PROJECT BLUE BOOK

PROJECT 10073 RECORD 1
1. DATE  TIME GROUP 2 LOCATION
5 Jun 67 DAYTON, OHIO
3. SOURCE
Civilian
4. NUMBER OF OBJECTS INSUF JATION
unknown
5. LENGTH OF F OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
unknown
6. TYPE OF OBSERVATION
unknown SEE CASE FILE
7. COURSE
lunknown
8. PHOTOS
Yos UYos
XX No XXNo
. PHYSICAL 9. VIDENCE IDENCE
Yos Yos
XX No XXNo
FORM FORM
FTD FTD SEP 63 0-329 (TDE) SEP 63 0-329 (TDE) Previous ditions of this forn n ay be used.
4

.
Poge 3
14. Did the object disappear while you were watching it? If so, how?
15. Did the object movs behind something at any time, porticularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
it moved behind:
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of: _
—
17. Tell in a few words the following things about the object:
a. SoundNone
b. Color_ b. Color Change from Red to Sreen to whte Change from Rod to Green to whte
.We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how 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 wouid have been covered by the match head? sighting, how much of the object would have been covered by the match head?
1. 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. 2
Place an arrow beside the drawing to show the direction the object was moving.

IF you answered Y 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 of
Area WPAEB
IF you answered YES, then how far away would you say it was? _
22. Whers were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
aInside a building .In the residential section of a city?
b. In a car G) In open countryside?
c. Outdoors Near an airfield?
d.In an airplane (type) e. Flying ovar a city?
e.. At sea f.
f. Other _ g.
24. IF you ware MOVING IN AN AUTOMOBILE or other vehicle at the tima, then complete the following questions:
24.1 What diraction were you moving? (Circle One)
0. North o. North c. East e. South g. West
b. Northeast . 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? 24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yos No
llowing?
a. Eyeglasses (Yes @ Binoculars Yes No
b. Sun glasses Yes f. Telescope No
c. Windshield g. Theodolite Yes No
d. Window glass Yes No h. Other
2. In order that you can give as clear a picture as possible of what you saw, dascribe in your own words a common
object or objects which, when placed up in the sky, would give the same appearance as the object which you saw.

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
60°
45 NW NS
-15° SW 35
S
2.Uraw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the 2. Uraw 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 the course. path, a "g" at the end of the path, and show any changes in direction during the course.
moving meving parallel to horizon
left to right left to right
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.

Paga 6
30. Have you aver seen similar objnct bafore. if so give date or dates and locution.
Was anyone else with you at the time you saw the object? (Circle One) Yos No
Y No
31.2 Please list thair names and addresses:
MrtMrs
2. Please give the following information about yourself:
T
NAME NAME
LasrName as Name Middi Name Middla Name
ADDRESS
Streat Street City Zone State
TELER NUMBE NUMBE! AGE RS AGE R5 SEx Female sEx Female
Indicate anv special experience, which might be pertinent.
VALORE
Duy Month Your
I

Cotor and in sane
sky sby as sepai
Dajlin
45424 15424
Day 8
.

questionnaire or a narrative explanation of your sighting.
Jecord report on howerer first
would provide details
Third repo leived
Ohio
4:424 45424
,

12 Gome e7
DEPARTMENT OF THE AIR FORCE
HEADQUARTZRS FORZIGN TECHNOLOGY DIVISION (APSC)
WRIGHT-PATTIRSON AIR FORCE BASE.OHIO45433
REPLY TO
ATTN OF TDET/UFO
SUBJECT UFO Ob vation e 1957
JUN 2 1 197
Dayton, Ohio 45424
Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation.
Request t you complete the attached FTD Form l64 and return it in
the envelope provided. Thank you for your observation
to the Air Force.
JAMES C. MANATT, COlOnel, USAF JAMES C. MANATT, ColOnel, USAF 1 Atch
Director Director of Technology and Subsystems FTD Form 164 w/envelope
TILAT :
1

14J67
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE BASE. OH10 45433
REPLY TO TDET/UFO
ATTN OF
SUBJECT JUN 2 1 1967
TO: Miss
Court
Deyton, Ohio 45424
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. Thank you reporting your observation
to the Air Force.
JAMES C. MANATT, ColOnel, USAF JAMES C. MANATT, Colonel, USAF 1 Atch
Director Technology and Subsystems FTD Form 164 w/envelope FTD Form 164 w/envelope
o t te
o  Tk o/

PROJECT 100/3 RECOND
1. DATE.TIME CROUP 2. LOCATION
12 3ne 57 13/04312 Dayton, Chio m
3. SOURCE 10. CONCLUSION
Civilian ASTRO (Mars) √
4. NUMBER OF OBJECTS Mars was on an azimuth of 223 degrees, elevation of 30
2 at time of sighting.
LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
2 hours, 10 minutes Observer stated object resembled Venus in carly evening. Ob-
ject had a blue-white to reddish and even a greenish color.
6. TYPE OF OBSERVATION Object was fuzzy and appeared have a pulsateing mocion to
Ground Visual (BX-TX) it.
. COURSE
South
8. PHOTOS
Yes
No
2. 2. PHYSICAL EVIDENCE PHYSI EVIDENCE
n Yos
8No
FORM
FTD SEP63 0-329 (TDE) S£P63 0-329 (TDE) Previous editione of thie form may be usad. Prevlous editione of thie form may bo uaad.
8
4

U.S. AIR FORCE 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.
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 parsonal information so
that if it is deemed necessary may conta further details.
1112
.When did you see the object? 2. Time of day:. 11 30
6 Hour Minutes
12 67
(Circle One): A.M. or P.
Doy Month Year
3. Time Zone:
(Circle One): a. Eastern Daylight Saving
b. Central Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
Dantn Chn
Nearest Postal Address City or Town State or County
5. how long was ob otel Duration) 2 10
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain
5.1 How was time in sight determined?
5.2 Was object in sight continuously? Yes A No
DAY NIGHI
a. Bright
b. Cloudy Cloudy
7IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): a. In front of you d. To your left
b. In back of you e. Overheod
c. To your right f. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD) 164, Jul 61, which is obsolete.

5 Ju
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FORZIGN TECHNOLOGY DIVIBION (ANSC)
WRIGHT.PA AIR FORCE 3A3K. OHIO 45433
5Gune6?
REPLY TO Naytr, Ohio
ATTN OF TDET/UFO
SUBJECT UFO 1967 JUN 1 3 1967
TO Mr.
Dayton, Ohio 45406
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, Thank you for reporting your observation
by p0ff to the Air Force.
Fame
JAMES C. MANATT, COlOneL, USAF JAMES C. MANATT, ColOneL, USAF 1 Atch
011ffo Director of Technology Director ology and and Subsystems FTD Form 164 w/envelope
.
0.0/130L
.

Fngn2
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 a. 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?
CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry
Hazy b. Fog, mist, or light rain
Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds Snow
. e. Don't remember
10. The object appeared: (Circle One): (Circle One):
a. Solid d. As a light
b. Transparent b. Transparent e. Don't remember
c. c. Vapor Vapor
If 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):
a. Brighter c.About the same C. About the same
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
aiy thie tine f yiar
12.The edges of the object were:
(Circle One):a. Fuzzy or blurred) e. Other
b. Like a bright star
c. Sharoly 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 s 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

(Circle One): Yes No Don't Know. IF you answered YES, then tell what
it moved behind: _
16. Did the obiect 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:
.Tell in a few words the following things about the object:
a. SoundN
b. Color Blineb4 T Add T
1. We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how 18. We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how
much of the objact is covered by the haad of the match. If you had performed this experiment at the time of the much of the objact is covered by the head of the match. If you had performed this experiment at the time of the
allt allt
. 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.
-

the object was?
(Circle One) Yes No
IF you answered YES, then how far away you say was?
22Where were you located 3Were you (Circle One)
(Circle One):
a. In the business section of a city?
aInside a building b. In the residential section of a city?
b. I In a car c. 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 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 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?
ülso at emo

when you first saw it. Place a "B" on the compass where you fast saw the object.
90 75=A
60
NW N3
15 3W
B
A
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 the course.
Jihe
A
ob2i
be X0
2. IF there was MORE THAN ONE object, then how many were there?
Draw a picture of how

Pags 6
30. Have you ever sae or objact bafore. If so give date or dates and location.
/5
(Y) No
31.1 IF you answered YES, did they sae the object to Circle One) Yos No
t Ohi
Dgti Ohi
32. Please give the following information about yourself:
NAME
Last Name First Name Middl Nama Middl Nama
ADDRESS DA:T:N 45166 QH1O
Streat Streat City Zone State
TELER NUMBER MBER AGE 43 SEX SEX 1
h might be pertinent. miaht be pertinent
Fo dstd 217 FA Bn
E
T PILOT APPROX 50 HRS LIGHT
AIRCRAFT
AMATUER RADID GENERAL CLASS w&WJL
3.When and to whom did you report that you had seen the object?
2 & 67 OD W PAE 13
Day Manth Yoar

afty a
9i05t
10:15p.M. A-Cld
Ol't
irsta, when A.
yurm at 50 12:40AM
prent to fd.
i shly at tint thie. 8.A.W.

13 Jne 67
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVIBION (AF3C
WRIGHT-PATTERSON AIR FORCE BASZ. OHIO 45433
REPLY TO TDET/UFO
ATTN OF
SUBJECT JUN 2 1 1967
TO: Mr.
Dayton, Unio 4 5406
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. Thank you for your observation
to the Air Force.
JAMES C. MANATT, COlOnel, USAF 1 Atch
Director of Te ology and Subsystems Subaystems FTD Form 164 w/envelope
Director
PO PT B OI/K
DO OTE T O/E
;

.
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 answ any questions as you possibly can. The information that you give will
be used for research
ccnclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, may contact further details.
I TIP
1. When did you see the object? Time of day: 0025
Hour Minutes
13 JUNE 1967 (Circle One): A.M.
or P.M.
Day Month Year
3. Time Zone:
(Circle One): a. Eastern (Circle One): Ca. Daylight Saving
b. Central b. Standard b. Standard
c. Mountain
d. d. Pacific
e. Other
e object?
Dayton Ohio Ohio
Nearest Postal Address City or Town State or County
(Total Duration) 45
Hours Minutes Seconds
Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? estimated ,
5.2 Was object in sight continuously? Yes No —
6.What was the condition of the sky?
DAY NIGHT
Bright a.
b. Cloudy b. Cloudy
7.IF you saw the object during DAYLIGHT , where was the SUN located as you looked at the object?
(Circle One): a.. In front of you d. To your left
b. In back of you e. Overhead
c. To your right f. Don't remember
FTD FORM
OCT 62 164 This form supersedes FTD 164, Tul 61, which is obsolete.

Pngn 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
A few b. Dull moonlight
c. Many G No moonlight - pitch dark
d. Don't remember
9. What were the weather conditions at the time you saw object?
CLOUDS (Circle One): WEATHER (Circle One):
@ Clear sky Dry
b. Hazy b. Fog, mist, or light rain
c. Scattered clouds Moderate or heavy rain
d. Thick or heavy clouds Snow
e. Don't remember
10. The object appeared: (Circle One): The object appeared: (Circle One):
a. Solid As a light
b. Transparent e. Don't remember
c. c. Vapor Vapor
If it appeared as a light, was it brighter than the brightest stars? (Circle One): . If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter a. Brighter c. About the same
b. Dimner b. Dimner d. Don't know
te ag As bright os 1t Mag Star.
.The edges of the object were:
(Circle One): a. Fuzzy or blu:red e. Other
b. Like a bright star
C Sharply outlined
d. Don't remember
1. Did the objact: (Circle One for each question)
a. Appear to stond 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 Don't know

Page 3
it? If so, how?
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: _
1. 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: 7. Tell in a few words the following things about the object:
a. Sound.None a. SoundNone
b. ColorWkite light b. Color_ White light
.
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
19. 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.

2 Addiess
3. Phone 4572
Tine: 1125 fuist bsmd 5gune 67
Locatio of ob sinev: Locatin f ob sinev: abcarratiny Abctrratiny
1bch s. of7ue ih (inf enet Ls of7u iif ent
mi Eof Tistioed itid
Lotia UF0:
7wiles away.
4

Mores in sperts
(Circle One) Yes (N\o)
IF you answared Y S, then what speed would you estimate?
21. Do you hink 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?
Where were you located when you saw the object? Were you (Circle One)
(Circle One):
a. In the business section of a city?
Inside a building b. In the residential section of a city?
b. In a car c. I In open countryside?
C. Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea f.
f. g. Other
. th time, then complete the following questions:
24.1 What diroction were you moving? (Circle One). 24.1 What direction were you moving? E Circle One).
a. North c. East c. East . South e. South g. West Wost
b. Northeast d. Southeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? _miles per hour. miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yos No
25.Did you observe the
a. Eyeglasses Yes No . Binoculars Yes
b. Sun glasses Yes f. Telescope No
c. Windshield Yes g. Theodolito No
d. Window glass Yes No h. Other

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
90°
60
45 NW
i
-15 SW
32,
28. Uraw a picture that will show the motion that the object or objects made. Place an "A" at t Uraw a picture that will show the motion that the object or objects made. Place an "A' the beginning of the the beginning of the
29. IF there was MORE THAN ONE object, then how many were there?
Draw a picture of they were arranged, and put an arrow to show the direction that they were traveling.
4 /

Page 6
30. Have you evar seen this, or a similar object before. If so give date or dates and location.
31. Was anyone else with you at the time you saw the objact? (Circle One) Yes No
Circle One) Yos No
32. Please give the following .Please give the following information about yourself: information about yourself:
NAME NAME Name Nama First Name Middla Name
45406
City Zone State
TELEPHONE E NUMBER AGE AGE H.3 SEX Male sEX Male
Extrerely intelligent inclivicoal (mD) seem to
Know what he was talking aboot
3.When and to whom did you report that you had seen the object? L.1 Valore
Day Month Year
OD

Pago 7
34. Date you completed this questionnaire:
Day Month Yoar
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.
!

PROJECT 10073 RECORD
TIME CRCIP 2. LOCATION
17/0430Z Dayton, Ohio (Witnesses)
10. CONCLUSION
Civilian SATELLITE (Echo I)
.. to RER OF OBJECTS
ECHO I was passing South of (1139L) on a NE
1 heading at time of sighting.
LENGTH OF DASERVATION 11. BRIEF SUMMARY AND ANALYSIS
15-20 tinutes that bhe object appeabed toa
(. TYPE OF OBSERVATION was compared in light brightness to that of a
disappeared or went behind clouds. Joject had no distinct
Groind Vis.l sound of its ovn. Color: iree.nsh-yellow compared to
COURSE moon and planets.
SI-E
F:OTOS
Yes
P-YSICAL EV DENC -YSICAL EV DENC -
F:
"OR r -lous mdillone of this form mey be t.ed.
1
. .
I
-

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.
:I:
When did you see the object? Time of day: 23 30
Hour Minutes
16
(Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One):a. Eastern (Circle One):Ca. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. e. Other Other
4. Where were you when you saw the object? 4. Where were you when you saw the object?
oroenuiek- L. Joline Ave., Dayton
Nearest Postal Address City or Town State or County State or County
5.How long was object in sigh 5.How long was object in sig otal Duration) 15-20
Hours Minutes Minutes Seconds
c. Certain c. Certain c. Not very sure Not very sure
Fairly certain Fairly certain d. Just a guess Just a guess
5.1 How was time in sight determined? WATCH WATCH
5.2 Was object in sight continuously? Yes X No_—
6. What was the condition of the sky?
DAY NIGHT
a. Bright a,
b. Cloudy b.
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
FORM
FTD OCT 62 164 This form supersedes FTD 164, Jul 61, which is obsolete.

b.
c. Scattered clouds Moderate or heavy rain
d. Thick or heavy clouds Snow
e. Don't remember
The object appeared: (Circle One): So
a. Solid dJ As a light
b. Transparent Don't remember
c. Vapor
a. Brighter c. About the same
b. Dimmer Dimmer d. Don't know
11.1 Compare brightness to some common object:
12.The edges of the object were: 12.The edges of the object were: Rifted ballon Rifaited balloon
(Circle One): a. Fuzzy or blurred (Circle One): a. Fuzzy or blurred e. Other. e. Other
b. Like a bright star 1
c. Sharply outlined
d. Don't remember i1
13. 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 Yes No Don't know
d. Give off smoke? V 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
-

Yes No Don't Know. IF you answered YES, then tell what
in front of: .
17. Tell in a few words the following things about the object:
a. Sound No
b. Color tt -
+ tanat
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 of the object would have been covered by the match head?
Abot sam Abut AaN aA head. head.
aA
. Draw a picture thar will show the shape of the object or objects. Label and include in your sketch any details 19. 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.

(Circle One) Yes No
75°iw 15 mine
IF you answered YES, then what speed would you estimate?
21.
(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? 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 airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
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? rcle 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.
(Circle One) Yos No
25. Did you observe the Did you observe object through any of the following?
a. Eyegiasses a. Eyegiasses No e. e. Binoculars Yes No
b. Sun glasses Yes No f. Telescope Yes No
c. Windshield Yes No g. Theodolite Yes No
d. Window glass Yes No h. Other
object or objects wh - give the same appearance as the object which you saw.
1

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 compass where you last saw the object.
90° Just below
75°
60
Constant
elev NE 5
30°
-15° 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 Draw a picture that will show the motion that the object or objects made. Place an "A" at t the beginning of the
path, a "B" at the end of the path, and show any changes in direction during the course.
2. IF there was MORE THAN ONE object, then how many were there?
Draw a picture of how Draw a picture of h they were arranged, and put an arrow to show the direction that they were traveling. y were arranged, and put an arrow to show the direction that they were traveling.

Deaof Oljict A
2.Ciculaw
4.Brigh aljithe sy
bieenlars
Cudif Sby SEND
Nag -Saithe I Clond 164
Te

Page 6
0. Have you ever seen this, or a similar object before. If so give date or dates and location.
No
31. 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:
32. Please give the following information about
NAME
Last Name First Nome Middle Name
DAYTON
ADDRESS
Street Streot City Zone Zone 4$06
4506
M M
TELEPHONE TELEPHONE NUMBE NUMBE AGE AGE SEX SEX
including any special experience, which might be pertinent. luding any special xperience, which might be pertinent.
/
.When and to whom did you r
67
Day Month Yoar
SDO FTD
0
I

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: 11 45
Hour Minutes
16 67
(Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One) a. Eastern (Circle One):a. Daylight Saving
b. Central b. Standard
C. Mountain
d. Pacific
e. e. Other Other
4. Where were you when you saw the object?
Home
Nearest Postal Address City or Town City or Town Stato or County
Tota! Duration) Total Duration) O
Hours Minutes Seconds
a. Certain a. Certain c. Not very sure c.Not very sure
Fairly certain Fairly certain d. Just,a-guess d. Just,o guess
5.1 How was time in sight determined? Watck
5.2 Was object in sight continuously? Yes No _
What was the condition of the sky?
DAY NIGHT
a. Bright a. LITTLE CLOUDY
b. Cloudy b. Cloudy
7IF 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
e. To your right F. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164, Jul 61, which is obsolete.

Page 2
8. IF you saw the object at NIGHT, what did you notice concerning ths 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't remember 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
b. Hazy Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared: (Circle One):
a. Solid d As a light with a tail
b. Transparent e. Don't remember
c. Vapor
If it appeared as a light, was it brighter than the brightest stars? (Circle One): If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a.Brighter Brighter c. About the same
. Dimmer d. Don't know
11.1 Compare brightness to some common object:
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred (Circle One): a. Fuzzy or blurred e. Other Other
b. Like a bright star b. Like a bright star
C. Sharply outlined Sharply.outliaed
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 No Don't know
g. Flash or flicker? Yes No Don't know
h. Disappeor and reappear? Yes No Don't know

Yes No Don't Know. IF you answered YES, then tell what
it moved behind:
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of:
17. Tell in a few words the following things about the object:
a. Sound N0
b. Color
8. We wish to know the angular size. Hoid 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? _/
0
tae avne aA north Y0
19. 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.

22. 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. In a car In open countryside?
c. Outdoors d.) Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea f. Flying g over open country?
f. g. Other
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? 24.1 What direction were you moving? Circle One) rcle One)
. North . North c. East c. East e. e. South g. West West
b. Northeast . Northeast d. d. Southeast Southeast f. Southwest h. Northwest Northwest
24.2 How fast were you moving? _.miles per hour. _miles per hour.
24.3 Did you stop at any time while you were looking at the object? √
(Circle One) (Circle One) Yes Yes No No
25. Did you observe the object through any oft 2. Did you observe the object through any of f the following? ,
a. Eyeglasses a. Eyeglasses Yes No e. Binoculars Yes No
b. Sun glasses b. Sun glasses Yes No f. Telescope f. Telescope Yes No
c. Windshield Yes No g. Theodolite Yes No
d. Window glass Yes No h. Other I
object or objects which, when placed up in the sky, would give the same appearance as the object which you saw.
V

,
show how high the object was above the horizon (skyline) when you last saw it. Place an "A" on the compass
0f
90°
75°
60 Constant elv
45° NE
o
-B
R3
-15° SW
S5
A S
28. Uraw 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. path, a B ar the end or the patn, and show any changes in direction during the course.
29. IF there was MORE TH 29. IF there was MORE HAN ONE object, then how many were there? _ AN 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. Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.

Same 13 and
Was anne  with you at he time you saw the bjCil On) Yes No
3.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and ad sses:
32. Please give the following information about yourself:
MRS
NAME
Last Name First Name Middie Nama
ADDRESS DAYT0N 45424 0175927
ADDRESS
Street City Zone Zone State
TELEPHONE NUMBER F F
TELEPHONE NUMBER AGE AGE SEX
Indicate any additionali information about yourself, including any spocial experience, which might be pertinent.
1
When and to whom did you report that you had seen the object?
Doy Month Yoar
-

PROJECT NOOTS NECOND
1. DATE ·TIME GROUP . LOCATION
20 Tun 67 21/0302 Duyton, Onjo
3. SOURCE 10. CONCLUSION
CAvil SATELLITE (Echo I)
4. NUMBER OF OBJECTS Dcho I was at y81 - 35N at 0259z traveling in a h aireccion
at time of sigating.
LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
a)ainutes Observer stated when she observed it just by eye aighe, bugee
TYPE OF OBSERVATION resembled a brighe star, then she viewed ob,gect rirouri. a
t.. teleccope and it resembled an oval gray star. Onjeet fiew in
Gnd Visual(TX-3X) a straight path ontil it past throxgh ? stars and onen it a,-
7. COU'RSE peared to make a slight turn to tne south.
SW-E
e. PHOTOS
n1 Yes
C1 No
2. PHYSIC VIDENCE
CH Yes
No
FORM
FTD STP63 0-329 (TDE) Previous editions of thie form may bn usod.
15 tuts

SATELLITE/ECHO I)
ECNo I OVER 78w AT 0 2592
35 N
NE
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 pos acerning the unidentified aerial phenomenon that you have observed.
Please try to ans questions as you possibly can. The information that you give will
be used for re 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.
TLIR 68.1
.When did you see the object? 2. -
Hour Minutes
JUNE 20 19i7 (Circle One): A.M. or P.M.
Mo Year
3. Time Zone: 3. Time Zone:
(Circle One): a. a. Eastern a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you sow the object?  .luck yurd
Wagtr Wagtrr ohir munt.
Nearest Postal Address Nearest Postal Address Cijy or Town State or County
5. How long was object in sight? (Total Duration) 20 b.76
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain. d. Just a guess
5.2 Was object in sight continuously? Yes X No
Ai
6. What was the condition of the sky? .X
DAY NIGHT in
a. Bright Bright 4
b. Cloudy b.
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
FORM
FTD OCT 62 164 Thie form supersedes FTD164, Jul 61, which is obsolete.

1'nyn 7
. IF you saw the object at NIGHT, what did you notice concerning the STAkS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle Onc):
a. None a. Bright moonlight
b. A.few b. Dull moonlight
c. Many. No moonlight - pitch dark
d. Don't remember d. Don't remember
.What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
Ca. Clear sky a. Dry
b. Hazy Fog, mist, or light rain
c. Scattered clouds Moderate or heavy rain
Thick or heavy clouds d. Snow
. e. Don't remember
10. The object appeared: (Circle One): The object appeared: (Circle One):
a. Solid d. As a light d.As a light
b. Transparent b. Transparent e. Don't remember
c. c. Vapor
1If it appeared as a light, was it brighter than the brightest stars? (Circle One): If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer b. Dimmer thetening d. Don't know
11.1 Compare brightness to some common object:
The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other ly acope .ival
Cb. Like a bright star S
c. Sharply outlined 60.6m.m.
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 No Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know

(H.S.. Scui)
②
1

SATELLITE/ECHO I)
ECNo I OVER 78w AT 0 259t
35 N
NE
U.S. AIR FORCE TECHNICAL INFORMATION
2 This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as pos cerning the unidentified aerial phenomenon that you have observed.
Please try to questions as you possibly can. The information that you give will
1 be used for res ur name will not be used in connection with any statements,
conclusions, or publicati ithout your permission. We request this personal information so
that if it is deemed neces we may contact you for further details.
When did you see the object? . Time of day: 11
Hour Minutes
JuNE 20 19i7 (Circle One): A.M. or P.M.
MonT Year
. Time Zone: . Time Zone:
(Circle One): a. Eastern (Circle One): a. o. Daylight Saving Daylight Soving
b. Central b. Standard
c. Mountain
d. Pacific
e. e. Other
.
Wayne asd hyorning Wayne and hyarning Wagtir Wagtr ohir Munt. ohir, mont.
Nearest Postal Address Cijy or Town State or County State or County
5. How long was object in sight? (Total Duration) 20
Hours Minutes Seconds
a. Certain c.Not very sure
b. Fairly certain. d. Just a guess
5.2 Was object in sight continuously? Yes x No _
What was the condition of the sky?
DAY NIGHT
a. Bright . Bright
b. Cloudy b. Cloudy
7.IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): a. In front of you d. To your left
b. In back of you e. Overheod
To your right f. Don't remember
I
FORM
FTD OCT 62 164 This form supersedes FTD 164, Jul 61, which is obsolete.

Poge 3
14. Did the object disappear while you were watching it? If so, how? 70, only when
W lift ut of sight
1Did the object move bshind somothing at any time, particularly a cloud?
(Circle One): Yes (No Don't Know. IF you answered YES, then tell what
it moved behind:
20
1.Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of:_
17. Tell in a few words the following things about the object:
a. sound to high for sound.
We wish to know the angular siz.Hold a match stick at arm's length in line with a known object and note how
NE ← =sw lini where airplane
take tt to our hamie, st
it lft the 2 stis: They
nit die is) of the big dijper
Mindle.

(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 bowvesithen the stars
IF you answered YES, then how far away would you say it was? _..
22. Where were you located when you saw the object? Were you (Circle One)
(Circle One):
a.In the business section of a city?
Inside a building b.In the residential section of a city?
. In a car c. 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
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)
1 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.
-
if thig tuere moving,
54
1

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 S- n the compass
when you first saw it. Place a "B"o the compass where you last saw the object.
90° 75
AY
60
30•
15 SW
C
M L.raw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the L.raw 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. path, a "B"" at the end of the path, and show any changes in direction during the course.
sujhltiia whit -A A
B
2. 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.

Y 10:50 chn caurue threugh iy p
10:5s N.E- C
10:15NWTS-F
10:20 NWTS-E
Yes No
31.1 IF you answered YES, did thay see the object too? (Circle One) Yos No
31.2 Please list their names and addresses: (60n) oumx addun
(202) aame adlion
(2i) Dame acidrss
miRi watch Thogh tilinpi mith me
.Please give the following information about yourseli:
NAME
Last Name First Nome Middl Name
ADDRESS Dayton 10- Chio
Streat City Zone Sta
rCI 3.3
Jice Flani ciratch
air partrol
.When and to whom did you report that you had seen the object?
20 Juine 1966 at 11:2o to wsight
Day Month Your
Fatleaon Ain fie Gam.

Page 7
Date you comp uestionnaire: 12 July 1966.
Day Month Year
. 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. Chast of sighting
X indienti stav) langelright
X X X
-
1-7
00;11
20 A5
a.
1885 s1:91L hInc
W
S -N ×
E )

TO:
Dayton, Ohio
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. Thank you for reporting your observation
to the Air Force.
1 Atch
/Director of Technology and Subsystems FTD Form 164 w/envelope
.
4

.
Page 8
Bigdipper sits in cicle on chart -
from
south to the Bte object otopped
TARIA on)
21JUNE67 a1SoME6r 03002 0300t
ECHO I ECHO I
0243 1i3. 13.
45 45
0263 0263 68
03032 0303Z
02y3 113 J3
16 35
02592 78W 35 N
O
)

Page 5
2. 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 compass where you last saw ihe object.
90° 75°
60
45 NE
30
O
15 SW S5
C
L.raw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the 28. 1 I
path, a "B" at the end of the path, and show any changes in direction during the course.
A A B
0 O >0 >O
WesT EKT
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.

Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
Ns.
31. 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) Y0 No
31.2 Please list their names and addresses:
te
32. Please give the following information about yourself: Please give the following information about yourself:
NAME NAME
Last Name First Name Middle Name $
ADDRESS Deron Derron OHO OAO
City Zone Zone State State
TELEPHONE NUMBER AGE AGE SEX
Indicate any additional information about yourself, including any special experience, which might be pertinent.
Hove
33. When and to whom did you report that you had seen the object? 4
20√nEC.7
Day Month Year

,
PROJECT 10073 RECORD
1. DATE- TIME GROUP 2 LOCATION
12 Jun 67 Dayton, Ohio 3
3. SOURCE 10. CONCLUSION
Civilian INSUFFICIENT DAEA FOR EVALUATION
NUMBER OF OBJECTS Send form l6l. to observer over 30 days ago, and not re-
1 turned as of this date, sight re-evaluated when returned.
5. LENGTH OF OBSERVATION 1BRIEF SUMMARY ANID ANALYSIS
1 hour SEE CASE FILE
6. TYPE OF OBSERVATION
Ground Visual (BX) Ground Visual (BX)
7. COURSE 7. COURSE
Southeast
8. PHOTOS 8. PHOTOS
n Yes .
No
9. PHYSICAL EVIDENCE PHYSICAL EVIDENCE
Yos
iXN
FORM
FTD SEP 63 0-329 (TDE) Previous oditions of this form may
,

Poge 3
14. Did the object disappear while you were watching it? If so, how?
No.
.
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): Yos No Don't Know. IF you answered YES, then tell what
it moved behind: _ C cKs
B
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of:
17. Tell in a few words the following things about the object:
a. SoundZroee a. SoundZrorne 11
b. Color Zeclng lghi b. Color Zacling Lighe.
We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how 8We 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? sighting, how much of the object would have been covered by the match head?
II
2
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.
kone
C
L

Poge 4
2Do you think you can estimate the speed of the object?
7
(Circle One) Yes No
IF you answered YES, then what speed would you estimate? -
-
(Circle One) Yes No
IF you answered YEs, then how far away would you say it was?
Where were you located when you saw the object? Were you (Circle One)
(Circle One):
a In the business section of a city?
Inside a building b.J In the residential section of a city?
b. In a car In open countryside?
Outdoors Near an airfield?
amampa7p In an airplane (type) e. Flying over a city?
e. At sea e. At sea f. Flying over open country? f. Flying over open country?
f. Other - g. Other _ g. Other
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) 24.1 What direction were you moving? (Circle One)
a. North c. East e. South g. West
. Northeast d. Southeast d. Southeast f. Southwest h. Northwest h. Northwest
24.2 24.2 How fast were you moving? 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
2. Did you observe the object through any of the following?
Eyeglasses Yes No e. Binoculars No
.Sun glasses Yes No F.) Telescope
c. Windshield No g. Theodolite Yes
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 common
object or objects which, when placed up in the sky, would give the same appearance as the object which you saw.
Roune Facling object.

L
iD
U.S. AIR FORCE TECHNICAL INFORMATION 7
This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as possibl econcerning the unidentified aerial phenomeno that you have observed.
Please try to answer as yquestions as you possibly can. formation that you give will
be used for research tion with any statements,
conclusions, or publications without your permission. We request this personal information so
that if it is deemee e may contact you for further details.
.When did you see the object? Time of day: 2300
Hour Minutes
20 4 67 (Circle One): A.M. or P.M
Day Month Year
Bta
3. Time Zone:
(Circle One): Eastern (Circle One) Daylight Saving (Circle One)a) Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object? 4. Where were you when you saw the object?
DErroN DeuroN OH10
Nearest Postal Address City or Town State or County
How long was object in sight Total Duration) not cailad
Hours Minutes Seconds
a. Certain c.Not very sure
.Fairly certain d. Just a guess
5.1 How was time in sight determined? _ 2.a .
5.2 Was object in sight continuously? Yes- No_=
6.What was the condition of the sky?
DAY NIGHT
a. Bright a.
b. Cloudy Cloudy
7.IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): a. In front of you d. To your left
b. In back of you e. Overhead
c.To your right f. Don't remember )
FORM
FTD OCT 62 164 This form supersedes F TD 164, Jul 61, which is obsolete.

9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry
b. Hazy Fog, mist, or light rain
.Scattered clouds c. Moderate or heavy rain
d.Thick or heavy clouds d. Snow
e. Don't remember 11
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid As a light
b. Transparent Transparent e. Don't remember msl
c. Vapor
I
If 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):
a. Brighter c. About the same
Dimmer Cb Dimmer d. Don't know
11.1 Compare brightness to some common object:
NE
12. The edges of the object were:
(Circle One):) Fuzzy or blurred e. Other
b. Like a bright star
c. Sharpiy outlined -6
d. Don't remember :1
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? No Don't know
f. Change shape? No) Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? es No Don't know

Page 7
34. Date you completed this questionnaire: 20 UN C7
Day Month Year
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.
'
none
- 7
P
√

8Bod )

Qs 12Junes7
- DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FORZIGN TECHNOLOGY DIVISION (APBC)
WRIGHT-PATTERSON FORCE DABZ. OHIO 45433
REPLY TO TDET/UFO
ATTN OF
SUBJECT June 1967
JUN 2 1 1967
Mis
TO:
Dayto 45424
unidentified observation. The information which
Reference your
we have received is not sufficient for a scientific evaluation.
Request t you complete the attached FTD Form 164 and return it in
provided Thank you reporting your observation
the envelope
to the Air Force.
JAMES C. MANATT, ColOnel, USAF 1 Atch
Subsystems FTD Form 164 w/envelope 164 w/envelope
Director of Technology Technology and

U.S. AIR FORCE 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 nany 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 may contact you for further details. r
.When did you see the object? .Time of day: R130
Hour Minutes
!2 JONE (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone: 3. Time Zone:
(Circle One): (Circle One): (G. G. Eastern 6 Daylight Saving
b. Central Central Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
Dayton Chie
-
Nearest Postal Address City or Town State or County
(Total Duration) 1
Hours Minutes Seconds
a Certain . Not very sure
.Fairly certain d. Just a guess
5.1 How was time in sight determined? _ extimated
5.2 Was object in sight continuously? YesV No
6. What was the condition of the sky?
DAY NIGHT
a. Bright a
b. Cloudy Cloudy
.IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): o. In front of you d. To your left
b. In back of you e. Overheod /
c. To your right f. Don't remember
FTD O 2R 164 FORM
This form supersedes FTD bsolete.

-
Pngn 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 a. Bright moonlight
A few b. Dull moonlight
c. Many No moonlight - pitch dark
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 àDry
b. Hazy b. Fog, mist, or light rain
Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
1. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid a. Solid dAs a light
b. b. Transparent e. Don't remember
c. Vapor
If 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 c. About the same c. About the same
. Dimmer b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
.The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
b. Like a bright star
O 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? No Don't know
f. Change shape? No Don't know
g. Flash or flicker? C Mo Den't know
h. Disuppeur and reappear? N Don't know