PROJECT BLUE BOOK

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1. DATE - TIME GROUP 2. LOCATION

31/03152

10. CONCLUSION

AIRCHAFT?

NUMBER OF OBJECTS

One

LENGTH OF OBSERVATION /|11. BRIEF SUMMARY AND ANALYSIS

10 - 12 liinutes

TYPE OF OBSERVATION

1,4 . ¢} ‘ _ , te: Fee tata t ; $
Ob}: c : A} : ri ‘° ; F be th, Ee gt t ty Hy €> ; mov nyily: st: ?* Sa t
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ites iy} tA ~« . ' vf 3 CYS B | }° : SUL « 15°

ro und=Vi sue 1

PHOTOS

O Yes
1K No
9. PHYSICAL EVIDENCE

QO Yes

xx No
FORM
FTD sep 63 0-329 (TDE) Previous editions of this form may be used.

HEAOQUARTERS PENS

FOREIGN TECHNOLOGY DIVISION a

AIR FORCE SYSTEMS COMMANDO re .
UNITED STATES AIR FORCE Cre ma
WRIGHT-PATTERSON AIR FORCE BASE, OHIO 4 , ee im)

REPLY TO be Waist

ATTN OF: TDFCS/61393
w 2 APR i936

TO: TDEW

While Duty Officer, I received a call from Mr. QE...
ike, Bellbrook Ohio, telephone
No. Oo claimed to have seen the same UFO that
was reported on the 30th of March 1965. He said he saw

a bright object larger than a star similar to what the
women from Lewisburg Ohio had seen. He said he saw it at |
about 10:15 on the 30th traveling from East to West and
then it appeared to turn and go North.

|
|
|
|
susvect: UFO Report

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CARL N. SCHAFFHAUSER |
Captain, USAF |
Departmental Support Branch

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YOU - THE NUCLEUS OF SECURITY!

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(er ene ere men eT ae EA em ee pape ae i ll i a a a i

U.S. AIR FORCE TECHNICAL INFORMATIOM

This guestionnava has been praperad so that you can give the U.S. Ai Force as much
information os possible concerning the unidentified aerial phenomenon that you have observed,
Please try to answer as many questions as you possibly can. The information rhat ycu give wi:!!
be used for research purposes. Your name will sof o9 used in connection with any statemeni:,
conclusions, or publications without your permission. We request this personal information sc
that if it is deemed necassary, we may contact you for further detaiis.

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SS SR oe SSS ee ane ene —= SSS SSS OS Sas ee Se Se ae See, Se | SET tee
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1. When did you see the object? 2. Time of day: card ae res: | oak
tour Minutes
o) * AS, | ee os a
~ ) , yn, f Ji . i me '
in i (Cirele One): A.M or ( P.M
Day Month Y gar .
3. Time Zone: eee ’ |
. Ps 4 " - i
rcle One): o. (Eastern (Circle sine}; a, Daylight Saving 1 |
>. Central b. Standard ‘ |
P s :
Mouriain j
J. Pacific ; |
a \_) "her | eae eS 5
:
: 4 Yoare vere yal er sy SUW The ooject: ‘
.
;
a 7 :
es ec ee ee oc Sine ;
Meorss' sata) Aderess City or Yown yrota uw County, ¢
;
| dew 23 ¢
5. How long was oo;act in signt? (Total Ouration) dita LE AS! Fae * 4
Hours Minutes Secords
:
4. Verein c. Nol very sure ;
o. (Fairly certain d. just a guess
5.1 How wos time in signt dervermined? _ ane errr Cf - —_
5.2 Was abject in sight continuousty? ya =... PR is is |
agiebiphels — — — eanperse-2 ~o © — — — ee ES ES + ORNS OOS ome ene Le ae ee wie ;
8. What was the condition of the sky? :
;
?
DAY NIGHT _ d
a, Bright a. (Bright
b. Cloudy b. Cloudy

7. IF you sew the object during DAYLIGHT, whare wos the SUN located as you locked 2: tha obsest?

07 APE ey, -_p 08 Fe OTL Ae

(Circle One), a, In front ot you d. To your left
b. Im boek of you e, Overhecd
c. To your rig 7, Don't remember
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1F you saw the obiect at NIGHT, what did you notice conceming the STARS and MOON?

8B.) STARS (Circle One): 8.2 MOON (Circle One):

a. None . el ong

b. (A few: il moonlight)

Ce Meny No moon ae ~- = pitch dark
d. Don't remember 4. Don't remember

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

~ CLOUDS (Circie One): WEATHER (Circle One):
a. ‘Clear sky sky a | (Bey) |
b, ear b. . ee mist, o¢ light rain |
c. Scattered clouds ¢. Moderate or heavy rain |
d. Thick or heavy clouds d. Snow

e. Don’t remember

LO LL LN A ALN LL ALLL AL A
'

10. The abject appeared; (Circle One): |

. a eN ;
a, Solid d. Asa ligne ’
b,. Tranasparen’ 2. Don't remember i

. Vapor ‘
ee A, LL LE AEE ll ceteieaeanettamgnntnininiaiilin animal

VV. Ft appears o4 2 i gnt, was 1/ ceigntar tnan me Brigntest stars? (Circis One): i
;
ia ;
3. \_Gri ghter c, Abvout the same
ri rer
b. Dimmer 4d, Don’t know
11,1 Compare orightness to some common abject: ;
“—_ 4 } Ts

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; PY ' — —_ / at ‘

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12. The edges of ne object were

‘Circle One): a. Fuzzy of blurred e. a
>. Like a brignt stor abide TH . WRN!
c. Sharply outlined — inmate lia
d. Don't remember _ a ia eateateaeinetipenincaniananneiiets
13. Did the object: (Cirele One for each question) :
c. Appecr to stand still at any time? ‘Yes No Don’t know ;
b. Suddenly speed up and rush away at ony time? Yess (Ne Don’? know
c. Break up into parts or explede? Yes No. Don’t know
d, Give off smoke? Yos ‘No Dan’t know
», Change bri qiiness? Yeas CNe Deon’? know
§, Change shope? Yes No Dan’? know
g. Flash or flicker? Yas No Don’? know ;
. Disappeur and reappear? Yos No Den’t know

se ~ace-shetaaaraaesaaaassant acest sat ce CO LLL LL LL LLL OL LL EL

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14. Did the object disappear while you were vatching it? If so, how?
Mee, Ma wh AT atom ANE on Cnty

15. Did the object move behind something at any time, particularly a cloud?

(Circle One): Yes (No Don’t Know, IF you answered YES, then tell what

Ne caitlin nents diiasinis lineman aitainamemsstegees
16. Did the objeet move in front of sisuaia" at any time, particularly a cloud?

(Cirele One); Yes (Ney Don’t Know. IF you answered YES, tha te!! wisat

a dk: Oe ee therein payne — ee

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

a. Sound A Dice:
. —_——<— —— - — - ~ - _—_— = = ee ee ————<— * <— c+ «

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b. Color edbtitaaraentiaie eo: Ss SA ee OY a «1 Cac ————— an ee
18. We wish to know the angulor size. Hold a match stick at arm's length in line with a known object and uct Sow

much of the object is covered by the head of the match, if you had performed this experiment at the tire: tf te

sighting, how much of the object would have been covered by the match head?
pe ms oie ys 1m oe ey ae ae ictal
A 4 A tlc A f. oat ae - a : CAC es —< :
{_*-« -< AG Se ae

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19. Draw a picture that will show the shape of the object or objects. Label and include in your sketch any details
of the object that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails.

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

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

(Circle One) No

(Vey

IF you answered YES, then what speed would you estimate? (arte

21. Do you think you can estimate how far away from you

(Circle One)

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(ves)

No

—
/

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o_o a ———_—_—- eer +--+" ~-er ::_ nk ees a see se

the object was?

IF you answered YES, then how far away would you say it was? Dette OL nna O

22. Where were you located when you saw the object?

(Circle One):

», Inside a building

In a car

Outdoors

In an airplane (type)
At sea
Other |

A A

v

23. Were you (Circle One)

a. in the business section of a city?
b. In the residential section of a city?
(ey In open countryside?
“d. Near an airfield?
e. Flying over a city?
f. Flying over open country?
i NE ae sts

a

—_—

-—--——

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

24.) Whot direction were vou moving? (Circle One)

a. North ec. East e. South y- West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? — smiles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle Qre) Yes No
25. Did you observe the object through any of the following?
a. Eyeglasses Yos 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 er nee eee

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—_—_——— —_— — ++

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26. 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 appearance as the object which you saw

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4

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27, In the following sketch, imagine thet you ore af the point shown. Plece an ‘'A'* on the curves: line to show how
high the object wes above the horizon (skyline) when you first sow it. Place 1 ''B”’ on the same curved line io |

show how high the object wos obove the horizon (skyline) when you last suw ij, Place an ‘''A’ on the compass
when you firs? sew it. Place o ''B’’ on the compass where you /ast saw the object,

7TS*°

——

-

28. Draw a picture that will show the motion that the object or objects made. Place an ‘‘A’' at the beginning of ihe
path, a ‘*B"’ at the end of the path, and show any changes in direction during the course.

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—_—_—-—— i

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29. IF there was MORE THAN ONE object, then how mony were there? ss
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

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30. Have you ever seen this, or a similar object before. if so give date or dates and location.

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

31.2 Please list their names and addresses:

32. Please give the following information about yourself:

re Mbt <letipisrneannet
Lost Neme Firs? Name | Middle Name
apt lilm cobiaiage te
State

Streer City Zone

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

33. When and to whom did you report that you had seen the object?
PLS | iv SFG

Day Month Yeor

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