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35, Information which you feal pertinent and which is not adequately covered in the specific points of the
questionnaire or a norrativea explanation of your sighting.

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U.S. AIR FORCE TECHNICAL IN FORMATICIN }
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This astion w1rea has been re sared ae) they] vo car a » » 39 . ' ° ‘Ss ee ~}
wis Gu ;iOms 172 Us SC Pp 2p G oO ri ¥v “MI YUIYS IND Uede aif FOrce as Much j
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information iS possible concerning tre unidentified ac ic] PHENOMENA Thal you ave ye orved, j
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Please try 7o Snswer GS many questions SS YOU OOS Bitty CoN. Thea iniormeation thai VO Give t+ ?
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99 USOC for reseurcn purposes. Your naine will po? ba used in connection with unyv stotemeni¢ |
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COneivsicons, Of publications #:tnout your permission. Ye request iS Dersonre ; infor Narest: 30 !

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that if it 's deemed necessary, we may contact you for turiher details.

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|. When did you see the object? ) fime of ¢ oe a
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—e me Lite ccaisinteraiaen us 3 Tt ALES ae wee wee Ff dies | ; wIrCiG Je } f a PA. OY od i, |
Day haonth Yoor “a / |

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A, “here were you when you saw the ob ect?

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Nearest Postal Address City or Town eatg or C

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5, How long was object in sight? (Toto! Duration) —_—— —— a ¢

a © rem oo _ 4

---- — =

Hours Minutes seconds

a, Certain c. Not very sure

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\b/ Fairly certain d. Justo guess

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5.1 How was time in sight determined? ESTiMPATED

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5.2 Was object in sicht continuously? Yes

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6. What was the concition of the sky?

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a, Bright . Bright

b. Cloudy

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{Circla One): a, In front of you -f o vour lef?
bh, In back of you ¢

c. To your right . Don’t remember

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FiO ocr 62 164 Chin form supersedes FTP 154, Jul 61, whi

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l4. Did the object disappecr while you were warching it? di so, how? ;

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iT WAS Aj 3 LOWER VUisiddRe.

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-———

15, Did the object move behind something at any time, particulorly a cloed?

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{Circle One? Yes No, Don’? Know. 1F you an > than fall:

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be eid :
it moved behind: eras sciiecensopoasiealeuie/aodes etic eben atiainieeees send acai iveeateee

16. Did the object move in tront of something at ony time, part j aclou
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(Circle One}: Yes No) Don’ ow, iF you onswered YES, ihe: :

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17. . Tell in a few words the following things about the object:

’ a. Sound _A4YMNE

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13. We wish to know the angular siza. Hold a match stick at orm’s length in line with a Known edject and ante how !

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much of the object is covered by the head of the match, If you had performed this experiment ay
;
sighting, how much of the object would have been covered by the match head?
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17. Draw a picture that will show the shope of the object or objects. Label end include in your aker:
of the object thet you saw such os wings, protrusions, etc,, and especially exhoust tro:is er vapor
Place an crrow beside the drawing to show the direction the chject was moving.

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2). Do you think you con estimate the speed of the object? :
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(Circle One) Yas fNod

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IF you answered YES, then what speed would you estimate?
:

21. Do you think you cen estimate how far away from you the object was?

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be

(Circle One} Yes /No

iF you answered YES, then how far away would you say i? was? _.-

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» ‘Nera were you (occted when you sow ihe ject! vw. WOT YOU Tir ore Ue]
(Circle One):

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a. In the business section of a city?

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a. Inside a building . & in ihe residential seciion of G city?
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Oo Ina cor . i CS8h countryside:

c. Outdoors
d. In an airplane (type)

c
d. Neer an cisfietd?
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o, At see ‘,

Flying over a city?
-

iying over open country?

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f. Other .2i¢ (MAS ote A Tt ae 8 ee ee

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~——-< . —-

24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questiens:

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tion were you moving? {Circle Ona)

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a. North ¢. tos? e. Sout oc, Wos?

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; b, Northeast d, Southeast f, Southwest Nn. Northwest '
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24.2 How fast were you moving? " miles per hour.

24,3 Did you stop at any time while you were looking at the cbjeci? ;

:
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| (Circle One) Yes No ;

?
— ee ——— ——-

25. Did you observe the object through any of the following?

us ' f } Bi | ‘§ ine ) rm! ‘
a, Cyegiasses Yes ih e. Bineccylars es, NO ;

b, Sun glasses Yes (No) f. Telescope Yes fxg
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ec, Windshield Yes i>} g. Theodolite Yeas (‘No
ye, WOe =f) ree :

d, Window gisss Yes (No) h. Other 2775 22) £4 4

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24, tn order that you can give as clear a picture as possible of what you saw, descrise

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ssiect or objects which, when placed up in the sky, would give the tame aopecrance as ib?

_

BP BRIGHT STAR

nT

—— ———

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LEE TS i TT eK TT TT ee 8 NE Me we mm 8 le mem

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aay a va tei a - » a.

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a a Ee ee ee ee Oe * ere FOS we Ont Fh ee ere 6 Oe ee . + ~ a * cue ~~ -o- “ee o- ce “- |
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: “° , . . . . . ’ ’ : ’ ;
+ 2Z/, in the following sketch, imagine that you are at the point shown. Placa an’ 4 ph the curved » ro Show how |
. ’ ..2 | t ’ ‘ ae ‘ - . ‘ . ‘ ;
; high the object was above the horizon (skyline) when you first saw it, Piece a '°3"" on the sane curved Hine to }
; ;

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; Snow how Aign ihe Gojyact W383 GOOv®s fae Porizen (skyline) Whon you fas SaW tr. riace Gn s “4 ehO cCoOmMpcaa |

, . . it se ~% | .

wren yoy firs? saw it, Place a B°° on tae COMpass where you fasi saw ihe onject, :
,

Ano

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foe Aye ce* Las

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—_— - —_ _—_—=- a —_—_——_— eee — “_-

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se

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» .Draw o picture that will show the motion that the object or objects mada, Piace an "A" at the beginnirg of the 4}
.

-~, i? ' ' . . ; .
path, o “'"’ of the end of the poth, ond show ony changes in direction during the course.

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29. IF thers was MORE THAN ONE object, then how many wears there?

Draw a picture of how they were arranged, and put an arrow to show the diraction thar hey ware traveling,

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30. Have you ever seen this, or a similar object before. if sa give date or dates and Joection, ;
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31. Was anyone else with you at the time you sew the object? (Circle One) Yes (No)

31.1 IF you answered YES, did they see the object too? ‘Circle One} Yes No

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31.2 Please list their names and addresses:

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32, Please give the following informetion about yourself:

SEO LLL LE ES me ——_—_—
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NAME mE Bie ;
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