PROJECT BLUE BOOK

I. DATE · TIME GROUP . LOCATION
11-12 Jue or 9 Ju (?) Barosoba, Florida
SOURCE 10. CONCLUSION .
Civilian ATRCRAFT
NUMBER OF OBJECTS
5LENGTH OF O ERVATION 11. BRIEP SUMARY AND ANALYSIS
Loso then 2 dinutes To objacts movig coross sky when one of ther naile an abrup
6. TYPE OF OBSERVATION tum to the North s.d up. 3ige and brlgirtiess comar-ble bo
Yanus. Flight from Wegt to Enst.
Ground-'isual
7. COURSE COLMENTS: Woness indicatud that objcots might be a/e but wes
concernod by one ranuver in aocond vith e/o turn at
Lamvered altioude, Desoripbion rather vaghe and much date
8. PHOTOS onitted. Case regarded as poseible a/e observation.
Ye
No
9. PHYSICAL EVIDENCE 9. PHY IDENCE
Y
TO No
FORM
FTD SEP63 0-329 (TDE) Previoue sdildons of this form caay be uand, Previous adildons of this form caay be uand,
.-
.

a. Inside a building b. In the residantiol saction of a city?
b. In a car c In open countrysida?
C. Outdoors d. Neor an oirfield?
d. In an airplane (type) o. Flying over a cily?
e. At sea f. Flying over open country?
6. g. Other .
24.1 What direction ware you moving? (Cirele One)
a. North East Squth g. Wesr
b. Northeast d. Southeast 1. Southwesr h. Northwest
24.2 How fast were you moving? _
24.3 Did you stop at any time while you ware looking at the object?
(Circle One) Yes No
through any of the following?
d. Eyeglasses Eyeglasses Yes e. Binoculars e. Binoculars Yos No No
b.s Sun glasses No f. Telescope Yes No
c. Windshield Yes g. Theodolit Yos No
d. Window glass Yes No
object or objects which, when placed up in the sky, would give the same appegronce ds the object which you sax.

M.
15
2objictsay.45 Thenore d ut
28.. Drow a picture that will show the motion that the pbject or objects moda. Place an ut t b
poth, a "g" at the end of the path, and show any changes in direction during the course. path, a "B" at the end of the path, and show any changes in direction during the course. ii
7
7 N
29. IF there was MORE THAN ONE object, then how many wers thare?
Draw a picturs of how they ware arranged, and put an arrow to show the direction that they ware travaling. yt

-506
30. Have you ever seen this, or a similar object before. if so give date or dates and location.
No
31. Was anyone else with you at the time you saw the objoct? (Circls One) Yes No
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their nomes and addresses:
Pleasa give the following information about yourself:
NAME
Last Name First Nome Middla Noma
ADDRESS
Strost City Zona Stoto
TELEPHONE NUMBE AGE / SEX E
Indicate any additional information about yoursslf, including any special experienca, which might be partinent.
.

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HEADQUARTERS
FOREIGN TECHNOLOGY DIVISION
AIR FORCE SYSTEMS COMMAND
UNITEO STATES AIR FORCE
WRIGHT-PATTERSON AIR FORCE BADE, OHIO
REPLY TO
ATTH OF: TDEW
SUSJECT: UFO 28 Aug 64
TO: Hq USAF SAFOI PB (Mrs Gaiser)
Wash D C 20330
This office has received a report of an unidentified flying
object observation by. of
Sarasota, Florida. This report contains insufficient data
for evaluation, therefore, request your office send an FTD
Form 164 to
FOR MANDER
ag.
Colonel, USAF
Deputy for Technolosy
and Subsystems ystems
..
8
YOU - THE NUCLEUS OF SECURITY!

This questionnaire
information as possible concerning the unidentified aerial phenomenon thar you have observed.
Plaase try to answer as many questions as you possibly can. The information thar you give will
be used for research purposes. Your name will not be usod in connection with any stataments,
conclusions, or publications without your permission. We request this persanal Informarion so
that if it is deemed necessary, we may contact you for further details.
1. When did you see the object? .Time of day:
Hour Minuses wwt.
See Remackoan 35
(Circle One): A.M. or P.MA.
Day Month Year
. Time Zone:
(Circla Onel Eastern (Circle One): a, Doylight Saving
b. Centrat b. Srondard>
c. C Mountain MounrGin
d. d. Pacific
e. e. Other
4. Whara were you when you saw the object?
Sesnta Sseta Hhd
Naorsst Postal Address Naorsst Postal Address City or Town Staks or County Stat or County
5. How long was objact in sight 5.How long was object in sigh (Total Duration) (Total Duration) old
Hour3 Hour3 Minuts Minutes Seconds
a. Cartain a. Cartain c. Not vary sure c. Not vary sure
. Fairly certain b.Fairly certain d. Just a guess
5.1 How was time in sight determined?.
5.2 Was object in sight continuously? Yes No k3
What was the condition of the sky?
DAY NIGHT
a. Bright a. Bright
b. Cloudy b.
7. IF you sow the objedt during DAYLIGHT, where was the SUN located as you looked at the cbjeah?
(Circla Ona): a. In front of you d. To your left
b. In bock of you e. Overhood
c. To your right f. Don't remember
FORM
FTD OCT 62 164 Thia form aupersedea FTD 164. Jul et, which ta obsolste.

CLOUDS (Cirele One): WEATHER (Cirele One):
a. Clear sky a. Dry
b. Hazy b. Fog, mist, or light rain
c. Scattered clouds Moderate or heavy rain
d. Thick or haavy clouds Snow
e. Don't remember
10. The abject appeored: (Circle One):
a. Solid d. As a light
. Transpcrent 3, Transpcrent e. Don't remember
c. c. Vapor
iIf it appeared as a light, was it brighter than the brightest stars? (Circlo One): i.If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer O-HN4ON
d. Don't know
11.1 Compars brightness to some common object: 11.1 Compars brightness to some common object: thie thirl
thechis te mee Lugte theclic te mee Lulte
12. The adges of the object wers: 12. The adges of the object were:
Whs flue white
(Circl One): a.Fuzzy or blurred (Circl One): a.Fuzzy or.blurred e. Other e. Other
b. Lika a bright stor
. Sharply curlined V
d. Don'tremember
.Did the object: (Circle One for soch quastion)
a. Appear to stond still at any time? Yes No Don't know
b. Suddanly speed up and rush away at any time? Yes) No Don't know t
c. Break up into parts or explode? Yes No Don't know
d. Give off smoke? Yas ( No Don't know
o. Change brightness? Yes No Don't know
f. Change shape? Yes No Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know
0107

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head in Line wieth fict Aaw the 2 objecte.
thape f mateh head. the obiect wouel be at bt stine
the Div math bend fell mateh bm lingth - lihe a eiti
Place an arrow beside the drawing to show the direction the object was moving.
Saw no detai A cbfety W
Amet w
we a lots y ofnd
W 1
E