PROJECT BLUE BOOK

.
N
PROJECT 10M73 RECORD
.Y
1. DATE-TIME OROUP 2. LOCATION
31161/01102 Petreon. iJeny
I3. SOURCE 10. CONCLUSION
Civilin Aircreft(possisle)
4. NUMBER OF OBJECTS
*
5. LENGTH OF 5. LENGTH OF OZSEL VATION ii. BRIEF SUMMARY AND ANALYSIS
Cnuse
Coservers wetch i a white eoloh-d object aith a d o Coservers wetch: i a white eoloh-d object aith a d d
6. TUPE OF OSSERVATION 6. TYPE OF OBSERVATION travel towerd the iM portion or th travel towerd the tM portion or th toy, There ws Y ty, There
Cround Vitual Craund Vieual sound during the antirs oblarvetion. Th- objeoe an ilr- sound during the antirs oblurvetion. Th- objeoe ann llr
7. a flashlight at t fairly eloso distince.
COURSE
' '
G. PROTCS C. PROTOS
D Yos
E No
2. PHYSICAL EVIDENCE
ti Yes
-

AIRCRAFT FORCE
DEPARTMENT OF THE AIR
HEADQUARTERS FOREIGN TZCHNOLOGY DIVISION (AVSC)
WRIGHT-PATTIRSON AIR FORCE BASX. OHIO 45433
REPLY TO TDET/UFO
ATTN OF
SUBJECT UFO Observation
1Jale7
TO
Paterson
Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation.
Request you complete the attached FTD Form 164 and return it in
the envelope provided. the envelope provided Thank you reporting your observation your observation
to the Air Force.
of
JAMES C. MANATT, COlOneL, USAF 1 Atch
Director Director of Technology and and Subsystem3 FTD Form 164 w/envelope

DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVIBION (AFSC)
WRIGHT.PATTERSON AIR FORCE BASZ. OHIO 4S433
REPLY TO
ATTN OF TDET/UFO
SUBJECT UFO Observation
TO
Paterson, New Jersey
Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation.
Request Request you complete the attached you the attached FTD Form 164 and return it in FTD rorm ara 1c ln
the envelope provided. the envelope provided. Thank you Thank you for reporting report your observation your observation
to the Ai to the r Force. ce
JAES C. MANATT, COIONel USAF 1 Atch
Director of Director Technologs echnolog: Subsystems FTD Form 164 w/envelope
,

"Two boys, residents of the South Paterson section of the city, spotted
what they elieved a.UFo shortly aiter 9 p.m. iWednesday night.
ML 12, of seventh grade student in St.
Agnes Grammar School called_the News as soon as he returned home after
viewing the trange site. sabd that he and his friend,
were walking on ue near
Park Street, shortly after 9 p.m. when they spotted a rather large, dim
glowing object in the sky. He said the object had a red center and hover-
ed about one minute in one then move pidly unti disap-
pered from view."
We might add something that was not mentioned article,
the object was close enough to the ground that a person would be able
to hear som sort of noise, but there was none.
Sincere
(
S

U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so that you can give the U.S. Air Force as much
informat an as possible concerning the unidentified aerial phenomenon that you have observed.
Pleose try any questions as you possibly can. The information that you give will
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.
=2= P SETTVALTAE
1. When did you see the object? Time of day: L4
Hour Minutes
Miry (Circle One): A.M. or P.M.
Doy Montl Year
.
3. Time Zone: . Time Zone:
(Circle One): a. Eastern (Circle One): a. Daylight_Saving DaylightSaving
b. Central (Standard
c. Mountain Mountain
d. Pacific Pacific
e. Other
4. Where were you when you saw the object?
PATERSON CCSE
Neares: Postal Address City or Town State or County
5.how long was object in sight? (Totel 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 objeer in sight continuously? No
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 DAYL , where was the SUN located as you looked at the cbject?
(Circle One): a. In front of you d. To your left
b. In back of you e. Overhead
To your right f. Don't remember
FORM
FTD OCT 62 164 Thla form supersedes FTD 164, Jul 61, which is obsolete.

a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Mary C. No moonlight - pitch dork
d.Don'ramamber - d. Don't remember
9.What were the eather conditions at the time you saw the o object?
CLOUDS (Circle One): WEATHER (Circle One):
a.Clear sky o. Dry
b. Hazy b. Fog, mist, or light rain
Scattered clouds c. Moderate or heavy rain
Thick or heavy clouds d. Snow
e. Don't remember
10. The cbiect appeared: (Circle One):
a. Solid d.(As a light
b. Tronsparent e. Don't remember
c. Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a.Brightar c. About the same c. About the same
. Dimmer . Dimmer d. Don't know
11.1 Compare brightness to some comman object:
Conho
1.The edges of the object were:
(Circle One): c.(Fuzzy or blurred e. Other
b. Like a bright stor
. Sharnly outlined
0. Don't remember
. Did the object: (Circle One for eoch question)
a. Appeor 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

Poga 3
If so, how?
15. Did the abiect move behind somothing at any time, porticularly a cloud?
(Circle One): Yes (No Don't Know. IF you answared YEs, then tell what
it moved behind:
16. Did the cbiect move in front of something at ony time, porticularly a cloud?
(Circle One): Yes No Don't Know. IF you onswared YES, then tell what
in front of: _
17. Tell in a few words the following things about the object: 17. Tell in a faw words the following things about the object:
a. Sound . a. Sound
b. Color
.We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how 8. 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 parformed this expariment at ths time of the much of the object is covered by the head of the match. If you had performed this expariment at ths time of the
sighting, how much of the object would have been covered by the match head? 0712
.Drow 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 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.
cntsile

No
22. Where were you located Were you (Circle One)
(Circle One):
o. In the business section of a city?
Inside a building b. In the residentia! section of a city?
In a car c. In opon countryside?
c. Outdoors d. Near an airfiold?
d. In an airplane (type) e. Flying ovar a city?
e, At sea f. Flying over open country?
F. Other g. Other
.IF you were MOVING IN AN AUTOMOBiLE or other vehicle ot the time, then complete tha following questions:
24.1 What direction were you moving? Circle One)
a. North c. East e. South g. Wost
. Noctheast d. Southeast f. Southwest h. Northwest
a. No e.
b. Sun glasses Yes No f. Telescope Yes No
c. Windshleld Yes No g. Theodolite Yes No
d. Window gless Yes No h. Other
g d 6in

Pag• 5
27. In the following sketch, imagine that you are at tha point shown. Place an "" on the curved line to show how
high the object was above the horizon (skyline) when you first saw it. Place a "B" on tha same curvad line to
show how high the object was above the horizon (skyline) when you last saw it. Place an "" on the compass
when you first saw it. Place a "B' on the compass where you last saw the object.
90° 75°
60°
4501 NW NU
30
-15 SW
Draw a picture that will show the motion that the object or objects made. Place an "A at the beginning of the
path, a "g" at the end of the path, and show any changes in direction during ths course.
D
29. IF there was MORE THAN ONE object, then how many were there? -
Draw a picture of ho ey were arranged, and put an arrow to show the direction that they were traveling.

(Yes No
Yos No
31.2 Ploose list thair names and addresses:
Fatsen alidde Mal Ger
NAME NAME
Last Name First Name First Name Middlo Nome Middla Nome
ADDRESS ADDRESS Doi
Stroet City Zone Zone State State
TELEPHONE NUMBER SEX LEL
information about yourself, experience, which might be pertinent.
Wid 31 May 1567
Day Month Yoar

. I
Poge 7
34. Date you comp s questionnaire: /3 JeCLL
Day Month Year
35. 1 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.
C tl naf bedave dike
plane af imy tjpe

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 possib concerning the unidentified aerial phenomenon that you have observed.
Please try to ansy ny questions as you possibly can. The information that you give will
be used for research urposes. 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.
B T1=:
-T- =1-*
9 2 10
When did you see the object? Time of day: a
Hour
31 Miy 1867 (Circle One): A.M. or P.M.
Day Montb Year
3. Time Zone: 3. Time Zone:
(Circle One): (Circle One): @. Eastern a. Daylight Saving a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other Other
4. Where were you when you saw the object?
Paterson PAteRson Prsine, NewJecs 2, NawJecsd
Nearest Postal Address City or Town State or County
5.How long was object in sight? (Total Duration) 2 15
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? pistpurtd
5.2 Was objeet in sight continuously? Yes No
What was the condition of the sky?
DAY NIGHT
a. Bright a. Brighn
b. Cloudy b. Cloudy
7.IF you sow 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 621 164 This form supersedes FTD 154, Jul 61, which is obsolete.

to indicate our planet has or is being visited by - OV - estrial
vehicles. UFOs do exist; but in reports only. vehicles. UFOs do exist; but in . 251 reports only.
21/1701 force's UFO program. orce's UFO program.
Thank you for interest interes
It Sefraii 1feun 9

and siveial thirs whe
me at diffennt tinee.
She prominant
olijeal I
betiveen home
The ob hen 2 Siat Steed t
abent sesl strcct liakt
hi shaped as
adell orane ned. Iatahed
through a sererof
mank O approtimately hakfor
1 hour,
Somethiig, It
1

the sont at abouta
30° angle to the
Bnt then here it had
topped the appeared oncthe
one evhs repiated the change in
light and Jollowed
uintil they dad gone.
ne proon or cloude tobe
el ,
Sx binshulars.
Ior about a wick after, both
iny watahed seveial
1FOs which wer in Sros
Thrces flying at 2 vey high attibede.
.

contaating yow
have
om in the hir Fome now and
of think I cocntry
A3
in er skig that docsnt thve.
Oun duty is to reten
throughout
I thaik meve 1 lost that goal
rderstand. .
what we dont
to epcopt thank you for you time.
39534

velopments, giving about visito
ou
Miami
-
"THE END"
151
CTORS_&_EDITORS_
This dramatic tape recorded interview, with narration by Mark of Mark-Age, then will be
made available as a syndicated, special feature program throughout the world. Newspaper
Inform-Nations, 327 N.E. 20 Terrace, Miami, Florida 33137. Thank you.

20man67 Page 1
U.S. AIR FORCE TECHNICAL INFORMATION B. IF you saw the object
L 8.1 STARS(Circle Ont
This questionnaire has been prepared so that you can give the U.s. Air Force as much a. None
Information as possible concerning the unidentified aerial phenomenon that you have observed. b.Afew
Piease try to answer as many questions as you possibly can. The information that you give will C. Many
be used for research purposes. Your name will not be used in connection with any statements, d. Don'treme
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. . What were the weath
CLOUDS (Circle One):
When did you see the object? 2. Time of day: a. Clear sky
Hours Minutes b. Hazy
elonT c. Scattered clouds
20 may 1467 (Circle One): A.M. P.M. d.Thick or heavy clou
Circle One): or
Day Month Year
10. The object appeared:(
3. Time Zoner (Circle One) a. Eastern (Circle One:_a. Daylight Saving (Circle One:_ a. Daylight Saving a. Solid
b. Central b. Standard b. Transparent Transparent
C. c. Mountain Mountain c. Vapor
d. Pacific
e. Other e. Other
11. If it appeared as a lig
4. Where were you when you saw the object? 4. Where were you when you saw the object? aBrighter
HoL/CHiLD SeHtoOL SUFFERN, N.Y. s1 b. b. Dimmer Dimmer
/ Nearest Postal Address City or Town State or Counry 11.1 Compare brightn
(Tatal Duration)
Hours Minutes Seconds
a. Certain c. Not very sure 12. The edges of the objec
Fairly certain d. Just a guess (Circle One): a. FL
5.1 How was ime in sight determined? e uted Leln b.Li
Tent doson c. St
5.2 Was ocject in sight continuously? Yes_- No tee liise Uncl d. D.
6. What was the coreition of the sky? Did the object:
DAY NIGHT a. Appear to stand st
Bright a. Bright b. Suddenly speed u
b. Cloudy c. Break up into part
d. Give off smoke?
7. IF you saw the sbject during DAYLIGHT, where was the SUN located as you looked at the object? Change brightnes
f. Change shape?
(Circle One): a. in front of you d. To your left Flash or flicker?
b. In back of you e. Overhead h. Disappear and ret
c. To your right f. Don'tremember √
FORM This form supersedes FTD 164, jut 61, which is obsolete.
FTD OOCT 62 164

I Paga 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 MOQN (Circle One):
a. None a. Bright moonlight
b.)A few 5. 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. Clearsky didet JDry
b. Hezy . Fog, mist, or light rain
c. Scattered clouds Dfer c. Moderate or heavy rain
Thick or heavy clouds d. Snow
e. Don't remember
a. Solid a. Solid ddAs a light ddAsa light
b. Transparent e. Don'tremember
c. C. Vapor
1. I it appeared as a light, was it brighter than the brightest stars? (Circle One): 1I it appeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common abject:
alnitu lisit an a lan Leadlisns
12. The edges af the object were:
(Circle Onek a. Fuzzy or blurred omer Caut tell
. Like a brightstar
Sharply outiined
d. Don'tremember
13. Did the objects (Circle One for each question)
a. Appear to stand still at any time? Yer. No Don't know
b. Sucdenly speed up and rush away at any time? YoMco Don't know
c. Break up into parts or explode? Yes No Don't know
d. Glve aff smoke? Yos No Don't know
. Change brightness? Y0s No Don'tknow langee
f. Change shape? Y02 No Don't know
. Flash ar flicker? Yos Don't know
h. Disappear and reappear? Yes) No
tistnlit
Kol tn0
&hen Caed wits
Vdgaien
1

5ade
21. Da you think you can es
(Circle One)
(Circle One): Yes/ No Don't know. IF you answered YES, then tell what
IF you answered YES, th
it moved behind:
Tees ly
22. Where were you lacated
(Circle One):
16. Did the obiect move in front of something gtany 16. Did the obiect move in front of something gtany time, particularly a cloud? time, particularly a cloud? aInside a building aInside a building
(Circle One): (Circle One): Yes No) No Don't know. Don't know. IF you answered YES, then tell what b_In a car
c. Outdoors c.Outdoors
in front of:. in front of: d. In an airplane (type)
e. Atsea e. At sea
f. Other f. Other
17. Tell in a faw words the following things about the object: so: d ondy
a. Sound. wore none t oly 24. IF you were MOVING IN
b. Color. b. Color 24.1 What direction were
o. North a. North
b. Northeast
18. 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 Hold atch stick at arm's lenath in jine with a known ohiect and note
object is covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of 24.2 How fast were you n
the object would have been covered by the match head? 24.3 Did you stop at any
(Circle One)
ine
.Did you observe the object
Eyeglasses
19. Draw a picture that will show the shape of the object or objects. Label and include sketch details of the object Sun glasses
in your any c. Windshield
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. d. Window glass
26. In order that you can give.
a light jects which, when placed
mnly
shipe

Page 3 Poge 4
Do you think you can estimate the speed of the object? When did nre
we (Circle One) Yes No
2abort F you answered YES, then what speed would you estimate?
Sam
21.
(Circle One) Yes No
what Wist a Dide high O
you answered YEs, then how far away would you say it was?
Where were you located when you saw the object? 2 Were you (Circle One) Stueelti
(Circle One): a. In the business section of a city?
Inside a building Inside a buiding b. D. In the residential section of a city? 1n the
what bIn a car b_In a car c. C. In open countryside?
c. Outdoors d. Near an dirfield? ny
d. In an airplane (type) e. Flying over a city? Flying aver a city?
e. Atsea f. Flying over open country?
f. Other. f. Other. g. Other
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 e. South g. West g. West
b. Northeast d. Southeast f. Southwest h. Northwest
how much of the how much of the wLA
ting, how much of 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 Yes No e. Binoculars Yes No
o. Sun glasses Yes No f. Telescope Yes No
letails of the object No Theodolite Yes No
eside the drawing C. Windshield g.
c. Windowglass Yes No h. Other
26in order mat you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
t which, when placed up in the sky, would givethe same oppearance as the object which you saw.
a light in the pley
/ inly

Official U.S. Air Force UF form
Page 5
27. In the following sketch, 1 imagine that you are at the point shown. Place an "A" on the curved line to show how high the object 30. Have you ever seen this, or a
was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show how high the abject 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°
60 N 3. Was anyone else with you c
31.1 IF you answered YES, c
$$
NW NE 31.2 Please list their names
30° at
t
24 all e
15 sw
Please giv te following in! 32. Please give the following inf
S s Fiet NAME
NAME
Lasti Lasti
23. Draw a picture that will show the motion that the object 23. 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 objects made. Place an "A" at the beginning of the path, a "B" at ADDRES
the end of the path, and show any changes in direction the end of the path, and show any changes in direction during the course. during the course.
A)
Ueni Uni
Indicate any additional info
2. IF there was MORE THAN ONE object, then how many were there?. De
33. When and to whom did you
20 2e
Day
this fi

Pnge2
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 g. Bright moonlight
b. A few b. Dull moontight
c. Many C. No moonlight - pitch dark
d. Don't remamber d. Don't remember
What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry
Hazy b. Fog, mist, or light rain
c. Scattered clouds Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
0. The object oppeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don't remember
c. Vapor
1.If it appecred as a light, was it brighter than the brightest stars? (Circle One):
O. Brighter aBrighter c. About the same About th
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
12.The edges of the object were:
(Circle One): . 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 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 Don't know
g. Flash or flicker? Yes Don't know
h. Disappear and reappear? Yes Don't know

Page 6
3Have you ever seen this, or a similar object before. If so give date or dates and location.
.
31. Was anyone aise 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 ist their names and addresses:
abostinf other gisle
all Atudeta attane Hehl
Pivoie give the tollowing intormafion about ygurselt:
NAME
Last Name First Name First Name Middle Name Middle Name
RIDGEW5O0N RIDGEWOON
DDE DD
Street Zone State
N
TELEPHONE NUMBER SEX. SEX
Wulistel Uulistel
Indicate any additional information about yourself, including any special experience, which might be pertinent.
.
.
33. When and to wham aid you repart that you hed seen the object?
20 panent
Day Month Year
Hhis Loren Cinsloted Ciy Lotheg
a medical Dootor.

awen
Official U.S. Air Force UFO form (
20 ha Page7
34. Date you compieted this questionnaire: Day Mopth 76
35.1 naiy el pertinent nd which s t adequately covered in the specic point f t questionnaire or a narrative explanation of your sighting. 7
Suffen, 20 hrinwtes
almost she Twith ig
mg
seaidenie L2s J Rideraod, 2g
O Len
1 alont
zrest here -
8 0 dive
Tue
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hewr fery

Imo only
OFFICIAL U.S.AIR FOR
Page l
U.S. AIR FORCE TECHNICAL INFORMATION 8. IF you saw the object at
8.1 STARS(Circle One):
This questionnaire has been prepured so that you can give the U.S. Air Force as much a. None
inrormation as possible concerning the unidentified aerial phenomenon that you have abserved. b.Af0
Please try to answer as many questions as you possibly can. The information that you give will c. Many
be used for research purposes. Your name will not be used in connection with any statements, d. Don't rememb-
conclusions, or publications without yaur permission. We request this personal information so
that if it is deemed necessary, we may contact you for further details. 9. What were the weather
CLOUDS(Circle One):
. When did you see the object? 2. Time of day: 9 20 a. Clearsky
Hours Hours Minutes b. Hoty b. Hoty
C. C. Scattered clouds
22 may 1967 (Circle One): A.M. A.M. (P.M. P.M. d. Thick or heavy clouds
or
Day Month Year
10. The object appeared: (Cir 0. The object appeared: (Cir
3. Time Zoner 3. Time Zoner
(Circle One):a. Eastern (Circle One): Daylight Saving a. Solid a. Solid
b. Central b. Standard b. Tronsparent
C. C. Mountain c. Vopor c. Vopor
d. Pacific d. Pacific
e. Other_ e. Other
11. If it appeared as a light,
4. Where were you when you saw the object? 4. Where saw the abject? Brighter Brighter
Rochester N.Y. Dimmer
TituS AVe
Nearest Postal Address City or Town Stary or County 11.1 Compare brightness
5. How lang was object in sight? (Total Duration) 3
Hours Minules Seconds
Certain c. Net very sure 12The edges of the object we
certain d. Just a guess (Circle One): a. Fuzzy
5.1 How was hime in sight determined? peching inywitah b. Likea
2. Sharp
5.2 Was coiect in signt continuously? es d. Don':
6. What was the canciten of the sky? .Did the object:
DAY NIGHT a. Appear to stand still a!
c. Bright a. Bright b. Suddenly speed up an
b. Clovdy b. Cloudy c. Break up into parts or
d. Give off smokn?
.IF you saw the object during DAYlGHT, where was the SUN lacated as you looked at the object? e. Change brightness?
f. Change shape?
(Circle One): a. In front of you d. To your left g. Flash or flicker?
b. In back of you e. Overhead h. Disappear and reapps
c. To your right f. Don't remember
FORM This form stpersedes FTD 164. jul 61, which is obsolete.
FTD OCT62 164

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 a. Bright moonlight
.Afew b. Dull moonlight
c. Many c. No moonlight-pitch dark
d. Don'tremember d. Don't remember
9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): WEATHER (Circle One):
c. Clearsky 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
Don't remember
10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent . Don'tremember e. Don'tremember
c. Vapor
1. If it apoeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter 6. . c. About the same
S. Dimmer S. Dimmer d. Don'tknow
11.1 Compare brightness ta some common object:
Traffic cautinn Lisht
12The edges of the object were:
(Cirele One/: a. Fuzzy or blurred e. Other.
5. Like a bright star
/ C. Sharply outlined
d. Don'tremember
13. Did the abiect (Circle One for each question)
a. Apcear to stand still at any time? Yes No Don't know
b. Suddeniy speed up and rush away at any time? es No Don'tknow
c. Break uo into parts or explode? Yes No Don't know
- d. Give off smake? Yes No Don'tknow
o. Change brightness? Yes No Don't know
f. Change shape? Yes No Don't know
g. Flash or flicker? Yes No Don'tknow
h. Disappear and reappear? Yes No Don'tknow

A
Official U.S. Air Force UFO form c
Page 3
14. Did the object disappear while you were watching it? If so, how? .Do you think you can estime
suddealy (Circle One)
disa
IF you answered YES, then
21. Do you think you can estimc
15. Did the object move behind something at any time, particularly a cloud?
(Circle One)
(Circle One): Yes No Don't know. IF you answered YES, then tell what
IF you answered YES, then
it moved behind:
22. Where were you located w
(Circle One):
1. Did the object move in front of something at any time, particularly a cloud? Did the object move in front of something at any time, particularly a cloud? a. Inside a building
(Cirele One): (Cirele One): Yes No Don't know. IF you answered YES, then tell what b. In a car b. In a car
c. Outdoors C. Outdoors
in front of in front of_ d. In on airplane (type)
e. At sea e. Atsea
f. Other. f. Other.
17. Tell in a few words the following things about the object: 17. Teli in a few words the following things about the object:
. Sound a. Sound_. Noseand 24. IF you were MOVING IN A
b.color ir kn ber 24.1 What direction were y
o. North
b. Northeast
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
cbject is covered by the head of the match. if you had performed this experiment at the time of the sighting, how much of 24.2 How fast were you mo
the abjecr wouid have been covered by the march head? 24.3 Did you stop at any tir
(Cirele One)
25. Did you observe the object th
a. Eyeglasses
19. Draw a picture ma i show the shape of the abject or objects. Label and include in your sketch any details of the object b. Sun glasses
that you saw suen as ngs, protrusions, ete., and especially exhaust trails or vapor trails. Place an arrow beside the drawing c. Windshield
to show the direerlon the object was moving. d. Window glass
N
26.1 In order that you can give a
jects which, when placed up
W ( E
stoppid hee Sta
F
2
. S

3e 3 Poge 4
20. 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?.
21. 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?
22. Whare were you located when you saw the object? 23. Were you (Circle One)
(Circle One): In the business section of a city?
Inside a building b. 'In the residential section of a city?
b. in a car c. In open countryside?
c. Outdoors d. Near an airfield?
d. In an cirplane (type) d. e. Flying over a city?
e. Altea e. Attea f. Flying over open country? Flying over open country?
f. Other_ f. Other. 9. Other Other
. IF you were MOVING IN AN AUTOMOBiLE or other vehicle at the time, then complete the following questions: 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 maving? (Circle One) 24.1 What direction were you maving? (Circle One)
. North a. North c. East c. East e. South g. West
. Northeast d.-Sontheast f. Southwest h. Northwest
nuch of the uch of the B 35
ow much of 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 abserve the object through any of the following?
a. Eyeglasses Yes e. Binoculars Yes No .
b. Sun glasses No f. Telescope Yes No)
the abject c. Winashieid (No Theodolite Yes No
the drawing g.
d Nindowgiass Yes (No) h. Other
26. In arder that you can give as clear a picture as possible of what you saw, describe in your own words a common object or ab-
jects which, when placed up in the sky, would givethe same appee earance as the object which you saw.
E
satellife
star or
V

Official U.S. Air ForceUFO form c -
Page 5
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 30. Have you ever seen this, or :
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 horizan (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Ploce a "B" on the com- No
pass when you last sow the object.
90° 75
N Was anyone else with you (
31.1 IF you answered YES,
NW NE 31.2 Please list their names
30
w E
15 SW SE
Please give the following inf
o S
- NAME 5
107
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 100
the end of the path, and show any changes in direction during the course. ADDRESS
TELEPHONE NUMBER
Indicate any additional infc
te . When and to whom did you
men obgict 22
repeafeat orce Day
eas
Costi slal. 5 WhE

Force UFO form continued
3e5 Page 6
the object Have you ever seen this, or a similar object before. If so give date or dates and location.
object was Ne
in the com-
31. Was anyone else with you at the time you saw the object? (Circle One) Yes (N\
31. IF yau answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
E
32. Plese give the following information about yourself:
NAME NAME Last Name First Name
Middle Name
ath, aBt ath, c "Bat Rochester 9 RochesterO N.J. N.J.
ADDRESS
City City Zone State
TELEPHONE NUM TELEPHO AGE 36 36 sEx_nale SEX_nale
loi ondn ep  . ny dinalnfoatin  r inlding cl xprnchichh  prn.
E
.
33. When and ts whom did you report that you had seen the object? Rochester Police
Res 22 5 G7
D=y Month Year MonroeCounty
fsvon Whec Radio sjation tir port

noodd to muke S T ee that n They
misht. hat
Co He obgect
12002ig ounoly from the ogict reposts
2 ied objicto wohr ib bookd jlying
like combs diojlo frte plcen Kave
languce
Dier.
1203.
I Hhen
Das stateo 1 fa
avat 0 Dlins. The cbct S
ott

hat n sece
of
bjects

(Circle One): Yes Don't Know. IF you answared YES, then tell what
it moved behind:
1. Did the object move in front of something at any time, particularly a cloud?
(Circle Oue): Yes (N№\o} Don't Know. IF you answerad YES, then tell what
in front of:
17. Tell in a few words the following things about the object:
6. Cola Hhite El jicl with' Red Center
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
Draw a picture that will show the shape of the object or objects. Label and include in your sketch any details
of the objeet 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.
1 wuite curside
REDACNTeR

1
OFFICIALU.S.AIR FOR
Page 1
U.S. AIR FORCE TECHNICAL INFORMATION 8. IF you saw the object at N
8.1 STARS(Circle One):
This questionnaire has been prepared so that you can give the U.S. Air Force as much a. None
infarmation as possible concerning the unidentified aerial phenomenon that you have observed. b. A few
Please try to answer as many questions as you possibly can. The information that you give will C. Many
be used for research purposes. Your name will not be used in connection with any statements, d. Don't remember
conciusions, or publications without your permission. We request this personal information so
that i it is deemed necessary, we may contact you for further details. 9. What were the weather co.
CLOUDS (Cirele One):
1.When did you see the object? When did you see the object? 2. Time of day: Time of day: 12 5 o. Claarsky)NLnd: Claarsky)VLnd:
Hours Minutes b. Hazy b. Hazy YOL45
C. C. Scatfered clouds Scattered clouds
Mm22 Mon 1962 (Circle One): or P.MA. or P.h. d. Thick or heavy clouds
Month Year
D=4 TMode TMoce AERRON AERROM
0The object appeared: (Circle 0.The object appeared: (Circle
3. Time Zoner 3. Time Zoner
(Circle One): a. Eastern (Circle One): a.Daylight Saving (Circle One): a. Daylight Saving a. Solid
b. Central b. Standard (o. o. Transparent Trunsparent
C. Mountoin C. Vapor
d.Pacific)
e. Other e. Other
I1. If it appeared as a light, wa
Where you when you saw the object? a. Brighter
b. Dimmer
Nearest Postal Address City or Town State or County 11.1 Compare brightness to
(Total Duration)
Hours Minutes Seconds
a. Cerrain Not very sure The edges of the object were:
o. Fainv certain d. Just a guess (Cirele One): a. Fuzzy or
5.1 How was hme in signt determined? Pr lonB .Like a br
c. Sharply
5.2 Was object in signt continuously? Tes d. Don'trer
6. What was the condition ot the sky? Did the object:
DAY NIGHT d. Appear to stand still at a
a. Brighe_ a. Bright b. Suddenly speed up and r
Claudy b. Cloudy
c. Break up into parts or exj
d. Give off smoke?
. IF you saw the abject during DAYLGHT, where was the SUN located as you loaked at the object? e. Change brightness?
f. Change shape?
(Circle One): a. In frant of you d. To your left g. Flash or flicker?
b. In back of you e.Overhead h. Disappear and reappear
c. To your right Don't remember
FORM This form stupersedes FTD 154, jul 61, which is obsolete.
FTD OCT 62 164

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?
CLOUDS (Circle One): WEATHER(Circle One):
a. ClearSkyINPLACS a. Dry
b. Hazy b. Fog, mist, or light rain
C. Scatfered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don'tremember
The object appeared:(Circle One):
B. Solid As a light
o Transparent e. Don'tremember
c. Vapor
1 it appeared as a light, wos it brighter than the brightest stars? (Circle One): 1.f it appeared as a light, wos it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same c. About the same
b. Dimmer d. Don'tknow
mty 11.1 Compare brightness to some common object:
12.The edges of the object were:
(Cirele One): a. Fuzzy or biurred
b. Like a bright star Amm
c. Sharply ourlined
d. Don'tremember
10. Did the coect (Circle One for each question)
a. appear to stand still at any time? Yes No Don't know
.Suddeniy speed up and rush away at any time? Yes No Don't know
c. Breck up into parts or explode? Yes No Don'tknow
d. Give off smoke? (Yes) No Don't know
Change brightness? Yes (No Don't know
f. Change shape? No Don't know
g. Flash or flicker? No Don't know
h. Disappear and reappear? No Don't know

Page 3
14. Did the object disappear while you were watching it? If so, how? 20. Do you think you can estimat
yel disapeared. 0 (Circle One)
dwhin IF you answered YES, then
thI2aAuogonnethething
21. Do you think you can estimat
(Circle One)
(Circle Ones Yes No Dan't know. IF you answered YES, then tell what
IF you answered YES, then h
it moved sehind:
22. Where were you located wht
(Circle One):
16. Did the object move in front of something at any time, particularly a cloud? a. . Inside a building
(Cirele Onel: Yes No) Don't know. IF you answered YEs, then tell what b. In a car
C Outdoors
in frant of: d. In an airplane (type)
c. At sea
F. Other
17. Tell in a few words the following things about the obiect:
24. IF you were MOVING IN AI
24.1 What direction were yc
b. Color
a. North
b. Northeast
neculae size. Hold a mgtch stick at grm's Jenath in line with a known obiect gnd note how g
26 In order that you can give a
jects which, when placed up
long
V

(Circle One) Yes (No)
F you answered YES, then what speed would you estimate?
21. Da 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?
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Cirele One):
a. In the business section of a city?
o. Inside a building b. In the residential section of a city?
b. In a car In open countryside?
c utdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. Af seo f. Flying over open country?
ther 9. Other...
2.4 IF you were MOvING IN AN AUTOMOBiLE or ather vehicle ot the time, then complete the following questions:
24.) What direction were you moving? (Circle One)
a. North c. East e. South g West
.Northeast d. Southeast Southwest h. Northwest
jectt which, when placed up in the sky, would give the same appearance as the object which you saw.
alorqw
5 1

2.
Official U.S. Air Force form
Page 5
9
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 30. Have you ever seen this, or a
was above the horizon n (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 Was anyone else with you at
31.1 IF you answered YES, di
NW NE 31.2 Please list their names ar
30°
w E A
15° 5 SE
. Please give the fallowing inforr
S s
NAMe DivEy
Lost Nor
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 2. 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 ADDRESS 35259
the end of the path, and show any changes in direction during the course.
5
( TELEPHONE NUMBER
RO RO 2-
6 Indicate any additional informa
29. IF there was MORE THAN ONE object, then how many were there?. D wos sick
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
Bur I S
33. When and to whom did you repot
More 22
Day
To mnimint

orce
Page 5
object Have you ever seen this, or a similar object before. If so give date or dates and location.
ct was
2 com-
3. Was cnyone 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:
32. Please give the following information about yourself:
ast Na First N5me
Bct CpritioN
ADDRESS loree Zone State
State
A TELEPHONE NUMBER TELEPHONE NUMBER AGE AGED SEX 91R
ay ditnal nfotin yursecludng pcal xprienchicht  pe tal inoain yursincludig lexpernht pe.
BI sen ir pesivey,
33. When and to wham did you report that you had seen the object?
M2N22 Nav 1967
D=y Month Year
TOmrirnithon
O

Official U.S. Air Force JFO form coi
Poge 7
34. Date you completed inis questionnaire: Mon 12 Me 1462
Day Month Year
Information which u el pertinent and which is t adequately covered in the specific points of t the
questionnaire or a narrative explanation of your sighting.
and then it
I Don't KNow
Pee The
-
Colce SicveR wiTh bRigh Coloe SicvER wiTh bRigh - -
O COLOREd LighTS
-

SILVER
C
Baighr Red
Light
This is WHAT IT LOOKEd LiKE
~

AIR FORCE TECHNICAL
This questionnaire has baen prapared so that you can give tho U.S. Air Force as much
information as possibla concerning the unidentified corial phenomenon that you have observed.
Plaasa try to answer as many quastions as you possibly can. The information that ycu give will
be used for resoarch purposes. Your nama will not be used in connection with any statemanis,
conclusjons, or publications without your permission. We request this personal information so
thar if it is daemed necossary, wa may contact you for furthar datails.
1. When did you ses tha object? 2. Time of day: 9 50
Hove Minutes
27 5 67 (Circlo One): A.M. or P.M.
Day Month Yeur
(27) -
3. Tima Zone:
(Circle Oneku. (Circle Onaku. Eastam (Circle Onaa. (Circle One a. Daylight Soring I Daylight Soring
D. Central b. Siandard
C. Mountain
d. Pacific Pacific
e. Other
4. Where ware you whan you saw the object?
Hellestoon Hellecton Ye
Noareat Poatal Addrsss Neareat Poatal Addrssa City or Town Stata or County
otal Duration) 15
Hours Minutes Soconds
. Cartain c. Not vary sura
Fairly certain d. Just a guess .
5.1 How was time in sight determined?
5.2 Was oblect in sight contlnuously? Yes. No
6. What was the condition of the sky?
DAY NIGHT
a. Bright G.
b. 6 Cloudy
7. IF you sow the object during DAYLIGHT, where was the SUN locoted as you looked at the object?
(Circle Ona): a. in front of you d. To your left
6. in back of you e. Overhead
To your right f. Don't remamber
FORM
FTD OCT 62 164 Thia iorm ouparaedes PrD I64. jut 61, whtch iv obsolete.
I

9. What wers the weather conditions at the tlme you sow object?
CLOUDS (Cirele One): WEATHER (Circle Ons):
a. Cleur sky c. Dry
b. Hazy O Fog, mist, or light rain
c. Scattared clouds C. Moderate or heavy rain
Thick or hoovy clouds d. Snow
e. Don't ramomber
10. The objack oppaured: (Circle One):
c. Solid As a light
b. Tronsporent O. Don't romember
=. Yepor
11. If it appecred as a lighi, was it brighter than the brightost stars? (C Circle Ona):
a. Brightor c. Abour the same mo stustocmpars-
b. Dupmes d. Don' hoowv
12. The adgas of the object ware:
(Circle Oneh Fuzzy or blurred o. Other
5. Like a bright ster
c. Sharply outlined
d. Don't remember n
13. Did the objecr (Cirale One for soch question)
a. Appear to stand still ot arry time? Cres) No Doa't know
b. Suddunly speed up and rush away at any tima? (Yes) No Don't know
c. Broak to into parts or explode? Yes NO Don't know
d. Give off smoke? Yos ND Don't know
a. Change brighlness? Y0D No Don't know
f. Change shape? Yes Don't Inow
2. Flash or flicker? Yo Don't lnow
h. Disappear and reappaur? 0 No Don't know

(Circle Ona) Yoss No
22. Whare wers you located when you saw the object? 23. Wera you (Circle One)
(Circle One):
o. In the business section of a city?
a. inside a building 5. In the residential section of a city?
b. in a car c. In open countryside?
cOutdocr d. Near an dirfield?
d. In an airplane (typa) e. Flying over a city?
. At sma Flying over open country?
S. Other
2. IF you were MOVING IN AN AUTOMOBILE or other vehicle ot the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
a. North c. East e. South 9. Wost
. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? miles per hour.

(Circla One): IF you answered YES, thea tel wh:at
in front of: -
17. . Tell in a few words the following things about the object:
0. Sound H AMn
b. Color tidte
.We wish to know the angular size. Hold a match stick at arm's langth in line with a known objoct ond nats how
much of the object is covered by the hoad of the mutch. If you had performad this experiment af the timns of ta
sighting, how much of the object would have been covared by tha match head?
of the abjeet that you saw-such as wings, protrusions, etc., and especially exhaust trails or vapor trails.
Place on arrow besids the drawing to show the direction the object was moving.
Olylxdf
-
Aound

Yos
IF you answered YES, than how for away would you say it was? .
2Where wore you located whan you sow the object? 23. Ware you (Circle One)
(Circle One):
a. In the business section of a city?
o.! Insids a building 6.) In the residential section oi a city?
b. In a car c. In opon countrysida?
63 Outdoors d. Near an airfield?
d. In an airplans (type) e. Flying over a city?
e. .At sea f. Flying over opan country?
1. Other - g. Other
time, then complets the following quostions;
Circle Ona)
. North c. East o. South y. Wear
b. Northeast d. Southeast f. Southwest h. Northwest
a. Yos e.
b. Sun gless*s Yes No f. Tolescope Yes
c. Windshield Yes No g. Theodolite Yos
d. Window giass Yes Nox h. Other
objoct or abjsers which, whan placad up in the sky, would giva the same appeurance as the object which you saw.
Eegattt

show how high the objoct was above the horizon (skylins) when you last suw it. Place an 'A' on the compass
90° 73°
NW NU
0
-15 3W 36,
28. . Draw a pleture that will show the motion that the object or objocts mado. Place an "A baginning of sho
path, a "g" ot the ond of the path, and show any changes in direction during the course.

3. Was anyone siso with you at the time you saw the objact? (Circle Ona) Yos No
31.1 IF you answared YEs, did they see the object too? (Circle One) Yos No
31.2 Pleas• list thair nomes and addrasses?
1. Ma
2 M2t
3 HilletoB
32. Pleoso give the following Information about yoursalf:
NAME
Last Noms First Nams Middl Nam
Ulle
Strout City Z.on9 Steto
TELEPHONE NUMBER AGE 23 SEX
theNeny
When and to whom did you rapert that you had sean the objoct?
S
Day Month Your

)
Pago 7
34. Do estionnaire: (c 62
Day Month Your
quastionnairs or a narrative explanation of your sighting.
Names sit to be usel
seglting
he  t fo go

contact the nearest Air Force installatin
pertinent
unable to determine the stimulus, the unable to determine the stimulus, the is sent to I
P Air Force Force Base for their
evaluation and
Your Your Piled for information purposes.

8
-
-
C-
= with a Gtth -

C. d ait ban C. On Din
7
, 1
End

o Ce, lefDly 31HHan
a .
670
SAFOIcC/Maj Rademacher/jad/79079/26 Jun 67
JUN 2 7 1967
Dear Mr
This replies to your recent correso ence on your unidentified
observation of May 3l, 1967.
We sre unable to undertaks a comprehensivs investigation on
your observation because it occurred outside the limits of the
United States. Your information will ba addad to our present data
base.
Attached Attached is a co 1
you wiah. you wiah.
Sincerely,
CGEORGE P. FREEMAN, JR. GEORGE P. FREEMAN, JR.
Lt Colonel, USAF
Chief, Civil Chief, Civil Sranch Branch
Community Relations Division
Office of Larormation
Attachment (FTD 164)
COORDINATED BY: SAFOI-CC
SAFOIC Coord cy
Cmbk cy
Rdrs cy
Acty cy
Stbk cy

Dof aly
Cinade
/
Dear Miss
ooservation of May 31, 1967.
We are unable to undertake a ccmprehensive investigation on
States. Y
-- interest in our
program ciated. 1s

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) whan you first saw it. Place a "B" on the same curved line to
show how high ths 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 compass where you last saw the object.
90° 75"
45° NW NU
3
A E
-15° SW SS,
28. Drow a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the L.row a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the
path, a "s" at the end of the path, and show any changes in direction during the course. path, a "s" at the end of the path, and show any changes in direction during the course.
E
29. IF there was HORE THAN ONE object, then how many were there?
Draw a picture of he they were arranged, and put an arrow to show the direction that they were traveling.

a
DEAR SIR;
WOULD YOU KINDLY SEND BY RETURN
SOME MORE OFFICMAL MORE OFFICAAL L U.S. AIR .U.S. AIR FORC FOR
THANK UFO UFO FORMS
YOU KINDLY

: UFO -
Page 6
n
Samne spot Powev about a yeau ago
3 Was anyone else with you at the time you saw the object? (Circle One) (Yes No
swered YEid they sect  Circe O) Yes No
31.2 Plaasa list their names and addresses:
Sam addisd menbis o
anily
Please give the following information about yourself: 32. Please give the following information about yourself:
NAME NAME Last Name First Name Middle Name
ADDRESS Cricouiini Dd. CricouriniDd. CANAOA
Street City Zone Zone State State
TELEPHONE NUM TELEPHONE NUM AGE_1O AGE SEX M SEX M
wel qualified qualifiel ni nui UFO and a pace Planets ete
n indicate any additional
Kvns all abunt the slay
1
di tuated in all abont t
His wother yo yeas old joust Saw
.
the clyect and wlse up JEAN
Fongut hot to REAE BASE 8MILES
t csto Ue) Away
33. When and to wham did you report that you had seen the object?
1ST TyLE 1967
D=y Month Year
-

J 1 T
A
Official U.S. Air Force
Page 3
4. Did the object disappear while you were watching it? If so, how? .Do you think you can estimate
(Circle One)
NO IF you answered YES, then whc
21. Do you think you can estimate F
15. Did the object move behind something at any time, particularly a cloud?
(Circle One)
(Circle Oneis Yes No Don't know. IF you answered YES, then tell what
IF you answered YES, then how
it maved behind:
22. Where were you located when
(Circle One):
16. Did the object meve in front of something at any time, particularly a cloud? a. Inside a building
(Circle One): (Circle Onel: Yes No Don't know. Don'tknow. IF you answered YES, then tell what b. In acar In a car
a a3 c. Outdoors
in frant of: d. In an airplane (type)
e. At sea Atsea
f. Other
17. Tellin a few words the following things about the object: 17. Tell in a few words the following things about the object:
NO NO C  fi C 24. IF you Were MOVING IN AN 24. IF yOu Were MOVING IN AN
a. Sound
b. Color_ iene dand UDA2 danl siey oenge siney erenge 24.1 What direction were you
b. Color
J L a. North
b. Northeast
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 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 24.2 How fast were you movir
object is covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of 24.2 How fast were you movir
the abject wouid have beeg covered by the match head? 24.3 Did you stop at any time
(Circle One)
alf 25. Did you observe the object thr
a. Eyeglasses
19. Draw a picture tet wil show the shape of the obiect or objects. Label and include in your sketch any details of the object b. Sun glasses
that you saw such as ings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing c. Windshield
to show the direeton the object was moving. d. Window glass
.
26. In arder that you can give as
jects which, when placed up
Nle
a
Saine thrugh Anmall Felesepe
30 Paviz

1e 3 Page 4
20. Do vou think you can estimate the speed of the object?
(Circle One) Yes No
IF you answered YES, then what speed would you estimate?_
21. Do you think you can estimate how far away from you the object was?
(Circle One) (Yres No
IF you answered YEs, then how far away would you say it was? 20niLes
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
o.In the business section of a city?
o. Inside a building b. In the residential sectiorof a city?
b. In acar c. In open countryside?
Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
0. As00 0. A+300 F. f. Flying over open country?
4. f. g. 9. Other
24. IF you were MOVING IN AN AUTOMOBiLE or other vehicle at the time, then complete the foliowing questions:
24.1 What direction were you moving? (Circle One) 24.1 What direction were you moving? (Circle One)
. North c. East e. South e. South g. West g. West
b. Northeast d. Southeast f. Southwest h. Northwest h. Northwest
ch of the
much of 24.2 How fast were you moving? miles per hour.
24.3 Did you stop at any time while you were loaking at the object?
(Circle One) Yes No
25. Did vou coserve the object through any of the follawing?
o. Evnglaues Yes No e. Binoculars Yes No
b. Sun giasses Yes f. Telescope Yes No
the abject Wincsmeid Yes No Theodolite Yes No
drawing C. g.
Windewplass Yes No h. Other
In order het you san give as clear a picture as passible 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.
bight star
7

AiR
FOREE BASE
OFFCIALU.S AIR FORC
Page 1
T U.S. AIR FORCE TECHNICAL INFORMATION 8. IF you saw the object at NIC
8.1 STARS(Circle One):
This questionnaire has been prepared so that you can give the U.S. Air Force as much a. None
infarmation as possible concerning the unidentified aerial phenomenon that you have observed. b. Afew
Please try to answer as many questions as you possibly can. The information that you give will c. Many
be used for research purposes. Your name will not be used in connection with any statements, d. Don't remember
conclusions, or publications without your permission. We request this personal information so -
. What were the weather con
CLOUDS (Circle One): CLOUDS(Circle One):
.When did you see the object? 1. When did you see the object? 2. Time of day: 2. Time of day: a. a Clear sky
Hours Minutes Minutes b. Hazy b. Hazy
Seattered clouds Seattered clouds
21s6 21s6 0174 1967 (Circle One): (Cirele One): A.M. d. Thick or heavy clouds
or P.M.
Day Month Year
10. The object appeared: (Circle 0. The object appeared: (Circle
3. Time Zone:
(Circle Onek (Circle Ona) 6. 6. Eastera Eastern (Circle Oneh a. Daylight Saving (Circle Oneh: a. Daylight Saving a. Solid
b. Central Central b. Standard b. Transparent Transparent
C. Mountain C. Vapor
d. Pacific
e. Other
1. If it appeared as a light, was
4. Where were you when you saw the object? a. Brighter
b. Dimmer
CAVADA
Nearesr Postal Address City or Town State or County 11.1 Compare brightness to.
Daker tha
5. How long was sbleer in slght? all (Total Duration) ! 10
Hours Minutes Seconds
Chrain Not very sure The edges of the object were:
b. Falriy certain Just a guess (Cirele One): a. Fyzzy or
5.1 How was time in sighr cerermined? fout . Like a bri
res c. Sharply
5.2 Was objeet in sight cantinuously? No d. Don't rer
6What was the condition of the sky? Did the object:
DAY NIGHT d. Appear to stand still at ar
a. Bright a. Bright b.Suddenly speed up and
B. Cloudy b. Cloudy c. Break up into parts or exp
d. Give off smoke?
7. IF you saw the object during DAYLiGHT, where was the SUN located as you looked at the object? e. Change brightness?
f. Change shape?
(Circle One): a. In front of you d. To your feft g. Flash or fticker?
b. In back of you e. Overhead h.Disappear and reappear
c. To your right f. Don'tremember
FORM This form supersedes FTD 164. jul S1. which is obsolete.
FTD OCT 62 164

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 a.Bright moonlight
b. A few b. Dull moonlight
e.Many No moonlight pitch dark
d. Don't remember
9. What were the weather conditions ot the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
0Clearsky 6.Dry
b. Hozy b. Fog, mist, or light rain Fog, mist, or light rain
c. Scattered clouds c. Scattered clouds c. Moderate or heavy rain c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember e. Don'tremember
10. The abject appeared:(Circle One): 10. The abject appeared:(Circle One):
a. Solid a. Solld d. As a light
b. Transparent . Don'tremember e. Don'tremember
c. Vopor
1if it appeared as a light, was it brighter than the brightest stars? (Circle One): 1 if it appeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter Bciahte c. About the same oAb
Dimmer d. Don't know
40A
11.1 Compare brightness to some common object: Marls
12. The ecges of the object were:
(Cirele One: a. Fuzzy or blurzad
b. Like a bright star
c. Shorply outlined l e
d. Don'tremember
1. Did tne ooject: (Circle One for each question)
a. 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 wot for
c. Breck up into parts or explode? Yes No Don't know
d. Give offsmake? Yos No Don't know
e. Change brightness? (Yos) 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

.
Official U.S. Air Force ESS
Page 5
27. In the fallowing 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
60 N
45
NW NE
30°
w E
RAA
15 SW SE
S
pictuhar willshow the motion that the object or jects made. Place an the beginning of the path,a r picturthar wil show the motion that the object or objects mada. Place anat the beginning of the path, a
the end of the path, and show any changes in direction during the course.
29. IF there was MORE THAN ONE object, then how many were there?.
Drew a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

Official U.S. Air Force
Foge7
34. Date you completed this questionnaire: 1 INNE 1S6?
Day Month Yea
Information which you feel pertinent and which is not adequately covered in the specific poit h
questionnaire or a narrotive explanotion of your sighting.
.
..

DATE LOCATION OBSERVER EVALUATION
Juna Fortland, Oregon INSUFFICIENT DATA
June Csceola,Mills, Ponnsylvania ENSUFFICIENT DATA
1 N. rOS) Sighting: Other (HAX)
Fhobe: INSUFFICIENT DATA)
2 McKeesgort, Ponnaylvania Other (CONFLICTING DATA)
Lincola, Dlinois AIRCRAFT
Karthus, Pennsylvania Satellite (ECko II)
Security. Colorado BALLOCN
Fairborn, Ohio INSUFFICIRNT DATA
Indian Hils, Colorado INSUFFICIENT DATA
1+≠≠ Bethany, Delawars Other (HOAX)
Dayton, Chio INSUFFICIENT DATA
Mosa, Arizona Other (BIRDS)
Rogo Park, New York BALLOON
Roaring Springs, Texas Other (BAIL LIGHTNING)
10 Eaon, Ohio Multiple INSUFFICIENT DATA
-11 Phoonix, Arizona INSUFFICIENT DATA
-12 Buffalo, New York INSUFFICIENT DATA DATA
'12 Dayton, Ohio Ohio Multiphe Multiphe INSUFFICINT INSUFFICIENT DATA
-12 -12 Dayton, Ohio Astro (METEOR) (METEOR)
12 -12 Dayton, Chio Ohio Multiple Astro (MAFS)
12 -12 Dayton, Ohio Satallite (ECHo I)
-14 Fortland. Oregon Fortland. Oregoa Multiple INSUFFICIENT DATA
-14 Landers, Califoria OTOS) oTOS) Sighting (NoT-OBSKRVED) Sighting (NOT-OBSKRVED)
Photo: Oth Photo: Other (PROCESSING
. DEFECT)
15 15 Seattlo, Washington Seattle, Washington BALLOON
-16 -16 Dayton, Ohio Civilian Satellite (ECHo I)
-16-17 -16-17 Chiesgo, niiaols Chieago, Iiiaols AIRCRAFT (W/ADVERTISING SION)
-17 Phosnix, Arizona Astro (METEOR)
-17 Xeala, Ohio INSUFFICIENT DATA
-17 Cassafras River, yiand Multiple AIRCRAFT
ADDIT (NOT CAsTs)
DATE LOCATICN SCURCE EVALUATION
Juns Harmond, Indiana Green 164,
- 2 Ko'kemo, Indiana Grean 164,
3. Dublin, Irsland Ltr,
6 Durango, Colorado Ltr,
7 Westmont, Illinois Ltr,
-10 Fottstown, Pennsylvania Green 164,43
11 Starkville, Missisaippi Green 164,
13 Adamsville, Canada Green 164,
14, Portland, Oregon Green 164,8
16 Searor, Pennsylyania Green 16h, Ler,

Patirer,
,Mew feriy07503
Please give the following . Please give the following information about yoursulf: information about yourself:
Last First Nome
ADDRESS ADDRESS Patersond 3 my
Streat City Zone Zone
* AGE 14 sx MAle AGE 1/ SEX MAle
TELEPHONE NUMB
1967
Day Morth Yoar

frund of frme asa heliciptel
heard. And after wnt head And after wnte l ssst mule Dave bien sost muld Dave bien
eneitee :
-

.
PROJECT 10O73 RECORD
1. DATE-TIME GROUP 2LOCATION
3i i0 57 01/02104 Paterson, New Jarse,
5. AOMICE 10. CONCLUSION
Mivilian AIRORATT
NUMBER OF OBJECTS No dsce presen-od to indlunte obgeet could noc
have 0670 or air rett.
LENGTH OF OSSERVATION LENGTH OF OSSERVATION 11. BRIEF SUMMARY AND ANALYSIS BRIEF SUMMARY AND ANALYSIS
2 m0065 15 15 seconds seconds Object appeared as a Mitshlight at close Ooject appeared as a Pitshlight at close rang. rane
red center, C red center, Objeet wns foocball or dise Object wns foocball or dise snsgec. sngoec. C.ec. C,ec.
1 l.. TYPE OF OBSERVATION flew in a straighs rlight path. flew in a straighs rlight pathi.
.. Tis
7. MOURSE COURSE
0 - 1 -
5. FIGTOS FAGTOS
Yes
Z. No
D. PHYSICAL EVIDENCE
.n Yey
No
FORH
PTD SEP33 C-319 (TD3) Previous sditions of thls form may bo uaed.