROJECT BLUE BOOK

PROJECT 10073 RECORD CARD
1. DATE 2. LOCATION 12. CONCLUSIONS
0 Was Ballaon
13 Nov 61 Canton, Ohio 0 Probably Balloon
3. DATE-TIME GROUP TYPE OF OBSERVATION 0 Possibly Balloon
Local_ 0602 Ground-Visual Ground-Rodor 0 Was Aircraft
0 Probobly Aircraft
GMT 131102Z AirViwal Air-Intercept Radar 0 Possibly Aircraft
5. PHOTOS 6. SOURCE 0 Was Astronomicol
Yes Y.s 0 Probably Astronomical
XD No Civilian 0 Possibly Astronomical PossiblyAstronomical
XD No
7. LENGTH NGTH OF OBSERVATION 8. NUMBER NUMBER OF COURSE 8 OtherPoss Hallucination OtherPoss Hallucinasion
000 00 Insufficient Data for Evaluation
Stationary Unknown Unknown
3-5 min 1
TO. BRIEF SUMMARY OF SIGHTING 1O. BRIEF SUMMARY OF SIGHTING Detailed report of objt Detailed report of objt 11. commenTS PosSible 11. cOMMENTS PosSible hallucination hallucination by
in view 3-5 min with whirring sound, rays, in view 3-5 min with whirring sound, rays, observer. observer.
l00-20o' overhead, hovering, dise shaped. 100-200' overhead, hovering, dise shaped.
Observer "felt" Observer rays.
)
,

Page 8
39. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you answer , then what speed would you estimate?
bject was?
(Circle One) Yes No
Please give the following information.about yourself:
NAME st Name First Name Middl Nome
Ohie
ADDRESS City State
TELEPHONE NUMBER TELEPHONE NUMBER
Ago_ Ago_ Sox1
Indicate any additional information about yourself, including any education, which might be pertinent. Indicate any additional information about yourself, including any education, which might be pertinent.
42. Date you completed this questionnaire: 13 I!. 61
Doy Month Yoor

You may re-
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 poges of the size paper may be attached
if they are needed.
NAME (Pleose Print) (Do Not Write in This Space)
CODE:
SIGNATURE
DATE. NOV. 13 1961
the If Hevembe
13 1461 at about Cio0 a.).r an
ll hd
Cd offor Caml
ol
the tute
the
the ontchtsf
Cary my

1 534d To bt Frid
DEPARTMENT OF THE AIR FORCE OFFICE OF THE SECRETARY
MEMORANDUM
B what
thi.
tho Cho the B atin Qtin
lelndd 2 22 tid. tid.
Eu
duinng
dil
8 fehe
"7 thrungl
-
Biee

Please try to answer as many
be used for research purposes, I be regarded as confidential moterial. Your name will not
be used in connection with any statements, conclusions, or publications without your permission.
further details.
When did yousee the object? Co C2
Time of day: Hour
11 lol Minutes
13
Day Month Yoar (Circle One): A.M. or P.M.
3. Time Zone: (Circle One): 0. Circle One): a Eastern
b. (Circle One): (Circle One): a a Daylight Saving Saving
Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you sow 4. Where were you when you sow the object?
Ctn Cfn Hio Hro
Nearest Postal Address City or Town City or Town State or State or Country Country
Additional remarks: Additional remarks: -
5. How long was object in sight? 8$
Hours Minutes Seconds
determined?
a. Certain c. Not very sure
. Fairly certain d. Just a guess
6. What was the condition of the sky?
DAY NIGHT
Bright a.
Cloudy b. Cloudy
7. IF you saw the obj during
(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
ATIC FOR FO 164 This form supersedes ATIC 164, 13 Oct 54.

Poge 2
8.1 STARS (Circle One): 8.2 MOON (Circle One):
o. None -
a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight - pitch dark
d. Don't remember d. Don't remember
.The object appeared:
(Circle One): o. As a light b. Shiny c. Dark d. Don't remember
If it appeared as a light, was it brighter than the brightest stars?
Did the object: 11. Did the object: (Circle One for each question) (Circle One for each question)
a. Appear to stand still at any time? Yes No Don't Know Don't Know
b. b. Suddenly speed up and rush away at any time? Yes No Don't Know
c. Break up into parts or explode? Yes No Don't Know
d. Give off smoke? Yes No Don't Know
e. Change brightness? Yes No Don't Know
f. Change shape? Yes No Don't Know Don't Know
g. Flash or flicker? Flash or flicker? Yes No Don't Know
h. Disappear and reappear? h. Disappear and reappear? Yes Yes No Don't Know
Did the object move behind d something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
it moved behind:
Did the object move in front of something at any time, particularly.a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of:_
. Did the object appear:  (Circle One): (a. Solid b. Transparent c. Vapor d. Don't Know
a. 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

te object that you saw such as wings, protrusions, e and especially exhaust trails or vapor trails.
Place an arrow beside. the drawing to show the direction. the object was moving.
1
-TUbE
RAy
The edges of the object were:
(Circle One): a. Fuzzy or blurred . Other
b.Like a bright star .Like a 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.
B

Page 4
B- A
BEACHBALL
how much of the object is covered by the head of the match. If you had performed this experiment at the time
about C the obj E C)
23. Did the object disappear:while you were watching it? If so, how?
Nissapp akwbile
common object or objects which, when placed up in the sky, would give the same once as the object
which you saw.
the that of a plate
with tube cennected te the
4
LiDeR -
SIDE

a. In the business section of a city?
a. Inside a building b. In the residential section of a city?
b. In a car c In open countryside?
c. Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other g. Other__
IaktcA walk
HSDRD ANUNCSUACSCEND
tions:
28.1 What direction were you moving? Circle One)
a. North c. c. East e. South South g. West
. Northeast . Northeast d. Southeast Southeast f. Southwest h. Northwest
IE
28.2 How fast were you moving?. miles per hour.
(Circle One) Yes Yes No No
saw the object? Circle One)
g. West
a. North C. East e. South h. Northwest
b. Northeast d. Southeast f. Southwest i. Overhead
30.What direction were you looking when you last saw object? (Circle One)
g. West
a. North c. Eost e. South h. Northwest
b. Northeast d. Southeast f. Southwest Overhead
31. If you ore 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 m the horizon (elevation).
31.1 When it first appeared:
a. From true North degrees.
b. From horizon degrees.
31.2 When it disoppeared:
a.From true North degrees.
b. From horizon degrees.

Poge 6
32. In the following sketch, imagine that you are at the point shown. F Place an "A" on the curved line to show how
high the
show how high the object was above the horizon (skyline) when you last saw it.
B
In the following larger sketch place an  at the position the object was when you first saw it, and a B at its In the following larger sketch place an A at the position the object was when you first saw it, and a B at its
B
a

Poge 7
4.What were the weather conditions at the time you saw the object?
1
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 Snow
e. Don't remember
35.When and to whom did you report that ycu had seen the object?
13 11 61 Ut.O
Day Month Yoar
CNTOn
36. Was anyone else with you at the time you saw the object?
(Circle One) (Circle One) Yes Yes No No
>.
36.1 1 IF you answered ,did they see the object too?
(Circle One) Yes Yes No
36.2 Please list their names and addresses: Please list their names and resses:
(Circle One) Yos No
then when, where, and under what circumstances did you see other ones?
FlyiG Savcer
T