PROJECT BLUE BOOK

PROJECT 10S7S RECORD PROJECT 1OS7S RECORD
1.GATETIME GROUP 1. ATETIME GROUP 2. LOCATION
San Pedro, Calirornia California (2 witnesses) (2 vitnesses)
30 Nov 66 1/0045
. SOURCE 10. CONCLUSION 10. . CONCLUSION
Civlian Possible (Hot Air) BALLOON Possible (Hot Air) BALLOON
4. NUMBER OF NUMBER OF OBJECTS
One
5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
Observer stated object appeared as a light. It appeared
5minutes lo seconds than the brightest star. Object brightness was
brighter object was white and
6.. TYPE OF OBSERVATION compared to that of the moon. The Object traveled in
a red center. Disappeared ver s slowly.
Ground-Visual northwest direction.
J a
COURSE
Northwest
8. PHOTOS
D Yes
No
2. PHYSICAL EVIDENCE
i7 Yos
No
FORM Previous editione of this form may bo used. Previous editions of this form may be used.
FTD SLP 63 0-329 (TDE) SCP63 0-329 (TDE)
.
.
.

time LaD pecciocly. :29Pm.
LCIA
2mo
o his is about all theipformation
cooporation Suncerely,

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:
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: 17. Tell in a few words the following things about the object:
a.SoundnAaui
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 experiment at the time of the sighting, how much
the object would have been covered by the match head?
1. Draw a picture that will show the shape of the object or objects. Lobel 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 drowing
to show the direction the object was moving.
7
Bottom O shaped
like a Ke
Hom UND gar aped
white white
0 a TOP TOP smoke SmOkE SmokE
BOTTOm BOTTOM
—
-

IF. you answered YES, then what speed would you estimate?.
Ne
. Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
Fyou answered YES, then how far away would you say it was?
here were you located when you saw the object? here were you locdied when you saw ine objeci? 3.Were you (Circle One) 23." were you (Cireie One)
Gircle One):
In the business section of a city? aIn the business section of a city?
inside a building In the residential section of a city? b.In the residential section of a city?
In a car In a car C. In open countryside? C. )n open countryside?
Outdoors Near an airfield?
In an airplone (type) In an airplane (type) eFlying over a city?
At sea f. F Flying over open country?
Other. g. Other_ Other_
# 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)
o. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? 40mph miles er her  u y loed
down
4.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No
Did you observe the object through any of the following?
. Eyegiasses No e. Binoculars Yes No
Sun glasses Yes No f. Telescope No
Windshield Yes No g. Theodolite Yes No
d. Window glass Yes No h. Other.
order that you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jects which, when placed up in the sky, would givethe same appearance as the object which you saw. "prateeep i me y woold gie.
a
regor regar _
1

X. A
Page 1
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 observed.
Please try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. Your name wili 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.
1. When did you see the object? 2. Time of day: 4 30 about
Hours Minutes
secord sar. fe Taksgwng
(Circle One): A.M. or P.M.
Day Month
3. Time Zone:
(Cirele
5.1 How was time in sight determined?
5.2 Was object in sight continuously? resxX No.
6.What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
Bright Bright a. Bright
5. b. Cloudy Cloudy b. Cloudy
7. IF you saw the object during DAYLiGHT, where was the SUN located as you looked at the object? 7. If you saw the object during DAYLiGHT, where was the SUN located as you looked at the object?
(Circle One)aIn front of you (Circle One):aIn front of you To your left d.
b. In back of you e. Overhead e. Overhead
c.To your right c. To your right f. Don't remember
FORM
FTD OCT62 164 This form supersedes FTD 164. jul 61. which is obsolete.
F

.
ORCE UFO FORM
Page 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
b. A few b.Dull moonlight
c. Many c. No moonlight-pitch dark
d. Don'tremember
.
9. What were the weather conditions at the time you saw the object? . What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): CLOUDS(Circle One): WEATHER(Circle One):
a Clear sky a. a. Dry cold cold
b. Hazy 5. 5. Fog, mist, or light rain
cScattered clouds c.Moderate or heavy rain c. Moderate or heavy rain
dThick or heavy clouds d. Thick or heavy clouds d. Snow
. e. Don'tremember
10. The object appeared: (Circle One):
a.Solid- bright d.As a light
b. Transparent e. Don'tremember
c. Vapor
If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer dDon't know
11.1 Compare brightness to some common object:
The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other.
Like a bright star
.Sharply outlined
d.Don't remember
Did the object: (Circle One for each question)
a.Appear to stand still at any time? Yes No Don't know
Suddenly speed up and rush away at any time? b.Suddenly speed up and rush away at any time? Yes No Don'tknow
c. Break up into parts or explode? Yes No Don't know
d. Give off smoke? Give off smoke? Yes No Don'tknow
e. Change brightness? Yes No Don't know
f. Change shape? Yes No Don'tknow
9. 9. Flash or flicker? Yes Yes No No Don't know
h. Disappear and reappear? Yes No Don't know
.

ohe 0 lower thar the axe point
neer
arcked
encndeatly
the Dtomic Energy Commeisiox
for to ihei righ(north)
V

questionnaire or a narrative explanation of your sighting.
wnoeher Joe
the eai,vas drier
inatker booked up ix = air
and said "Jneuer xae ayet
lke iclar it come
down / a eroked as
ciigls. straghs 11
itleheprgon wand zanet
for aban for aband hiles. dralledco draeledciox
daee ndoee and looted a andloosed a
adden
2top and yusr stayed There
.

Page 6
Have you ever seen this, or a similar object before. If so give date ar dates and location.
rRecer
3. 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:
treer
tt, 37ew 3ork 13760
Please give the follemina information about yourself:
NAME fuer
Last Name First N Middle Name
2 o1 nd
33. When and to whom did you report that you had seen the object? e husbaxd, huzbraxd,
Q a Ergerieer
Day Month Year Year the sashe day the sasie day
$1\{}1 cater
B

Official U.S. Air Force
Page 5
27. In the foilowing sketch, imagine that you are at the point shown. Place an "A" on the curved line to show how high the object
was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show how high the object was
above the horizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90 75°
N
45°
NW NE
_00B
w E
BRAASS
15 SW SE
JA 0 s
Draw a picture that will show the motion that the object or objects made. Place an A" at the beginning af the path, a "Bat 28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the beginning af the path, a "B" at
the end of the path, and show any changes in direction during the course.
e
scopped Auddenly A
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 traveling.
3

DATE: 18 December 1966
FROM: Raymond E. Fowler
TO: NICAP
Washington ce: APSC-FTT (TDETR)
Congressman W.li. Bates
ATTENTION: Richard Hall
Assistant Director
SIGHTING BACK OUND:
I met Mir. Richard Syemes after lecturing to a group at the First
Congregational Chrch. Sw . Massachusetts. Later I
dispatched Investigator Gary Storey to interview him. Fr. Symes
filled out the standard NIcAP UFO FoRM and signed it. A copy is
EVALUATION:
It is hard to say just what was observed. Neither observer saw the
objects arrive or leave I they seemed to hover with no motion
whatsoever. The wind was The wind was blowing blowing at at a good 20 knots, NE so clouds knots, NE so clouds
would have moved quite a distance would have moved quite a a distance in fifteen fifteen minutes. minutes. The lower
object seemed to be shimmering whil the smaller smaller object above it object above it
seemed non-reflective. It is possible that some type of mirage was seemed non-reflective. It is possible that some type of mirage was
witnessed. In itself there is insufficient evidence to indieate that witnessed. In itself there is insufficient evidence to indicate that
the report involves an authentie UFo. It is submitted for information the report involves an authentie UFo. It is submitted for information
purposes. It might serve as supplenentary evidence if other reports
are received for that time and date.
Resp Res mitted,
Rahond E. Fowler
Chairman: NICAP MASS SUECOM
.

ALLOON ALSO
S0 t Pedee Coliy.
U.S. AIR FORCE TECHNICAL INFORMATION I
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 observed.
Please try to answer as many questions as you possibly can formation that you give will
be used for research purposes. Your name will not be used in conne on 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.
When did you see the object? 1. When did you see the object? 2. Time of day: l.UCand 45 73
Hour Minutes Minutes
30 i1 1966 (Circle One): (Circle One): A.M. A.M. or P.M.
Day Month Year Year
3. Time Zone: Time Zone:
(Circle One): a. Eastern (Circle One): a. Eastern (Circle One): a. Daylight Saving
b. b. Central Central 6 Standard
c Mountain
Pacific
e. Other
4. Where were you when you saw the object?
San Pedro CaliFornia
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 0 5 10
Hours Minutes Seconds
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? was objecr in srgmr conmuousiy? Yes NoX
What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
a. Bright
b. Cloudy b.
7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? 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. Overhead
c.To your right f. Don't remember
FODU

Issved magazine or in anothar publication. Please try ver as many questions
pieas use anothersheel of paper. Please print or typewrite. Your asslstance is of great value and Is genulnely appreciated. Thank you.
Name Mr. Richard Symmes Place of Employment Durkee-
Addren 48 Pick-iok Hoad Occupation Controller
Marblehead, Maes. Educatlon Graduate Univereity of Mass.
Telephons 531-5852 Special Training
2. Date of Observation November 15, 1965 Time 7:15AM PM East Time Zone
3. Locality of Observation Beverly iiass.
4. How long did you see the object? : Hours 13 Minutes Seconds
5.
6. Positlon of the Sun or Moon in relation to object and to you. Sun "as in *12 east dor:
7 i-lblez
11. lif so, compare the brightnass with the
12. Did the object(s) - (Please elaborate, If you cen give details.)
a. Appear to stand still at any time?
b. Suddenly speed up and rush away at any time? No
c. Break up into parts or explode?
d. Give off smoke?
e. Leave any visible trail? so
F. Drop anything? No
g. Change brightness les
h. . Change shape? h. Change shape? io io
i. Change color? Change color? No No
13. of, or behind of, anything? if so, please elaborate giving distanca, size, etc, if possibla.
14. Was thare any wind?YeF Wes thare any wind?YeF if so, pleaze give diraction and speed. if so, please give diraction and speed. North East at: 20 Knota North East at: 20 Knots
15. 15. windshiold, ndowpane, storm window, screaning,
ate? NO ate? No What?
15. Did the object(s) have any sound? No What kind? What kind? How loud? How loud?
17. Please tell if the object(s) was (were) -
a. Fuxzy or blurred. No
b.. Like a bright star, NO

a. Self-luminous ? Ye E
b. Dull finish? No
c. Reflecting? Yee
Transparent? Nc
19. Did the object(s) in motlon? No
20. Tell the apparent size of the object(s) when compared with the following held at arm's length:
a. Pinhead d. Nickel ai Orange
b. Pea e. Half dollar Grapefruit
c. Dime f. Silver dollar 1. Larger
Or, if easier, give apparent size in Inches on a ruler held at arm's
21. in the directicn of Eeve
22.
23.
24. Cec n   n
25.
26. MNRO
Rock.
27. What was the elevation of the object(s) i
28.
32. date, if possibla) regarding this or simile arvatiors, or any other background materlal. material to you
33. the name and rank title of the oge is office, and
ook place. No
alaborate carefully. No
34. We should like permission to quote your name in connection with this report. This action will encouroge other responsibl We should like permission to quote your name in connection with this report. This action will encouroge other responsibl
citizers to report similar observations to NiCAp. However, If you prefer, we will keep your name confidential. citizers to report similar observations to NiCAP. However, If you prefer, we will Please not
your choice by checking the proper statement below. In any case, please fill In all parts of the form, for our own confidentic your choice by checking the proper statemant below. In any case, please flll In all parts of the form, for our own confidentic
files. Thank you for your cooperation. filos.Toapk vo tion
You may use my name. VYde Pleas keop my name fidential.
D11128

.
I
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.
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Page 2
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 . Bright moonlight
b.) 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? 9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): WEATHER (Circle One):
a. Clear sky a. a. Dry AND COLD
b. Hazy EasT Fog, mist, or light rain
c. Moderate or heavy rain
d.Thick or heavy clouds d. Snow
e. Don't remember e. Don'tremember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One): # soLId Lg
(a.Solid dAs a light # soLId Ggs
(a.)Solid D As a light
6. Transparent e. Don'tremember
c. Vapor
If it appeared as a light, was it brighter than the brightest stars? (Circle One):
Lag Brighter 2. About the same
SMALLO Dimmer Don'tknow
11.1 Compare brightness to some common object:
LESS b H +HN Moo bu Bi T
ArpLaNe FI. AWAK
.The edges of the objectwere: SLigthTLy
(Circle One): Fuzzy or b LYda
b. Like a bright star
Sharply outlined
d. Don't remember
Did the object: (Circle One for each question) (Circle One for each question)
a.Appear to stand still at any time? Yes No Don'tknow
b.Suddenly speed up and rush away at any time? Suddenly speed up and rush away at any time? Yes Don'tknow
c.Breck up into parts or explode? Yes Yes Don'tknow
d. Give off smoke? Yes No Don'tknow Don't know
e. Change brightness? Change brightness? No Dontk Gon't
f. Change shape? f. Change shape? Yey Pot Pou wor DEpENd INOON DEPENd INOON
9. Flash or flicker? Flash or flicker? Don'tknow S15
h. Disappear and reappear? h. Disappear and reappear? No Don't know
.

Page 1
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 observed.
Please try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. 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.
1. When did you see the object? 2. Time of day: C 45
Hours Minutes
23 NOV 1966
(Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One) Eastern (Circle One): Daylight Saving
b. Central O Standard
c. Mountain
d. Pacitic
e. Other
Where ere you when you saw the object?
AVE
Neal City or Town
5. How long was object in sight? (Total Duration) 0 12 O SEC
Hours Minutes Seconds
Certain Not very sure
Fairly certain
5.1 How was time in sight determined?
5.2 Was object in sight continuously? 5.2 Was object in sight continuously? Yes_ Yes No1/ No H
6.What was the condition of the sky? 6. What was the condition of the sky? IN EAST IN EAST
DAY NIGHT chouds
a. Bright a. Bright
b. Cloudy b. Cloudy b. Cloudy (SIGHTING IN S.TON.) (SigHTING IN S.TON.)
IF you saw the object during DAYLiGHT, where was the SUN located as you looked at the object? y sa e  dur DAYH wh was t  locat as y  at h ct?
(Circle One): a. In front of you . (Circle One): a. In front of you d. To your left d.To your left
b. In back of you e. Overhead e. Overhead
c. To your right f.Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164. jul 61, which is obsolete.

t
Page 2
8.1 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 Bright moonlight
A few 6. Dull moonlight
c. Many No moonlight - pitch dark
d. Don't remember Don't remember
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
@ Clear sky Clear sky Dry Dry
b. Hazy b. Fog, mist, or light rain
c. c. Scattered clouds Scattered clouds Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid D. As a light
b. Transparent e. Don't remember
c. Vapor
1. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
0 Brighter c. About the same
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
alnct as bright as the moon , but amaeler,
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)
a. Appear to stand Appear to stand still at any time? still at any time? Yes Yes No Don't know
b. Suddenly speed up and rush away at any time? Yes No Don't know Don't know
c. Break up into parts or explode? Yes Yes No (No Don't know
d. Give off smoke? Yes Yes (No (No Don't know
e. Change brightness? Yes Yes No No Don't know
. f. 5 Change shape? Yes Don't know
g. Flash or flicker? Yes ②29 Don't know
h. Disappear and reappear? Yes Don't know
.

(Circle One) Yes No
IF you answered YEs, then what speed would you estimate?. 400 MPH
21. Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
.In the business section of a city?
a. Inside a building In the residential section of a city?
b b. In a car c. In open countryside? C. In open countryside?
c. Outdoors Near an airfield?
d. In an airplane (type) d. In an airplane (type) e. Flying over a city? e.Flying over a city?
e. At sea f. Flying over open cou Nearbut
f. Other.
T.0T iN siGHTing AYed 1
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. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No
25. Did you observe the object through any of the following?
a. Eyeglasses e. Binoculars Yes No
.Sun glasses f. Telescope Yes No
C. Windshield g. Theodolite Yes No
d. Window glass Yes No h. Other
v
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 ob-
AN BUTitNould
AipLANE
AirpLANOT
BattWArds A
EX:
Dih, A traveli

27. In the following sketch, imagine that you are at the point shown. Place an "A" on the curved line to show how high the object
was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show how high the object was
above the horizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
$90$ 75
B PosiTivE
GMNOT SDEOF
NW NE
30
w E
BRAAs
Sw SE
-
S
28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the path, a "B at
the end of the path, and show any changes in direction during the course.
o
.

UFO
Pa3A5
30. Have you ever seen this, or a similar object before. If so give date or dates and location. NEXT Day
IN SciENce + MecHaNics PG 2ND REpo
NdS VEry siniLar SEE No. 35.)
31. Was anyone else with you at the time you saw the object? (Circla One) Yes No
31.1 IF you answered YEs, did they see the object too? (Circle On) Yes No
31.2 Please list their names and addresses:
ArE
AHLYN,. 05107
32. Please give ation about yourself:
NAME First Name Mi
ADDRESS N.08107
City Zone State
TELEPHONE NUMBER 12\rac2}$ SEX.
Indicate any additional information about yourself, including any special experjence, which might be pertinent.
I HAVE Beore tHis
AND WOULD QUESTIONAIRES.
- 31
33. When and to whom did you report that you had seen the object? N
3 EC 66
Day Month Year
JON. N.J ANY ROAD
00077
.

Official U.S. Air For
Pogs:
. Did the object disappear while you were watching it? If so, how? Bel rod AHose
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): Yes Don't know. IF you answered YES, then tely what
it moved behind:_ Hous 30-40F1 Wide APPro
.Did the object move in front of something at any time, pcrticularly a cloud?
(Circle One): Yes No Don't know. IF you answered YES, then tell what
in front of:_
17. Tell in a few wordls the following things about the object:
a. Sound_ NONE LSAN
0F
EMALL
-
1
.
L

20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
S1 IF you answered YES, then what speed would you estimate? #00 MPH
. Do you think you can estimate how far awcy from you the object was?
(Circle One) Yes No
IF you answered YES, then how far away would you say it was? wo? 2.5 M1
Where were you located when you saw the object? 22. Where were you located when you saw the object? 23. Were you (Circle One) Were you (Circle One)
(Circle One):
a.In the business section of a city? aIn the business section of a city?
a. Inside a building Inside a building b. b In the residential section of a city?
b b. In a cor In a cor c. In open countryside?
C. Outdoors Near an airfield?
d. In an cirplane (type) eFlying over a city? e.Flying over a city?
e. At sea f. Flying over open cout NEarbUT
f. Other
TOOT iN SiGHTing Ayed
2. 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. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No
2s. Did you observe the object through any of the following?
. Eyeglosses Yes No e. Binoculars Yes
b. Sun glasses Yes No f. Telescope Yes No
c. Windshield Yes No g. Theodolite Yes No
d. Window glass w glass Yes res No h. Other
AN AN BuTitu ould
AiPPLANE AirpLANE
AirpLANo Be FLyiNg
Bacti wArds BattwArds ) 1
Ex: EX:
Dir, G TraVEL G Icd NL)

Page 1
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 observed.
Please try to answer as m questions as you possibly can. The information that you give will
be used for research purposes. 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.
1. When did you see the object? . When did you see the object? Time of day: Time of day: C 45
Hours Minutes Minutes
23 NOV. 1966 1966 (Circle One): P.M. P.M.
(Circle One): A.M. or
Day Month Year Year
3. Time Zone:
(Circle One) (Circle One)) Eastern (Circle One): Daylight Saving
b. b. Central 6. Standard
c. Mountain
d. Pacitic
e. Other
Where were you when you saw the object?
AVE OAK LYN Cansdencounty NJ
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) Q 120 SEC
Hours Minutes Seconds
Certain c. Not very sure
6.Fairly certain
5.1 How was time in sight determined? watc
5.2 Was object in sight continuously? Yes_ NoV/
6.What was the condition of the sky? IN EAST
DAY NIGHT clouds cLOUAS DDT
a. Bright .Bright a.Bright
b. Cloudy b. Cloudy (SIGHTING IN S.TON.) (SIGHTING IN S.TON.)
IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? IF you saw the object during DAYLGHT, 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. Overhead
c. To your right f. Don'tremember f. Don'tremember
FORM This form supersedes FTD 164. jul 61, which is obsolete.
FTD OCT 62 164
1
9

Page 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):
None Bright moonlight
5 A few b. Dull moonlight
C. Many c.No moonlight—pitch dark
d. Don't remember dDon'tremember
. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One):
a.Clear sky a. Clear sky G.7 a.7 7Dry Dry ANP HNP
b. Hazy EasT Fog, mist, or light rain .Fog, mist, or light rain
c Scaterd loudsiN s c. Moderate or heavy rain c.Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared:(Circle One): 10. The object appeared: (Circle One):
# soLId # soLId L4g
a. Solid a.Solid As a light
. Transparent 5. Transparent e.Don'tremember e. Don'tremember
c. Vapor c. Vapor
1. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
Lag Brighter 2 About the same
SMAL Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
T HHay MooN bu B Ta
ATKDLaNE F AWHY
The edges of the objectwere: sLighTLy
(Circle One): Fuzzy or bered ada
Like a bright star
Sharply outlined
Don't remember
Did the object: (Circle One for each question)
a. Appear to stand still at any time? a. Appear to stand still at any fime? Yes Yes No Don't know Don'tknow
b. Suddenly speed up and rush away at any time? bSuddenly speed up and rush away at any time? Yes Yes Don'tknow Don'tknow
c. Break up into parts or explode? c. Break up into parts or explode? Yes No Don't know Don't know
dGive off smoke? d. Give off smoke? Yes No Don'tknow Don'tknow
e. Change brightness? Change brightness? No pont poRe
f. Change shape? Yes Yey PR owaN
g. Flash or flicker? Don'tknow ANCLVSIS ANELVSIS
h. Disappear and reappear? No Don't know
1
.

4 3
UNIDENTIFIED FLYING OB- merlen said the UFO appear-
JECT PHOTOGRAPHED-Pe- ed to be about 18 feet across,
ter Kaemmerlen, 15, who lives flying at a height of some 50
off Wilson Place, Cornwall, feet and was blueish gray in
is believed to be the first per- color, but did not glow as
son in town to have sighted some of the "flying saucers
and photographed a UFO. were reported to do where
Above is the proof, substantiat- they were sighted in the War-
ed by Paul Wilson of Cedar wick and other areas. After
Lane, who also saw the flying he got his shot of the flying
object. Top photo shows the object he said it slowly turn- .
dise approaching the Daniel ed south and then with incred-
Neal home on Wilson Place ible speed took off and disap-
and the bottom is an enlarge- peared over the Storm King
ment. Peter told The Corn- Mountain horizon. The youth
wall Local reporter that he did not mention his experience
was taking pictures with his was taking pictures with his to anyone until he developed ntion nis experience
Argus Instamatic camera and the film in his darkroom and the film in his darkroom and
standing in a lot below the made prints of the UFO in the =
LeRoy Wilson home at 3:30 LeRoy Wilson home at 3:30 Cornwall Central High School
p.m. Friday when he was darkroom, so that he would darkroom, so that he would
startled by a flying disc com- have photographic proof to
ing towards him from tre vi- ing towards him from tre vi- show. Pete vows it was the
cinity of the Hudson River. As real thing and not a garbage
i approached the Neal home can lid tossed in the air, as
it seemed to pause momentar- some of his classmates jok-
v  long enough for him v ,long enough for him to ingly charged.
betaheKaemmerion) obetahe Kammerion)

IF you cnswered YES, then how far away would 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?
(b. In a car a. 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?
f. Other g. Other.
24. IF you were MOVING IN AN AUTOMOB!LE or other vehicle ot the time, then complete the following questions:
24.1 What direction wer
a. Eyeglasses Yes No e. Binoculars Yes
b. Sun glasses No
Yes No f. Telescope Yes No
© Windshield Yes. No g. Theodolite Yes No
d. Window glass Yes No h. Other_
-
In order that you can give as clear a picture as possible of what you saw, describe in your own words a com  r .
jects which, when placed up in the sky, would give the same appearance as the object which you saw.
A light which iReATicHily clinnged IoTewsiTys Sren
DIM TOUERY BRiGUT, AND DRRTED DIM TOUERY BRiGHT, AND DRRTED AbouT AbOuT AT UARYINj AT UARYING
specds, specds,
E

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: whewiT DistppegRed cwer The bekizin
bcbind a ridge of hills
Dte mo ont  h  y tpiclar c?
(Circle One): YesNo Don't know. IF you answered YES, then tell what
in front of: when iT Mooed iN SrowT CE sTARS
17. Tell in a few words the following things cbout the object:
a. Sound_ DiDNT NCTice RNy.
. Draw a picture that will show the shape of the object or objects. Label and include in your sketch any details of the abject
that you sow such as wings, protrusicns, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving.
clecTric bulb cicald in A otRkened rocin.
hu
7

Page 3
14. Did the object disappear while you were watching it? If so, how? et seuty
to yea,
staitid
.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:
Did the object move in front of something at any time, particularly a cloud? 1. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes 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. Soundny0 a.Soundn ..
b. color slt wras ditito cvith a red cinter.
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 experiment at the time of the
sighting, how much of the object would have been covered by the match head?
the tshole match head
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.
CATALINA

Page 2
8 IF you saw the object at NiGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circie One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few Dull moonlight
G Many c. No moonlight—pitch dark
d. Don't remember 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 @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'tremember
The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other_
Like a bright star
c. Sharply outlined
d. Don'tremember
Did the object: (Circle One for each question)
a Appear to stand still at any time? No Don'tknow
5. 5. Suddenly speed up and rush away at any time? Yes No No Don'tknow
C. Break up into parts or explode? Yes Yes No Don'tknow Don'tknow
d. Give off smoke? Yes No Don't know Don'tknow
e Change brightness? Yes No Don'tknow
i. f. Change shape? Change shape? Yes No Don't know
g. Flash or flicker? Yes No Don'tknow
h. Disappear and reappear? h. Disappear and reappear? Yes No Don'tknow Don'tknow
.

/
Page 1
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 observed.
Please try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. 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 dctails.
1. When did you see the object? 2. Time of day: 15 (approx.)
Hours Minutes
25 11 66 (Circle One): P.M.
A.M. or
Day Month Year
5. How long was object in sight? (Total Duration) !U
Hours Minutes Seconds
a. Certain c. Not very sure
Fairly certain d. Just a guess
5.1 How was time in sight determined? esTimnTe
5.2 Was object in sight continuously? Yes No
6.What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHL
a. Bright a. Bright a. a. Bright
b. Cloudy 5. 5. Cloudy Cloudy
IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? 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 dTo your left dTo your left
b. In back of you e. Overhead
c. To your right f. Don'tremember f. Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164, jul 61, which is obsolete.

Official U.S. Air Force
Page 5
above the horizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90 75°
N
$$\fra{}$
NW NE
30 B
w E
A
15o SE
0° S
29. IF there was MORE THAN ONE abject, then how many were there?_ BNly oe
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

1
UFO form continued
Page 6
a
No
Was anyone else with you at the time you saw the object? (Circle One) No
31.1 IF you answered YES, did they see the object too? (Circle One) Ce No
31.2 Please list their names and addresses:
Mr+Mrs Nic M. HANse
RR.AI KR.HT
ArCAiLA Wiscousio ArCALA Wiscossio
54012
32. Please give the following information about yourself: Please give the following information about yourself:
NAME First Name Middle Name
Last Name Middle Name
ADDRESS RR. Areadin Wis.
City Zone State
TELEPHONENUMBER AGE_ 20 SEX M
Indicate any additional information about yourself, including any special experience, which might be pertinent.
iN US.NA0y CN BUHR& U.S.S.SARATOGACCUH-GO)
33. When and to whom did you report that you had seen the object?
N00Ne No oNe
Day Month Year

becrise
Asked then is they knew what it would be.
cF iTs brighT Ae55
Also changed. SineTines very bighT, ANDSOie-
Times gaiTe Din. guiTe oin. BOTh of ThESE HETIONS DiDNOT
Seen 7 To hauC ANY sET PATTeEN. DATTeEN.
BoTh
suile suile IT IT

sevem
oebe beach
iwhon nnd cre to
tyes 2s2 sties in A
3tar
222 he rpeed

1 - 14 DECEMBER 1966 SIGHTINGS
3
DATE LOCATION. OBSERVER EVALUATION
Dec Brandon, Florida Insufricient Data
Dec Philadelphia, Pennsylvania Insufficient Deta
Dec Delaware Memorial Bridge, Delaware Insufficient Data
Bessemer, Michigan Insufficient Data
Beachwood, New Jersey Aircraft
San Mateo, California Aircraft (Possibl)
Hopedale, Massachusetts a wek Aircraft (Possibl)
Honda Canyon Road, California Other (GROUND LIG
Minneapolis, Minnesota Insufficient Data
Kloten, North Dakota Other (FIREWORKS)
Holly Hill, Florida Insufficient Data
Houma, Louisiana Insufficient Data
7 Denver, Colorado re Astro (SIRIUS)
8 Springfield, Ohio Multiple Multiple Aircraft (Possibl Aircraft (Possibl)
9 California, Nevada California, Nevada Multiple Other (ARTIFICICL)
CLOUD REL
9 Johnson City, Tennessee Aircraft (Possibl
10 Phan Rang, Republic Viet Nam Phan Rang, Republic Viet Nam Mil Astro (METEOR)(FT
13 New York City, New York Aircraft (Possibl) Aircraft (Possibl
13 Miles City, Montana Multiple Astro (SIRIUS)
13 Boulder, Colorado Multiple Multiple Astro (SIRIUS) Astro (SIRIUS)
Dallas, Georgia Multiple Aircraft (Possibl
Dayton, Ohio Multiple Aircraft
ADDITIONAL REPORTED SIGETINGS (NOT CASES)
DATE LOCATION SOURCE EVALUATION
Dec Wichita Fal ls, Texas TO) Chemical or water
Dec Denver, Colorado
Dec Grand Rapids Michigan
Dec Iran
Dec Toledo, Ohio
1 Middleboro Center, Massachusetts ha
12 Dodge City, Kansas
12 Fairhauem, Massachusetts
13 New Milford, Pennsylvania
13 S. O. Plfd., New Jersey

.
Page 4
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?
Do you think you can estimate how far away from you the object was?
(Circle One) Yes) No
IF you answered YEs, then how far away would you say it was?
2. Where were you located when you saw the object? . 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?
b.I In a car In open countryside?
Outdoors dNear an airfield?
d.In an airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other _ g. Other
a. Eyeglasses Yes Binoculars Yes
b. Sun glasses Yes 8299 f. Telescope 99
c. Windshield Yes g. Theodolite
d. Window glass Yes h. Other
2In order that you can give as clear a picture as possible of what you saw, describe in your own words a common
aqlnt oge agiont aige rucol rol hof coal
Lights Lights

Pago 5
.In the following sketch, imagine that you are at the point shown. Place an "A" on the curved line to show how
high the object was above the horizon (skyline) when you first saw it. Place a "B on the same curved line to
show how high the object was above the horizon (skyline) when you last saw it. Place an "A"" on the compass
90.
75°
5 NW NE
E
15° -15° SW
S3
path, a "B" at the end of the path, and show any changes in direction during the course.
Fide A A
2. IF there was MORE THAN ONE object, then how many were there? dn
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
.

Paga 6
.Have you ever seen this, or a similar object before. If so give date or da lates and location.
no ——
Yos 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:
.Please give the following information about yourself: 32. Please give the following information about yourself:
NAME NAME
Last Name First Name Middle Name
ADDRESS SarPedro Califoria
Street City Zone State
TELEPH AGE13 SEX MAle
tyditinal aabu urecud  expein wht  pert.
am
rerd 107s books Abaut them
When and to whom did you report that you had seen the object? 3.When and to whom did you report that you had seen the object? mY Parest MY Parests
30 n0irMBEC1966 NOUrMBEE 196
Day Month Year

Page 7
34. Date you completed this questionnaire: 1967
Day Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting.
an aiplare etaited to
it aind then
disappiau.
I

3o No66
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AF3C)
WRIGHT.PATTERSON AIR FORCE BASE. OHIO 4S433
HEPLY TO TDET/UFO 15 March 1967
ATTN OF
Observation, 30 Nov 66 30 N00.66
SUBJECT UFO
San Pedec, Calif.
TO:
San Pedro, 90732
Reference your unidentified observation. The information which Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation. we have received is not sufficient for a scientific evaluation.
Request you complete the attached FTD Form 164 and return it in Request you complete the attached FTD Form 164 and return it in
the envelope provided. Thank you for reporting your observation
to the Air Force.
JAMES C. MANATT, COlOnel, USAF JAMES C. MANATT, COlOnel, USAF 1 Atch 1 Atch
Director Director of Technology alo and Subsystems Subsystems FTD Form 164 w/envelope
1
.
3
2