PROJECT BLUE BOOK

PROJECT 10073 RECORD
1. DATE • TIME GROUP 2. LOCATION
Dec 65 0730Z La Crosse, Wisconsin
3 SOURCE 10. CONCLUSION
Civilian Insufficient data for evaluation. Insufficient data fcr evaluation.
A NUMBER OF OBJECTS NUMBER OF OBJECTS /
One
5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
N/A
SEE CASE SEE CASE E FILES FILES
6. TYPE OF OBSERVATION Dimactor
Maxwall AF ATTN: Archi Aetospace S K3H3
Ground Visual
7. 7. COURSE Maxwall AFB, Alabano ArrN: Archivos Bronch Aetospace Studins Inst RET
N/A . RETURN TO: 1165
B. PHOTOS
0 Yos
No
9. PHYSICAL IDENCE
0 Y.s $ m
No
FORM

1% A Form l6h and return it in the-envelope provided.
4 -
We wish to thank you for reporting your oheervation to
+ the Air Force.
I
2.
a
Sincerely,
1
mty

U.S. AIR FORCE TECHNICAL INFORMATION
This questionnair been prepared so that you can give the U.S: Air Force as much
information as possi ncerning the unidentified aerial phenomenon that you have observed.
Please try to answ questions as you possibly can. The information that you give will
be used for resear Your name will not be used in connection with any statements,
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, we may contact you for further details.
ia
1. When did you see the object? .Time of day: 30
Hour Minutes
(Circle One): A.M. or P.M.
Day Month Year
1965
3. Time Zone: 3. Time Zone:
(Circle One): a. Eastern Eastern (Circle One): a. Daylight Saving
(6) (6) Central Central b. Standard b.Standard
c. C. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object? 4. Where were you when you saw the object?
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration)
Hours Minutes Seconds..
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuously? Yes
6. What was the condition of the sky?
DAY NIGHT
a. Bright o. Bright
b. Cloudy b. Cloudy
7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): a. In front of you d. To your left +
b. In back of you . Overhead
c. To your right f. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164, Jul 61, which is obaolete.

Pagn 2
8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
/
a. None a. Bright moonlight
.A few b. Dull moonlight
c. Many c.. 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 a. Dry
b. 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):
a. Solid d. As a light d. As a light
b. Transparent . Don't remember
c. c. Vapor
1. If it appeared as a light, was it brighter than the brightest stars? (Circle One): 11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter c. About the same
b. Dimmer d. Don't know
1l.i Compare brightness to some common object:
12.The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
b. Like a bright star
c.) Sharply outlined
d. Don't remember
. Did the object: (Circle One for each question)
o. 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 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 or flicker? Yes No Don't know )
h. Disappear and reappear? Yes No Don't know

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14. Did the object disappear while you were watching it? If so, how? Yo
1
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
it moved behind:
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of;
17. Tell in a few words the following things about the object:
a. Sound_
b. Color_
18. We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how
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Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes Nio)
IF you answered YES, then what speed wauld you estimate?
21. Do you think you can estimate how far crway from you the object was?
(Circle One) Yes No
IF you cnswered YES, then how far awaw wrould you say it was?
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Inside a building b.in the residential section of a city?
h. In a car c. In open countryside?
c. Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
At sea f. Flying over open country?
F. Other 9. Other
yu were MOVING IN AN AUTOMOalL or other vehicle at the time, then complete the following questions: yeu were MOVING IN AN AUTOMOalL or other vehicle at the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
a. North c. F: st c. F:st X e. South e. South g. West
b. Northeast . Northeast d. Southeast d. Southeast f. Southwest f. Southwest h. Northwest h. Northwest
24.2 How fast were you moving? __miles per hour.
24.3 Did you stop at any time whil ycaut were looking at the object?
(Circle One) Yes No
25. Dd you observe the object through any of the following?
Eyeglasses Yes No . Binoculors Yes No
Sun glasses Yes No f. Telescope Yes No
Windshiel. Yes No S. Theodolite Yes No
Window glass Yes No h. Other
rder that you can give as clear a picmure as possibla of what you saw, describe in your own words a common
t or o cis hich, when placed up in the sky, would give the same appearance as the obiect which you saw.

high the object was above the horizon (skyline) when you first saw it. Placs a "B" on the same curved line to
when you first saw it. Place a "B" on the compass where you last saw the object.
90 75"
60
NW NA
15 3W
2Draw a picture that will show the motion that the object or objects made. Placs an "A" at the beginning of the Draw a picture that will show the motion that the object or objects made. Placs an "A" at the beginning of th
path, a "B" at the end of the path, and shuw any changes in diraction during the course. path, a "B"" at the end of the path, and shuw any changes in diraction during the course.
29. IF there was MORE THAN ONE object, then how many were there?.
Draw a picture of how they were arranged, and put an arrow to show the direction that they were travsling.

Pago 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyore 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:
8
32. Please give the following information about
Last Name First Name Middlo Nama Middle Nama
ADDRE Cracte narle
Street City Zone State
TELEPHONE NUMBE AGE 2 AGE SEX
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and to whom did you report that you had seen the objeet?
Day Month Year