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INFORMATION ONLY

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U.S. AIR FORCE TECHNICAL INFORMATION |
ti

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This questi j as |
| + qvestionnaire has bean prepered so that you can give the U.S. Air Force os nuch |
. imrormahe 3 . . : - a : “ ' > es
| ; N os possible -oncerning the unidentified serial Phenomenon thar yOu hove observed |
’ ease ry ft rw “7 . |
ry fO aMwer as many WUestions os you possibly can. The inf formation that you give will |
- 4 r * : 7 |
i be used for reseer-5 purposes. Your name will nor be used in connection ith any siatemen:
5h ents /
; - rm ets -~ “ - ‘
COMCiUSIONS, or a: sheations without Our permission. We reque nis per i! inf |
| : vest this person Ntormation <9
.r'os? * i? ge wm r= |
2 iS deemed ecessary, we may contact you for Surther eteils.
| )
oo% 72n did you see the sbjer:? 2. Time of ¢
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| SPSS Sb. Ww Siew ASS. YN A | :
Newrest Paves Middcows os Suanaeanasoameeneeans “ . a ie ™ & See
| " City or Town Site rCo
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| | | | | > oo => —_— _
{| % ow long was object in sight? (Toraj Duration) Pier XtN,
+ —— -_-—— oe. _ - Se ee ee, -—-- — ee —_———~—-— «
| . Hours Minutes Seconds |
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, . IF you 5a *-e@ odject et NIGHT, what did you notice concerning the STARS and MOON? :
. ’

ne: 8.2 MOON [Circle One):

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i ?. What were © weather conditions at the time you saw the sbjeer? i
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| —_————--—— —_——_ ——— - oom fee -_ —— oe —_— 2 —~ © Sn alleen tet atid —- — |
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| _ Official U.S. Air rorc

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’

'
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~~ ——— |
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' 14, Od the object disappeer while you were watching it? lf so, haw? Aes > | .
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Did the object move behind samething at any time, particulariy a cloud? *

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(Circle Ones Yes ‘No - Don't know, IF you answered YES, then tell whar
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} 36, Did the abject move in front of something ot any time, particularly a cloud?

—

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{Ciecle One): Yeas N a) Don t know. IF you answered YES, then tell wnar
: NO ey
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13, We wish to know the ongulor size. Hold a match stick at arm's /engtn in line with a known object and note how much of the

_

object is covered by the Sead of the match, If you had performed this exper'ment at the time of the sighting, how much of

the object would have been covered by the match head? ~ A. ON - <2

-——— . \ “4 > aN

—-—
eee

Draw a picture tact will show the shape of the object or objects. Label and inciude in your sketch any details of the abject |

.
tv

(hat you sew such as wings, protrusions, ete., and especially exhaust trails or vapor trails. Place an arrow beside the drawing

*-.

"ow the direciion the object was moving

- ae indi tae eel a _— = ee. oe

oo re

eee ee ee

| fede)

i i een seed

2 UFO form continued

Page 4

= vou gnswared VES, then how for away would you say if was?

em em mm ee

: 7 ae -- - ~ . ssetithenes sane abescnelials butane eNiiinnesinms ae a ee ’ .
| 29, Da you think you can estimate the speed of the object?
‘Circle One) Yos No * ae ‘ ‘
: 7
‘
} iy you srswerad YES. than what speed would you estimate? a ee Cs Ot : x ‘
' | \ an in <n ET ee ,
Cet a eee ~ ee -— a te.. —_ . —— —_—— —_— —_
j - : : :
: = au fore yOu Can estimote how far away rom you thre object wes?
| Cercle One; Yas No >
|
|

ss - —_———ie: — -_-_-_e-_— ee — ——_——
|
-
; : _
: (7 ere were yoy located when you sow the abrect? 23. Were you (Circie Ore)
‘ . ~
; 2 -
; >. In the Dusiness section of a sity?
: ;
} “sida o building Cb In the residential section of a city?
; 2 car c. In open countryside?
’
' ; “Outdoors ad. Near an cirietd?
IN cirpians (type) e. Flying over a city?
Ab tea F. Flying overopen country?
| J]
i thar ‘ : . a, Zi / fe EB IFUOIT ._recdencnsepeninlens bon - one pins aeneeeneae
/ ;
; oo meer ee lee ——<—= —— Oe ne ——_ - ——_ - in a ee le
,
' 24. © veo ware MOVING IN AN AUTOMOSILE of other vehicle at the time, then complete the following questions:
" ;
| ‘. r a - . .
) Vear direction ware you movirg? ‘Circle One)
| ’ ' + , ’ \ . \ s q . _ a ation -
e > 7 ee - ay! ss . : rwerh ~ 8) VV ost
: j b. Mortheos? 3. Southeast fF Southwest h Northwest
; ' 23.2 ow 'as? were you m ving? a ae — ! ser hour
: ;
»* —_ '* * -
/ : 243 Did you step at ony time wh @ -ou were looking at tha object?
: :
' ” (Ciecle One — Yes , NO
‘
a a ea —-- — -- —_ —= —_ - * —— ——— ee
25. foe you observe the object through any of the following?
; -
>. Eyeglasses Yas le e. Binoculors Yes < No-
: » Sur giasses Yes a ) f. Telescoo# fas No
ce Wiresnieid Yos Nee g. Theedolite Yes No
4d Window glass (es No” h. Other < ss « "
— .———- —_—_———— | _—_— a ee me

+ orcter hor vou can give as clear a oncture as possibile of what you saw, describe in your own words

\w

ectt wreck, #hen placed up in she sky, would give the some opoecrance as the object which you saw

Se ee ee
.

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———— ee ee Re me es tte te tee ey ee ee = ee

common obieect or ob-

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wait iClal aD v“iy crore

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ee yr rr rr re nn 8 + ee 8 a Oe eR et A 8 Re Ce ee ee ee ee 7"
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ren} ey an here woe ” ? +} mint ck "9. . r A lene saa line te cho no by teed . ier?
: , noeqgine 7 yvyv . su me por ; ws Wri, ; ce an an ' ' 7 Ti : iy ic) & Iwi we ; |
" ~ ; . ; : °
wren | LF wife) wh an yoy Fy :} sow it. Fiance oa ° on ine some cur vod lj ‘to «}, > } iw hiah ine obec! wo,
; / 7 - 4 ’
. : ’ . ‘ee . - :
izon (skylina} when you last saw it, Place an “A 1 the comocss when vou firs! sow it. Place a “B” on the cor )
. -
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aw pie ture thet will show the rccor yey? the object or obiects meade. 2) sce an"A‘ atthe begianin 4 of the 's ath, a “R' P

;
the end of the peth, and show any cherges in direction during the course.

/
|
;

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| ee ee ee —e ——_— ——-= = -_——_—— —- ——- _- --- |

‘= ~ T : ; ’

| 29. IF there was MORE THAN ONE object. then how many were trere?__§_1_ 32-2 “= NN
’ on _ ; ; .
Drew 3 picture cf how they were crranged, ard put an arrow to show the direction that they were traveling. |

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30. Hove you ever seen this, or a similar object before. !f 50 give date or doles end location
j
|
— --<- — —_——— -_—_ —— — - - _— ~ —— ee Biel
! 31. Wose + alte with you ot the time you saw the object? (Circle One: Yes c No
: : —_—-= . ' . .
3} : syswered YES, did they see the object tad? (Circle One Yes No
~ : 1)
| 31.2 w ist Phair nemes ond addresses:
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