PROJECT BLUE BOOK

PROJECT MO73 RECORD
J. DATE · TIME GROUP 2. LOCATION
3 January 66 04/0330z Burbank, Chio (2 Witnesses)
3. SOURCE 10. CONCLUSION
Salellite Prak.
Civilian
4. NUMBER OF CBJECTS
One
5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
5 Minutes Object appeared in the NNE and disappeared in the SSW on a
straight and level course. Object appeared as a white light
6. TYPE OF OBSERVATION No wings, or exhaust and no noise was observed. Observer was
Ground-Visual in a moving auto at the time.
7. COURSE
east was 5ound that the object astrsvel.
Souths by
eist.
8. PHOTOS

FRon NNE TO 5SE AT A STANDARD
HGIGHY , IT D1O NOT VARY WE WERE
ON INTGRSTATE -ft 71 2 MIL65 EASTOF
STATE # 76 AT BURBANK . 1T NAS
WROTE YO DAVID DIGT2 JCIENCE
A

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 cerial phenomenon that you have observed.
Please try to answer as many questions as you possibly can. Tha information that you give will
ba used for research purposes. our 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 yau for further details.
I. When did you see the object? 2.Time of day:
Hour Minutes
3RD LANUARY (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone: . Time Zone:
(Circle One): a. a. Eastern (Circle One): a. Daylight Saving
Central b. Standard b. Standord
c. Mountain
d. Pacific
e. Other
ONINTRTATE#TI ON INTEITATEHT EZ E.OFOHIC*76 E.OFOHICF76
4. Where were you when you saw the object? NEAR
BURBANK,CHO BURAANK,OHO BURBANK, OHO WA BURBANK ,OHO WAYNE COUNTY NE COUNTY
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration)
Hours Minutes Seconds
24EJ5
a. Certain c. Not very sure
Fairly certain d. Just a guess
5.1 How was time in sight determined? WAS LEAQLY IN SIEHT IN FRONT OF US
5.2 Was object in sight continuously? Yes No
6. What was the condition of the sky?
DAY NIGHT NOMOONIBCLIEVE BOTNCT
a. Bright 0. Bright cLvG7
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 e. Overheod
c. To your right f. Don't remember
FORM
FTD OCT 62 164 Thia form supersedes FTn lo4, Jul ol, which is obsolete.

Page 3
14. Did the object disappear while you were watching it? If so, how?
STRAIGHT, DIRGCT COURJE
15. Did the cbiect 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:
. Sound .NONE a. Sound.. NONE THAT WG HEARD THAT WE HEARD
b. Color.. b. Color. ONLY BRI6H7WHI7E AS ALIEH7 BRI6H7WHI7E ASALIE17
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 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
much of the object is covered by the head of the match. If you had performed this axperiment at the time of the 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?
AB007 114
OnJCCT WOULD BE A HRCFA nATCH CCNG-
19. Draw a picture that will show the shape of the objsct crobjeers. Label and include in your sketch any details
of the object that you saw such as wings, protrusions, etc., and aspecialily exhaust trails or vapor trails.
Place an arrow beside the drawing to show the direction the object was moving.
NO Wiales
NOPROTE0SION
NOEXMAUSTOR
VAPOR TEAIL5
ONLY ONE CBJY Bu7i7 sCtw() HrveSGaeos a
To GOr CONiR nS IT EOT CLOSER BEPatoFgM
4O VAPOR 1RAIC WASLEFY BNND NT

Pago 4
20. Do you think you can estimate the speed of the object?
SSTIMATE
(Circle One) Yes No ONLY
500mPH
IF you answered YES, then what speed would you estimate? 1
21. Do you think you can estimate how far away from you the object was?
(Circle One) (Yes) No ESTIMATE
AT ONLY
IF you answered YEs, then how for away would you soy 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?
) In a car c. In open countryside?
c. Outdoors .Near an airfield?
d. In an airplane (type) e.Flying over a city?
e. At sea f. Flying over open country?
f. Other g. Other
24. IF you were MOVING IN AN AU TOMOBILE 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. Northeast d. Southeast F. Southwest h. Northwest
24.2 How fast were you moving? _ 6 miles per hour.
WE5LOWEODo 7OABOU7
(Circle One) Yes No 30MPH- CAFS1CUOAR
25. Did you observe the object through any of the following?
a. Eyeglasses No e. Binoculars Yes
b. Sun glasses Yes No f. Telescope
c. Windshield Yes) No Theodolite Yes No
Window giass Yes No h. Other
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.
ATHICK.SAORTC/EAR
L
-

whan you first saw it. Place a "B" on the compass where you last saw the object.
90 75
60
N
E
R3
L15 SW S
28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the baginning of th 28. Draw a picture that will show the motion that the objact or objects made. Place an "A" at the beginning of the
path, a "B at the end of the path, and shion uny changes in direction during the course. path, a "B" at the end of the path, and shion uny changes in direction during the course.
A A- NEDJA MGDUA
#71
BULBAUL
29. IF there was MORE THAN ONE object, then how many were there? ONE
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

Pago 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
NO
31. Was anyone eise 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 ond addresses:
MY WjFE
CHIPPENACAKG,OH1O
32. Please give the following information about yourself:
NAME
Last Name First Name Middle Nams
BCVO, CHIPPEWACARE 44215 OHO
ADDRESS
Street City Z.one State
TELEPHONE NUMBER AGE 48 SEX MALE
Indicate any additional information about yourself, including any special experience, which might be pertinent.
MY 5rUDy IN SCHOOL AND My WORKHAVE
BEGN MOSTCY IN DRAETNC-
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33. When and to whom did you report that you had seen the object?
25 JANVARY 1966 SCIENCEEETORDF
Day Month Year THE CLEVELANOPRESS
DHONOT REPOZT ITOJTIL HE RETURMEOFRAMHISVACRTOA

Paga 7
34. Dats you completed this quastionnaire:
Day Month Yoar
35. Information which you feal pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting.
NNG
WE SAW A BRIGAT WHITG LIGHT TO OUC CEFF
AND AHEADAT FIRSTWETHOUCHZIT MIGH
BIGAND
CONEE2PROGABLY BCCAUIG
I7 5CemGD TO GET
1T WAS GTTTING CLOJGRIT.NAS NOT AN
NE
A VFO To
LC

Chivpe ike, Ohlo 44215
it Dear Mr
Reference your unidentifled obaervation of 3 Jamuary 1966.
The informetion in your letter is not surricient for evalua-
tion. F Request you complete the attached FrD Form l64 and
return it in th envelope provided.
We wish to thank you for reporting your observation to the
Air Force.
Sincerely,
THAZ
33
- =

1
Chippewa Lake, Ohio 44215
. Dear
a
-4
a
2
Reference your unidentified cbservation of 3 January 1965.
-
The information in ycur letter i3 not suffieient for evalua-
S8
-= a
tion. Request you completa the attached rrd Form l6h and
return it in the envelope provided. in
We vish to thank you for reporting your observation to the
Air Force.
L2s
T
Sincerely,
2104
2
T
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