PROJECT BLUE BOOK

DATE - TIME GROUP
11 July 65 12/03002

2. LOCATION

Summerset, Pennsylvania

10. CONCLUSION
AIRCRAFT

4. NUMBER OF OBJECTS

2 1/2 Minutes

6. TYPE OF OBSERVATION

Evaluated as an aircraft obsetvation. No data presmted to
indicate object was NOT an. aircraft

13. BRIEF SUMMARY AND ANALYSIS |

Object was slid. Was very high, moving very fast. Object
moved from 3 to Win 21/2 minutes. ~

Groum=-Visual (3x-TxX

7. COURSE
Vest

8. PHOTOS

O Yes
WLANN®

9. PHYSICAL EVIDENCE

QO Yes
XE Ne

FORM ys
FTD sep 63 0-329 (TDE) previews editions of this form may be used,

' ae WHAKAGE

U.S. AIR FORCE TECHNICAL INFORMATION

This questionnaire has been prepared so thot you can give the U.S. Air Force os on
information as possible concerning the unidentified ceria! phenomenon that you have observed.
Please try to answer os many questions as you possibly can. The information that you give wil!
be used for research purposes. Your name will not be used in connection with any statemenis,
conclusions, or publications without your permission. We request this personal information se

that if it is deemed necessory, we may contact you for further details.

Ss SS

=

1. When did you see the object? 2. Time of aot _F PM bcclecck
Hour Minutes
sh ae: Pa he ESS PAY
2 OE Ae / / (Circle One): P.M.
Day Month Yeor
eee 96S ten
3. Time Zone: :
(Circle One): (a. Eastern (Circle One); a, Daylight Saving
Central b. Standard
c. Mountain
d. Pacific
e. Other

4, Where were you when you saw the object?

: PX
a
 WUMMER SET _ 2 j= Neal 2 ee DD ee
Stote or County

Necrest Postal Address City of Town

5. How long wes object in sight? (Total Duretion) a ae coal

Hours Minutes Seconds
Certain c. Not very sure GO rh
Ob °) Feirly certain d, Justa guess

_ 5.1 How was time in sight determined? Sage ag te / :
5.2 Wos object in sight continuously? Yerj_ No

6. Whot was the condition of the sky?
DAY 7 GHT

Bright ( a: /Bright
b, Cloudy “6, Cloudy

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

(Circle One}: a, in front of you d. To your left
b. In back of you 2, Overheod
c. To your rignt f. Don’t remember

Sa ee ee en

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FORM
FTD ocr 42 164 This form supersedes FTD 164, jul 61, which is obsolete.

— " , —_ ” . .
MM Miia NNO SA Autebilinee eee

Page 2

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8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
| BT STARS (Circle One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Many ¢. No moonlight — pitch dark
d, Don’t remember d. Don’t remember

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

CLOUDS (Circle One): __ WEATHER (Circle One):
(a. Clear sky Ca. dry

>. Hazy b. 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):

(oe) Solid ds Ke-e light
b. Transparent e. Don't remember
c. Vapor

1}. If it appeared as a light, was it brighter than the brightest stors? (Circle One):

a. Brighter c. About the some
b. Dimmer d. Don’t know

11.1 Compore brightness to some common object:

12, The edges of the object were:

(Circle One): a, Fuzzy or blurred e. Other
b. Like a bright stor

c. Sherply cutlined 7
d. Don’t remember — ani

13, Did the object: (Circle One for each question)

a. Appear to stond still at any time? his (Yes) AX N o> Don’t know
b. Suddeniy speed up ond rush awey at anytime?  ‘ Yes No Don’t know
c. Breok up into parts or explode? Yes No Don’t know
d. Give off smoke? Yes No Don’t know
e. Change brightness? Yes No Don't know
f. Change shape? Yes No Don't know
g. Flash of flicker? Yes No Don’t know
h. Disappear ond reappear? Yos No Den’? know

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14,

15.

16.

7.

19.

a
Puge 3
Did the object disappear while you were ‘watching it? If so, how?
aR,
Ae > 4 ; Waban
Did the object move behind something at any time, particularly a cloud?
(Circle One): Yes No Gi Don’t Kno IF you unswered YES, then tell what

it moved behind: —

Ot TO Ce em ee tee

ee a a er te ae

~~ ee ete eee — owe - Se ee ee - —— —~_ ” - _-

ewes aS eee

Did the objeet move in front of samething at any time, particularly a cloud? X + ny
(Circle One): ~~ Yes No Don't Know. — IF you answered YES, than tal! what

serene ee Set
in front of:

_— —~———- - — _ oo (mr we

a= eee re

-_—_ — —_

a wt ee ee

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

Ge. Sound

a
— —_—_-_—————_— —— -_———- -—_ —

i Colne.

We wish to know the angular size. Hold a match stick at arm’s length in line with a known object and not. how

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?

Drew a picture that will show the shape of the object or objects, Label ond include in your cbateh ¢ any deroils
of the object that you saw such as wings, protrusions, etc., and especially exhaust trails or vépor trails.

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

Tamm RA NN ani a Nk a la al 8 i a Nr near et lm ied wl een Le ; dita on.4 }

ee
.

0. Do you think you can estimate the speed of the object? py, V2 ha frat
(Circle One) Yes No D ; Ed

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

4. A

df
J

21. Do you think you can estimate how far away from you the object was? (, ‘ Vv

(Ciecle Ome) Yeu Ne nee

IF you answered YES, then haus Oe away would you say it was?

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

a. In the business section of a city?
a, Inside a building ean b. In the residential section of a city?
b. Ina car c. In open countryside?
c. Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea f, Flying over open country?
1, nen eee ao, Loe 6. | OMG8 si

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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 g- West
b. Northeost d. Southeost f. Southwest h. Northwest

24.2 How fast were you moving? ____miles per hour.

24.3 Did you step at ony time while you were locking at the object?
(Circle One) Yes No

25. Did you observe the object through any of the following?

a, Eyeglesses Yes | No | e. Binceviors  _ rex” No

b. Sun glasses Yes No ' f. Telescope C Yes > No _ /

c. Windshield Yes No g- Theedolite Yes ~ No

d, Window glass Yes No Ua 7 gees ie SESE SS ES aie eee ee eer ee

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 appeorance as the object which you sow

raged

27. In the following sketeh, imegine thet you ore et 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. Place 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 firs? sew it. Ploce o ‘’B’’ on the compass where you /ast saw the object.
90°

Ts°

28. .Draw a picture that will show the motion that the object or objects made. Place an ‘’A*' at the pepineing of the
path, o OP ct ne, end of the path, and show any changes in direction during the course.

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t/a. ae

’

Sit ner Peak 2

AA a At ae eA

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

/

Li donk de te sead Tain dine adie ieee? Mekeenh od) Aileen ee iis mies ia 6) tal amelie’ A okie inde bie te ih ionleih Ica

' J age 6

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

31. Was anyone else with you at the time you saw the object? (Circle One) Yes No

31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:

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. 4

32. Please give the following information about yourself; |

NAME

TELEPHONE NUMBER

AGE 2. SEX |

indicate any addirional information about yourself, including any special experience, which might be pertinent.

“7 4

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33. When and to whom did you report that you had seen the object? A F ee ey

ee I —

° Day Month Yoor a = 4
Sot” “UL —_- Lid iat Ata ater A/O RFR
=. ee weed oO eZ Ad oe J

y

34. Date you completed this questionnaire:

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