PROJECT BLUE BOOK

PROJECT JUU/S RECURD
1. DATE · TIME GROUP 2. LOCATION
20 Jan 67 21/0205Z Spencer, Indiana one witness
3. SOURCE 10. CONCLUSION
Civilian Insufficient Data for evaluation! mk
1. NUMBER OF OBJECTS 1
one
5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
5 minutes
6. Cbserver reported a red and yellow flickering object
TYPE OF OBSERVATION that was observed for about 5 minutes. It did not
Ground Visual disappear but was to have fallen to the earth. The
7. COURSE observer had been seeing them all summer. She has
reported various sightings to the local authority
Downward but no action has been taken.
9. PHOTOS
D Y.s D Ys
2. PHYSICAL EVIDENCE EVIDENCE
i7 Yos
XXNo
FORM FORH
FTD SEP63 0-329 (TDE) FTD SEP 63 0-329 (TDE) Previoua editions of thla form may bo usod.

information as possible concerning tha unidentifiod aarial phenonenon that you havo ol nervei.
Ploass try to onsw any questions as you possibly can. The information that ycu give will
ba used for ressarch rposes. Your name will not bo used in connection with any statemenis,
conclusions, or publications without your permission. We roquest this parsonal information sc
that if it is deemed n nacossary, , ws may contact you for further details.
1. When did you see tho object? ?. fime of
Hour Minuina
1412 (Circle One): A.M. or F.M.
Day Month Your
3. Tima Zone: X!
(Circle One): a. Eastern (Circle Une):a. Doylight Saving
b. Central b. Standard
c. Mountoin
d. Pacific
o. Other
4. Where were youg7 n you saw the object?
stal Address City or Town State or Counly
5.2 Was objeet in sight continuously? Yos No_
What was
DAY NIGHT
o. a. Bright
b. Cloudy b. Cloudy
7. IF you sow the
(Circla Ona): a. In front of you d. To your left
b. In bock of you o. Overhaad
c. To your right f. Don't romember
FORM
FTD OCT 62 164 Thie form suparsedes F ich in obsolete.

CLOUDS(Circle Ona): WEATHER (Circls One):
a. Cloor sky 0.Dry
b. Hazy B. Fog, mist, or light roin
c. Scatter-d cloods Moderote or haavy rain
d. Thick houvy cloud Snow
0. Don't romamber
10. The abjeci appaarad: (Circle Ono).
o. Solid d. As a light
. Tronspoiont e. Don't romamber
c. Yopor
11. If it appeorrd as a light, was it brighter than ths brightest stars? (Circle One):
G. Brighter . Brighter c. About the same
b. Dimmer d. Don't know
-
LinY AFL
12.The odges ai the objoct were:
(C.iclo (ne) a. Fuzzy or blurrod . Other
b. Like a bright stor
C. Sharply outlined
c. Don't ramomber
Did the objeet (Circls One for eoch question)
a. Appear to stand still at any time? Yos No Don't know
b. Suddanly speed up and rush awcy at any time? Yes No Don't know
c. Break up into parts or exploda? Yes No Don't know
d. Give off smoke? Yos No Don't know
e. Change brightness? Yos No Don't know
f. Change shope? Yos No Don't know
g. Flosh or flicker? Yea No Don't know
h. Disappear and reappear? Yes No Don't know

Pagn 3
11
15. Did the object move something at any time, particulurly a cloud?
(Circle One): Yes No Don't Know. IF you onswered YEs, then tall what
it moved behind:
(Circle One): Yes No Don't Know. IF you answered YES, then e! 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 objoct and nr 'ow
much of the bject is covered by the head of the match. If you had performed this exporiment at the tin: i ti.
sighting, how much of the object would have been covered by the match head?
1. Draw a pleture that will show the shape of the objoct or objects. Label and includa in your sketch any dotails
of the abjeet thar 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.
ON

(Circle One):
a. in the business section of a city?
o. Inside  building b. 1 In the residential sucticn si a city?
b.In a car c. In open countryside?
c. Outdoors d. Near an airfisld?
d. In on airplano (type) a. Flying over a city?
e. At seo f. Flying over opon country?
1. Other g. Othor -
24. IF you wore MC AN AUTOMOBILE or other vehicle time, then complete the foll queations;
ircle Ona)
. North c. East . South y. West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fost were you moving? miles per hour.
24.3 Did you stop at any timo while you ware looking at the objoct?
Yos No f. Telescopa
c. Windshlald Yes No g. Thoodolito Yes
d. Window gloss Yes No h. Other
hlch you sow

show how high the objoct was above ths horizon (skyline) when you last suw it. Ploce an "A on the compass
9O 73
6
NW NU
15 aw
n boginning ot she
poth, a "g" at the ond of the path, and show any changes in direction during the course.
DE
Pep

(Circle Ona) Yos No
31.2 Pleoso list thair names and addrasses:
de&ynomel
tonigf. age
32.Please give tha following infermation obout yourself:
NAME
Last Nama Firat Nama Middl Numa
ADDRESS Stroot Zona Stotu
City
AGE 37 SEX
bid
Indeats any odditional Information about yourself, Including any special exparience, which might b pertinanr.
C2lw 1
-t d2ly C17 red
Day Month Yoar

Poga7 /
34. Date you c Day Month Yeur
questionnaire & a narrative explanation of your sighting.
J
laylight to
ogbll ilndl0
li fill /
1.d
punaty
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