PROJECT BLUE BOOK

‘1. DATE - TIME GROUP
6 May 65 07/04002

2. LOCATION

Brookville, Qhio

3. SOURCE 10. CONCLUSION
Civilian — amcrarr = Pa
4. NUMBER OF OBJECTS
Data did not inideate flight pattern, however no indication the‘
One the object could NOT have been caused by an aircraft.

5. LENGTH OF OBSERVATION
5 Minutes
6. TYPE OF OBSERVATION

11. BRIEF SUMMARY AND ANALYSIS

Dull moonlight, many stars clear sty dry night. Object
appeared as a light mch brighter then the stars. Motion
included stationary portion and sudden burst of speed. Objed
didappeared suddenly. Small. Bright white color. Roux sh:
Initial observation at 45 deg elevation in SE, disappearance
at & deg elevation ih South. Flicht in strait line,

Ground=-Visua 1

7. COURSE

West

8. PHOTOS

0 Yes

9. PHYSICAL EVIDENCE

FORM
FTD sep 63 0-329 (TDE) previous editions of thie form may be used,

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Sige : DAVID SHELL —
| BROOK Vicce, OC, Ac

| CNet fase o€5 )

U.S. AIR FORCE TECHNICAL INFORMATION —

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 ol:serveii.
Please try to answer as many questions as you possibly con. The information that you give will
be used for research purposes. Your name will no? be used in connection with any 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.

]. When did you see the object? 2. Time of day: 23 © )
Hove Minutes
hi Mar 116s" coeGuk = um ae te

Month

3. Time Zone:

(Circle Ogshi 2, Eastern > (Circle One); ving
B. Central b. Standard

c. Mountain
d. Pacific
e. Other

4. Where were you when you saw the object?

fio Hie Pond Bienoc wie 0, eettarer’

Neorest Postal Address City or Town State or County

5. How long wes object in sight? (Total Duration) shaliiestnstghiaiy tiles ve So |

Hours Minutes Seconds

% + c. Not very sure
qm_Foiely consin_— d, just a guess
5.1 How was time in sight determined? Me Se) a

5.2 Was object in sight continuously? Yes kK OP wees

— eo eee fee

6. What was the condition of the sky?
DAY NIGHT

a. Bright << Bright
b. Cloudy b. Cloudy

7. IF you sew the object during DAYLIGHT, where was the SUN located as you looked ct the object?

a ae ee ©

—_

AiO Ri ie Ravan. eth treet

(Circle One): °. In front of you d. To your left
b. In back of e. Overhead
¢. To your af yoo f. Don’t remember

I.

FORM
FTD OCT 62 164 — This form supersedes FTD 164, Jul 61, which ie obsolete.

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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 Pg poor
b. A _ Dull moonlight ~~
<Schery > c. No moonlight — pitch dork
« Don't remember d. Don't remember

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

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

4 > a CR te nin

azy > Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow

e. Don’t remember

10. The object appeared: (Circle One): _

a. Solid C d. Aso light?
b. Transparent e. Don’t remember

Cc. Vapor

If it appeared as a light, was it brighter than the brightest stars? (Circle One):

Ca. Brighter" ghter c. About the same
Dimmer

d. Don’t know
11.1 Compare brightness to some common object:

_ NACH AD ote ae STS

The edges of the object were:
(Circle One): urred | e. Other

b. Like a bright stor>
~ onarply outlined

d. Don’t remember

13. Did the object: (Circle One for each question)
a. Appear to stand still at any time? (Yes _ No Don’t know
b. Suddenly speed up and rush away at any time? ( Yes No_ Don’t know
c. Break up into parts or explede? Yes CNo / Don't know
d. Give off smoke? Yes « Don’t know
e. Change brightness? Yes No Don’t know

f. Change shape? Yes ¢ No 3 Don’t know
g- Flash or flicker? | Yes N Don’t know
h. Disappear and reappear? | Yes ‘> ) Don’t know

Page 3

14, Did the object disappear while you were «watching it? If so, how?

Ves , DISAPPEARED SUDBNEOLY

rm mi we ee me ee ee ee

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

ne Tt SEEESEID AL SN WepRREEOC Pe eee Re ee ee eee

16. Did the objeet move in front of sgmething at any time, particularly a cloud?

(Circle One): Yes No Don’t Know. IF you answered YES, then tel! wisat
ek esihseliseiaitaidilbiactainallc tend, <ateaalieessasies

Seen n Ene —_—— —_——~— a a ae eee ees ee ee

am mn es ee eae

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

a. Sound Si Sry, eae 8 eee Se sitet: dihtnasecilbiaancldidtnasmmns toca
b. Color SS BR bas WIT be

18, We wish to know the angular size. Hold a match stick at arm's length in line with a known object and nv. how

much of the object is covered by the head of the match. If you had performed this experiment at the time af the
sighting, how much of the object would have been covered by the match head? |

;

WVourd Have Covered Ale Of Jr

19. Drew a pleture 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.

la.
[Cur Db

-

..
ll
’

i twee &

2. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you answered YES, then what speed would you estimate? — EE

VER kA > 7 bh :

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

(Circle One) Yes (ne)

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

22. Where were you located when yee saw the object? 23. Were you (Circle One)
(Circle One):

a. In the business section of o city?
section of a city?
c. In open countryside?
« Near an airfield?

. Flying over a city?
f, Flying over open country?
CIPI acesciscmnnesemmneies

a. inside a building
b. Ina car

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

f, Other

24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions;
24.1 What direction were you moving? (Circle One) |

a. North — c. East e. South y- West
b. Northeast d. Southeost f. Southwest h. Northwest

24.2 How fast were you moving? ___miles per hour.

24.3 Did you stop ct any time while you were looking at the object?

(Circle One) Yes No
25. Did you observe the object through any of the following?
co. Eyeglasses Yes ¢ No e. Binoculars Yes ; No )
b. Sun glasses Yes ( No _ - , Telescope Yes No VD
c. Windshield Yes ‘No > g. Theodolite Yes ¢ Ne >
d. Window glass Yes at SR eS

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 some appearance as the object which you sow

ee — - w~ <— - "

rege J

27. In the following sketch, imagine that you ere at the point shown. Place an ‘'A'’ on the curver: line to show how
high the object was above the horizon (skyline) when yuu first saw it. Ploce 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 sew it. Ploce o ''B’’ on the compass where you /ast sow the object.

TS°

90°

28. Draw a picture thet will show the motion that the object or objects made. Place an ‘*A* at the beginning of the
path, a ‘8’ at the end of the path, and show any changes in direction during the course.

IER LADE

29. IF there was MORE THAN ONE object, then how many were there? \0 Ltty ONE
Drow a picture of how they were orranged, and put on arrow to show the direction that they were traveling.

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 object? (Circle One) C Yes )} No
31.1 IF you answered YES, did they see the object too? (Circle One) “Mie > No

| —  s 4 — CwiceS

Book viccé On jo

32. Please give the following information about yourself; s
NAME —_ oa os Zs
iret Neme Middle Nemo |
"DD | ms
ADDRESS ); | LL e é On i aa

Lost Neme
Street City Zone State

TELEPHONE — °° & 2F AGE <2 sex _Mace

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?

(. _ May lo J

Day Month

35. Information which you feel pertinent and which is not adequotely covered in the specific points of the
questionnaire or a narrative explanation of your sighting.