PROJECT BLUE BOOK

}. DATE - TIME GROUP 2. LOCATION
November 1954 03302 Hancock, New York

Senn

3, SOURCE 10. CONCLUSION

Civilian SATELLITES
— = SE
4. NUMBER OF OBJECTS
One

5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS

2 to 3 Minutes Object observed on seve occasions moving across xy. Brigiter

ences me 7 than the North Star. “oved through alout 1/4 sky amd dis-
6. TYPE OF OBSERV N appeared.

Gro und—Visual
COMMENTS: «(Observation of satellites moving into earth shadow
creating the sudd@ disappearance is a logical esplanation for
Easterly the reported observations. Due to the absence of specific times
. nares —————————eesiaryi dates an idmtification of the specific mject is not possible.
i Case regarded as various satellites observations.

7. COURSE

9. PHYSICAL EVIDENCE

O Yes

XXNe

FORM
FTD sep 63 0-329 (TDE) Previous editions of this form may be used.

Jage 6

30. Have you ever seen this, or a similor object before. |f so give date or dates and location.

Wes sar. 257. 54 ee f— b> Ft, |

-

betes: aug time, 7 ditFeken py,

io me

31. Was anyone else with you at the time you saw the object? (Circle One) Yes Ge)
31.1 IF you answered YES, did they see the object too? (Circle One) Yos No

31.2 Please list their names and addresses:

32. Please give the following information about yourself;

NAME
Lost Neme , 4. ie of |

i. / : |

ADDRESS — (4-2 A sigimnell |
Street aane Ble Zone |

TELEPHONE NUMBER AOA age SY sex riya

indicate any odditional information about yourself, including any special experience, which might be pertinenr.

Se ee

| te ee —_- — --e-o-_o---— ee ee

33, When and to whom did you report thet you had seen the object? Wh 2 dj , h/ a

9 |
f —— : ee ee /‘ me + ar po en. |
' Yoor = Pre? i oor 2 =

Woy saonn

Page 7

. 34. Date you completed this questionnaire: tf | / 2
Day Month Yeor

—— ee — —— —_ = a

35. Information which you feel pertinent ond which is not adequately covered in the specific points of the
questionnaire or a norrative explanation of your sighting.

|
\
bc Get |

8 January 1965

Dear Messrs. eiibeo nd =aNaeRe

Reference is made to your recent letter in
which you indicate that you have observed several |
objects which you cannot identify. | |

Attached is a copy of PTD Form 164 which is
used for reporting unidentified flying objects to
the Air Force. This form should be filled out
as completely as possible and returned to this
orfice for evaluation.

Sincerely,

MASTON M. JACKS
Major, USAF
Public Information Division
Office of Information
1 Aten
FTD Form 164

Messrs. REREDGe, Gee &
Ena

RB
Hancock, New York, 13733

U.S. AIR FORCE TECHNICAL INFORMATION

1. When did you see the object?

Mot

i

Day

Month

J

1164

Yoor

|

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 ycu give will
be used for research purposes, Your name will not be used in connection with ony statemenis,
conclusions, or publications without your permission. We request this personal information sc
that if it is deemed necessary, we may contact you for further details.

ee

2. Time of day:
tour

(Circle One):

Se eS See eee a ese ee ee eet

/O

re ee at ee ee

: som

Minvtes

A.M. or En)

Be es Cee a ee hee.

3. Time Zone:
(Cirela

Daylight Saving
>.) Stondard

(Circle One): a. Easter ae}: 6
b. Centra

c. Mountain

d. Pacific ; |

e. Other

'
t
'
'
t
i ie Ne Sane

4, Where were you when you saw the object?

Ha AL ac WA. De. Lawak 2 coy

City or Town Stote or County

re  -  e a

Neorest Postal Addrasa

5. How long was object in sight? (Tote! Duration) a FG To SHIM

Hours Minutes Seconds
a. Certain c. Not very sure : ; |
;
b. Fairly certain d, Justo guess tT) in 2 } |
o :
5.1 How was time in sight determined? =o + OF QvOosse of i
5.2 Was object in sight continuously? Yos e— No — |
— Te Se eo ie ee ee ee ee 3 |
6. Whot was the condition of the sky? £
?
DAY NI ;
a. Bright 1. Oriant
; b, Cloudy b, — oudy
! —_ —e —— ° 2 ae .
7. IF you sew the object during DAYLIGHT, where was the SUN loccted os you looked at the object? :
(Circle Gne}: a. In front of you d. To your left ;
b. In beck of you @. Overheod N
y e. la your right . Don’? remember

FORM

. FTD ocr 62 164

|
UJ

Thies form supersedes PTD 164, Jul Sl, which Is obsolete.

Page 2

—
“

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

. None | a. Bright moonlight
- Afew - b. Dull moonlight
2 moonlight ~ pitch dark

(Don't remember”

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

. c
. Don’t remember d

CLOUDS (Circle One): . _ WEATHER (Circle One):

G. Clear sky } is
b. Hozy b, Fog, mist, or light rain
c. Scattered clouds ¢. Moderate or heavy rain
d. Thick or heavy clouds d. Snow

e. Don't ramember

-_—— —— —— —

10. The object appeored; (Circle One):

a. Solid
b, Transparent e. Von't rememe

c. Vapor

1]. If it appeored os a light, was it brighter than the brightest stors? (Circle One):
é. Brighter ) c. About the same

b. Dimmer d. Don’t know

11.1 Compare brightness to some common object:

PRE Gh tS fe thal Ne Qty Sea

— -

-~—

12. The edges of the object were:

(Circle One): g. Fuxzy or blurred e. Other
Like a bright stor

c. Shorply outlined

d. Don’t remember

-— ——_____—-- $$$

tele ind Waka 4et ae ne a Se ee ee ee

13. Did the object: (Circle One tor aach question)

a. Appear to stond still at ony time? Yos fio> Don’t know

b, Suddenly speed up and rush away at ony time? LEY) No Don’? know

c. Sreak up into ports or explode? Yos CToD Don’t know

d. Give off smoke? Yos No Don’t know

eo. Change brightness? ‘Yo No Don’t know

f, Change shape? Yos No Don’? know

je PF ossh o¢ flicker? Gap > Jon’? mow
h, Disaooeer ond reapoear? , os 0) Don't know Z
I

a

14,
Movi Ny wast ro

OF the sk¥ ANL made ow og
twe S1424-eand Fhok* StRasghr UP FNTO—fhE _AHY Ang

Page 3

Did the object disappear while yo were ‘vatching it? |f so, how? /&5, SRM At aoe ee eee
EteT ENT te Fer Abort te THE Seen

Ship LPAWa Rye Veye perreer |

AFhOR MakiVO tre

ComPLetely ovp oF sigpr -witlt 4eR 2 seeends Ste Rann
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): Yes Don’t Know. IF you answered YES, then tell what

it moved beh ind: ’ Sue ~

Se te ae

Did the objeet move in front of semething at any time, particularly a cloud?

17.

« Sound 1.VhoM WA ¥
b. Color LRNDLT- White

ee

18.

19.

We wish to know the angular size. Hold a match stick ot arm's length in line with a known object and not, ‘5:
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?

-—-—-— — —_—— _ -

Draw a picture thot will show the shape of the object or objects. Label and include in yous sketch ony detoils

of the object that you saw such oe Gings, profrusions, etc., and especially exhaust trails or Vopor trails.

Place on arrow beside the drawing to show the direction the object was moving.

(Circle One): Yes Don’t Know. IF you onswered YES, then tel! wisat
in front of: mines re ater aw z i 1A ae
Tell in a few words the following things about the object: '
wv

20. Do you think you can estimote the speed of the object?

(Circle One) Yes

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

21. Do you think you can estimate how far away from you the object wos?

(Circle One) Yes

IF you answered YES, then how far away would you say it was?

-———

22. Where were you located when you sow the object?
(Circle One):

a. inside a building

d. In an airplane (type)
e. At sea

f. Other

23. Were you (Circle One)

in the business section of o city?
in the residential section of a city?
c. In open countryside?

d. Near an airfield?

e. Flying over a city?

f, Flying over open country?

g- Other

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

24.1 What direction were you moving? (Circle One)

| 0. North c. East e. South y. West
b. Northeast —d. Southeast f. Southwest h. Northwest?
q 24.2 How fast were you moving? - miles per hour.
24.3 Did you ston at any time while you were looking at the obdiect?
ai (Circle Gne) Yes No
: 25, Did you observe the object through any of the following?
ao. Eyeglosses Yos No e. Binoculars Yes ne\ /
b. Sun glasses Yes No f. Telescope Yes °
c. Windshield Yes No g. Theodolite Yes No ;
d. Window glass Yes No h. Other ‘in =

26.

Like

/

Dune gt fhe { & U ai \/ ote O Qa P /- fe >

‘
in

4 LJ P
4, — Pal ‘ ,. ‘i

—=

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 appecrance os the object which you sow

Pages

27. In the following sketch, Imagine thet you ore st the point shown. Place on ‘'A*’ on the curves line to show how |
high the object wos above the horizon (skyline) when you first sow it, Places a ‘'B’’ on the same curved line to

show how high the object wos above the horizon (skyline) when you last suw it. Place an ‘'A”’ on the compass
when you first saw it. Ploce o ‘'B’’ on the compass where you /ast saw the object,

90°

TS5°

28. .Draw a picture thot will show the motion that the c»ject or objects made. Place an ‘'A*' at the beginning of the
path, a ‘’B”’ at the end of the path, and show ony changes in direction durjng the course.

as

————

oo

29, IF there was MORE THAN ONE object, then how many were thera?
Drow a picture of how they were arranged, and put on arrow to show the direction that they were traveling.