PROJECT BLUE BOOK

TYPE OF OSSERVATION direction over tho Sassafrts River, There were arro ih
broun' Visual to to 30 flashes in a zig zag pattern. Tne firot fl rhv
7. COURSE were about as britht as a brirht star. The last floah :
- diminished somosh t, and simply ctorpod about 47
eaard above the horison. The flashes Seemed to be at rarL
FIOTCS intervels but the Aiatonce intervals vried gresti .
5 Yes Contect with Bendix Fligat Oporotions rovealed ciet
Ne MASa C-llsA airer'ft ws in the erea using a 4Opo wy:
9. PHYSICAL EVIDENCE trcting light leo'tst on the bottou of the airar Ite
17 Yox n7 Yo- .
8 No
FORM ant i
F-TD FTD SED <=D6 C.3"g (ThF) oravious aditons ol thta form mas ba used. C.3"o (ThF) oravious aditons ol thta form mas ba used.
-
,
.

2 Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
IF you answered ES, then how far away would you say it was? 1
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a.Inside a building b. In the residential section of a city?
b. In a car c. In open countryside?
c. Outdoors d. Near an airfield?
d. In an airplane (type) a. Flying over a city?
e. At sea f. Flying over open country?
f. Other (At anchor on a boot) 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 mov Circle One)
- c. North c. East c. East e. South South g. West West
e. g.
b. Northeast d. d. Southeast f. f. Southwest h. h. Northwest
24.2 How fast ware you moving? miles per hour. miles per hour.
24.3 Did you stop at any time while you were looking at the object? 24.3 Did you stop at ony time while you ware looking at the object?
(Circle One) Yes Yes No
2. Did you absarva the object through any of the following? object through any of the following?
a. Eyeglasses Eyeglassos Yes No No e. Binoculars
b. Sun glasses Sun glasses No f. Telescope Yes
c. Windshiald Yes No g. Theodolite Yes
d. Window glass Yes No h. Other
26. In order that you can give as clear a picture as possible of what you saw, describe in your own words a common
object or objects which, when placed up in the sky, would give the same appearance as the object which you saw.
Bright star
)
-

when you first saw it. Place a "B"" on the compass where you last saw the object.
90°
73°
60°
NW NZ
E
15 3W
S6
Draw a picture th ill show the motion that the object or objects made. Place an "A" at the beginning of the
path, a "B"
30 30 flashes flashes
K20 K 20
B
29. IF there was MORE THAN ONE object, then how many were there? 2. IF there was MORE TH 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. Draw a picture of h were arranged, and put an arrow to show the direction that they were traveling.
/

Philadelphia
32. Please give the fallowing informarion about yourself:
NAME Last Name
First Nams Middis Nara
ADDRESS =Philodelpha 19107 Pa.
City Za00 Stn
TELEPHONE NUMBET AGE 37 SEX Male
Indicate any additional informatien abour yourself, ineluding any special axporience, which might be pertinent.
Good, cleav obsevver, 1n genevol; vationàl,
lso
St., Plladelphia, Pa. St., Phladelphia, Pa.
pilot)
——
33. When and to whomn did you rengt that you had saan the abjeet? U.S.A.F.
19 June 1967
Math Yeur )

Poge 7
Toly 1967
34. Date you cor 1 3}$ Month Yoor
35. specific points of the
questionnaire or a narrative explanation of your sighting.
Coveved (n letter 6 diag vain
my
Sent to you 6-19-67,
- -
- :
-
)

.
1 ,
MEMO FOR THE RECORD: 21 July 67
-
Contact was made with Mr Information officer, Aberdeen
Proving Ground. Mr. said that he did not believe that
any craft from the proving ground could have been responsible for
the sighting. The grounds consists of 7500 acres and their craft
do not go outside the limits on missions. Mr. said that
he would check into the matter in detail and if he found anything
he would call.
-
E
,

Maryland are
assistan reciated,
Director of Subsystems
1st Indorsement Ist lhdorsemeirc
TO: TO: TDET/UFO TDET/UFO
FM: Bendix Flight Operations
Review of the flight Review of t the flight records on file this station reveals that a C-ll8A,
NASA 428 was conducting ; tests or the EEVES Ranging ar ES Ranging and I Tracking System Tracking System
in the vicinity of Friendship in the vicinity of Friendship Airport Airport from June 18/o20c June 18/0200 GMT to 18/0515 GMT. 18/0515 GMT.
This would place this aircraft This would place this aircraft in the reporte repor ghting on
17 June 2230 EDT.
These tests were These tests were conducted conducted at varying at varying altitudes of 5000 altitudes of 5000 to l2000 feet, to 12000 feet,
displaying a 4050 watt tracking light racking light located on the bottom of the aircraft. the aircraft. .
HNose d
Howard L. Naslund
Manager
Bendix Flight Operations
-

Page 1
U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so thot you can give the U.S. Air Force as much
information as possible concerning the unidentified cerial phenomenon that you have observed.
Please try to answer as many questions as you passibly 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.
2.Time of day: 9 30
1.When did you see the object?
Hours Minutes
SUNDAY fune 1967 (Circle One): A.M. or P.M.
Doy Month Year
3. Time Zone:
(Circle One): a. Eastern (Circle One):. Daylight Saving
6 Central Central b. b. Standard Stondard
C. Mountain Mountain
d. Pacific
e. e. Other
4. Where were you when you saw the abject?
1EHAMMOND HAMMMOND FNDIANA FNDIANA
Nearest Postal Address Nearesr Postai Address City or Town State or County
5. How long was object in sight? 5. How long was object in sight? (Total Duration) (Totai Duration) O 45
Hours Minutes Seconds
6Certain Certain c. Not very sure c. Not very sure
6. Fairly certain 6. Fairiy certain d. Just a guess
I I
5.1 How was time in sight determined? 5.1 How was time in sight determined? THG OBUGCT
5.2 Was object in sight continuously? Yes. V No
6. What was the condition of the sky?
DAY NIGHT
a. Bright a._Bright
b. Cloudy brCloudy
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 yourright f. Don'tremember
SeeIT
FORM NIGHT
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 the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
b. Afey bBull moonlight
c. Many C. No moronlight-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):
a. Clearsky (ia. Dry)
b. Hazy 5. 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. Ihe object appeared: (Circle One):
a. Solid + A2 0 ligh
b. Transparent e. Don'fremember
c. Vapor
1 If it appeared os a light, was it brighter than the brightest stars? (Circle One):
.Brighte c. About the same
b. Dimmer d. Dan'tknow
11.1 Compare brightness to same common object:
CAIGHIG IHAN IHE STREGTLFGH
1The edges of the objuct wers:
(Circle Onel: a. Fuzzy or blurred .oter. Di A BRFGH
b. Like a bright star TAQ
smaply outined
Don'tremember
e.
f. Change shape? 2②2 Don't know
g. Flash or flicker? Don't know
h. Disappear and reappear? Don't know
-

(Circle One): Yes No Don't know. IF you answered YES, then tell what
IN EPONJ OF
in front of:
CL
17. Tell in a few words the fallowing things about the object:
VER VERY, LOVD
b. Color ORANGeE
18. We wish to know the angular size. Hald a match stick at arm's length in line with a known object and note how much of the
object is cavered 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?
NOT BERY
MUC
19. Draw a picture that will show the shape of the object or objects. Label Land include in your sketch any detoils of the object
that you saw such as wings, protrusions, etc., and especially exhayst trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving.
~,

O form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
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. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Inside a building In the residential sectian of a city?
b. In a car c. In open countryside?
C. Outdoors dNear an airfield?
d. FIn an airplane (type) e. Flying over a city?
e. Atsea f. Flying over open country?
f. Other 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? (Circle One)
a. North c. East e. South 9. 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 lime while you were looking at the object?
(Circle One) Yes No
25.Did you observe the object through any of the foilowing?
a. Eyeglasses Yes e. Binoculars
b. b. Sun glasses Yes f. Telescope Yes No
c. Windshield 8 Theodolite Yes Yes
g-
d. d. Window gioss Yes Yes No h. h. Other Other THE N A 6Y6 EY6
In order that you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jects which, when placed up in the sky, would give the same appearance as the object which you saw.
4
WITHLF TTLE DOTS
ON FT
a

Firendship Airport, since the past, these aircraft have
Goddard Space Flight Center, and in
teen respons
10:CO p.m. June am., June 18, a
Between the area of the reported sighting at
C-118A NASA aircraft was in 17. The tests were conducted
approximately 10:30 p.m., June 1 tracking light
at varying altitudes, displaying a 4050-watt
located on the bottom of the aircraft.
cannot identify your positively,
Although we
we do believe we do believe this aircrart
sighting.
Sincerely,
BARNETT B. YOUNG
Lt Colonel, USAP Lt Colonel, USAF
Chief, Civil Branch
Community Comunity Relations Relations Division
Office of Information Info
ME
Philadelphia, Pennsylvania 19133
SAF-OICC SAF-OIC
J.Tunre
L-Coord oy - SAF-OIC
Combk oy- SAF-OIC
Reader cy - SAF-OIC
Activity cy - SAF-OIC
Stayback.

Page 5
27. In the following sketch, i imagine that you are at the point shown. Place an "A" an 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
A C3
NW NE
30
W E
BRAAS
15 SE
3
s
o
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 "8" ot
the end of the path, and shaw 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 they were arranged, and put an arrow to show the direction that they were traveling.
THERE ONL Y 7
WAS
1 ONE
OB JECT

7.
fO form continued. SS
* 5 Page 6
30. Have you ever seen this, or a similor ebjact before. I so give date or dates and location.
NO F HAVENT
31. Was anyone else with you at the time you saw the abject? (Circle One) es No
31.1 IF you answered YES, did they see the object too? (Circle One) N
31.2 Please list their names and addresses:
32. Please lon about yourself:
NAME First Name Middie Name
ADDRESS HAMMON
State
TELEPHONE NUMJE SEX/3
Indicate any additional information about yourself, including any special experience, which might be pertinent.
Day Month

0.
Official U.S. Air Force U
Page 7
34. Date you completed this questionnaire: ASUNDY fre 1967
Day Month Year
35. Infaton which u e pertnent n hic equatly coveed  e sec po t /
questionnaire or a narrative explanation of your sighting.
-

U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so thot you can give the U.S. Air Force as much
infarmation 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.
.When did you see the object? 2.Time of day:
Hours Minutes
2 Zeine 19c7
Manth (Circle One): A.M. or P.M.
Day Year
I done kno
3. Time Zone:
(Cirele One): a. Eastern) (Circle One): a. Daylight Saving
b. Central b.(Standard)
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
Houande
Nearest Postal Address City or Town State ar County
5. How long was abject in sight? (Total Duration) 30
Hours Minutes Seconds Seconds
a. Certain c. Not very sure
b. Fairly certai b. Fairly certain d. Just a guess d. Just a guess
5.1 How was time in sight determined? b lstiannnt eatia
5.2 Was object in sight continuously? YesK No
What was the condition of the sky?
a NIGHT
c. a. 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. Overhead
c. To your right I. (Don'tremembed
FTD FORM
OCT 62 164 This forim supersedes FTD 164. jul 61, which is obsotete.

Page 2
8. IF you saw the object at NiGHT, what did you notice concerning the STARS and MOON?
8.1 STARS(Circle One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight-pitch dark
Don't remember d.
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
a a. (Dry)
b. Hazy b. Fog, mist, or light rain
C. Scattered clouds C. Moderate or heavy rain
d. Thickorheavy clouds d. Snow
e. Don't remember
10.1 The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent .Don'tremember
c. Vapor
1 If it appeared as a light, was it brighter than the brightest stars? (Circle One):
o. Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
tanpairofpo
The edges of the object were:
Circle One): a. Fuzzy or blurred e. Other. -
Like a bright star
c. Sharply outlined
d. Don't remember
a. Appear to stand still at any time? Yes Don't know
b. Suddenly speed up and rush away at any time? ras Don'tknow
c. Break up into parts or explode? Yes Don't know
d. Give off smoke? Yes Don't know
e. Change brightness? Yes @et0999 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
1

IF
it moved behind:
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes N Don't know. IF you answered YES, then tell what
bu=
in front of:
17. Tell in a few words the following things about the object:
24. IF
a. Sound_
2
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 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 2.
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? 2
alaut alrauk 3
25. C
19. 19. Draw Draw a picture that will a picture that will I show show the shape of the shape of the object or objects. Label and include in your sketch any object or objects. Label and include in your sketch any details of details of the object
that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an an arrow beside the drawing arrow beside the drawing
to show the direction the object was moving.
EAST 26.1
-
-
C
N NTH

cOutdoors d. Near an airfield?
d. In an dirplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other g.
24. IF you were MOvING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
a. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? miles per hour.
24.3 Did you stop at any time while you were looking at the abject?
(Circle One) Yes No
5. Did you observe the abject through any of the foilowing?
a. Eyeglasses Ye e. Binoculars Yes
b. Sun glasses Yes NO f. Telescope Yes 3
c. Windshield Yes N0 g. Theodolite
d. Window glass Yes N h. Other

4
..I
Official U.S. Air Force U
Page 5
27. In the following sketch, in imagine that you are at the point shown. Place an "A" on the curved line to show how high the abject 3C
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 harizon (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 3
NW NE
30
B w
E
ARMAS
15° SW SE
32
28 Draw a picture that will show the motion that t the object or objects made. Place an "A" at the begioning of the path, a "B" ot
the end of the path, and show any changes in direction during the course.
A 3B
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. Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
&
R9

~
UFO form continued
Page 6
30. Have you ever 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 object? (Circle One)
31.1 IF you answered YES, did they see the object too? (Circle One) Ye No
31.2 Please list their names and addresses:
Ne is
Hokoma,hoe. -
46901
32.F Please give the following information about yourself:
IName First Name
ADDRESS Dolena And.
City Zone State
TELEPHONE NUMBE AGE. SEX Male
Indicate any additional information about yourself, including any special experience, which might be pertinent.

fo look.Ke
lost it, d
to the house
boehis
seeit
,1

icefes Lene Sd 17Gine?
Hinnaft/ poside)
NASA 428 WAS INTHE
AIRCRAFT AREA ATTIME OF
TDET/UFO SIGHTING.
(Maj Quintanilla/70916/mhs/3 Aug 67) AUG 3 1967
UFO servation, 17. June 1967
Bendix Flight Operations
Friendship Airport
Baltimore, Maryland 21203
Our office has
over the Sassafras River in northeastern Maryland on the night of
17 June 1967. Request information on any flights of the seven,
four-engine aircraft which are operated for Goddard Space Flight
Center, NASA. Possibly, one of these craft was in the northeastern
Maryland area at approximately 2230 EDT, 17 June 1967. Your
assistance is appreciated
CD P B OI/II AMES C. MANATT, ColOnel, USAF
Mirector ology and Subsystems
LEAL

o low ifs oay A Dablis Drand
Proposed reply to letter from
aly 24, 1967 (Sighting 4 Jun 67)
Reference your recent letter in which you requested information
on unidentified flying objects.
With the information which you submitted in your letter, it would
be extremely difficult to offer an explanation on your observation.
Essential data such as flight characteristics, meneuvers, and duration
evaluation.
Also, it is not possible for us to undertake an investigation
into the cause of your observation, since your sighting occurred out-
side the 1 limits of the United States.
The inclosed information on the Air Force's program on unidentified
Force's program on unidentified
flying objects should be of interest to you. interest to you.
Thank you for bririging your observation to
to our attention. our attention. We
hope that hope that your visit to the United States is pleasant. your visit to the United States is pleasant.
to Sefni 4 any 67

and
Ooe.
more S
Too much 9
you

characteristics, angular velocities, or weather information,
we are unable to undertake a scientific investigation. Had
base immediately, an on-the-spot investigation would have been
possible.
We hope the inclosed Project Blue Book repor be of
help to you in identifying your observation.
Thank you Thank you for reporting your observation to the Air Force. - your observation to the Force.
Sincerely,
Chief, Civil Branch
Community Community Relations Division
Office of Information Information
.
Attachment
Durango Coloredo 813C1

report
I was going out to look It
is a refractor, a three inch.
Just as I was going out I noticed object passing
from east to west very fast. It was only i
three seconds.
It was about the size of an egg at arms length, the
shape was oblong, it was white with a blue haze around it.
It could have been a meteor or comet. I would like
to know if_there were any comets in the Durango area at
the time.
I am twelve years old. I have read about them
many times, and didn,t swamp gas,
or a hallucination , or satellite.
Sinecreily
-

than members of the Project Blue Bock office.
area
If the Chanute AFB investigator found
instrument landings then this could have
the immediate area making
Such aircraft on instrument missions have
been what obsery
sightings in the past. in the past.
been in the been area, our radar sensors and P
such an event. We
from your area on the date of your
have received no additional reports
sighting.
to Lefi 20 Jel 67.

radio stat but they gave it no
concern. So some O f U5 went a ned
reported it to the 0O lice The
also gave no con BUT a local
newsp aper the 7 sent over a
reporter who LA wed some of
- ti. +
recess was a
small ST n E. Bot OV the hay boc
from the Police Station Josech
Barrett and 13y self Sal it again
in the and Size OR A.
footoall. It dropped
from its bottom and the disappeare
I

P.5. - please reply
0 :
↑
1
TH15 15 THE
OBJ ECT AS IS HOW
SEIEN BMTHE B THE THIS BARRETT ANP ANP
rMTRr JOE JDE BARRETT
ENTIRE SCNOOL I SAW IT.
NOTE:
THESE ARE
ALMOST TO ExAcr
SCALE.
CLEASE EXCUSE THE THIS is wilT
TAPE on THE CLPPING THE TIAT
BUTS It TORE WHILE I
CUTING IT O OF BOTTOM LOUKED LIKE

read this at ter yor've read 1
pe
clipping.
Sir:
IY the U.F.O. was a
tell me what plane
patern like this:
SIGHTED AT AGOUT
UFO WAS FIRST MILES AWAY
FEET ABOUT 3
70 WEST
IN THE
80 FEET U.F.O pook
→ A CLIMB
AND A
DIVE HERE
70 FEET t5 MOVE D
ABOUT 40 MOVED
MP.H_, MP.H, AND →+ SUDDENLT SUPPENL, T
QUICkLY DIUED
-60 FEET FEET BEHIND BEHIND THE MHE TREES REES
*
50 FEET
HERE HERE [5 GAINED A
SPEE SPEE OF 0F ABOUT 200)
FEET M.P.H. MO H
40
TREES
C
-30 Feer
20 FEET

Official U.S. Air Forc
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.
A
$90$ 75
60 N
NW NE
30 B
W E
BRA
15° SV SE
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"ot
the end of the path, and show any changes in direction during the course.
DISNPAERED
DISAPAC
29. IF there was MORE THAN ONE object, then how many were there?
Draw a picture of how they were arranged, gnd put an arrow to show the direction that they were traveling.
2.

i SASSAFRAS RvER Mol
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE BASZ. OHIO 45433
REPLY TO TDET/UFO 11 July 67
ATTN O7
.
SUBJECT UFO servation 17 June 67
TO:
Co.
Ave.
Philade ,Pa.
Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation.
Request you complete the attached FTD Form l64 and return it in
the envelope provided. T Thank you eporting your observation
to the Air Force.
USAF 1 Atch
Technology bsystems FTD Form 164 w/envelope

31.2 Please list their names and addresses: brother and sister
32. Please give the fallowing information about yaurself:
Last Name First Name Middle Name
a at
ADDRESS TTSTOUN PA
Street City Zone State.
TELEPHONE NUMBER AGE8+11 SEX M F
Inca ydital nfoatin o yurscdng el epn wht  pert.

Official U.S. Air Force U
Poge7
34. Date you compleled this questionnaire: 13 1DAE 1967
Day Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points af the
questionnaire or a narrative explanation of your sighting.
SIMALAR
SAW,
17
WE
ONE ovcour
WAS

3 INFO ONLY
NO CASE
",
Page 1
8.IF yc
U.S. AIR FORCE TECHNICAL INFORMATION 8.1
This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as possible concerning the unidentified aerial phenomenon that you have observed.
Please try to answer as many guestions 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. 9. Who
CLO
MIDNIGHT a.
2. Time of day: b.
1. When did you see the object? Hours MinulCh c. S
d. T
10 UONE 6967 (Circle One): A.M.) or
Day Month Year
10. The
3. Time Zone: (Circle One) a. Daylight Saving. a.
(Circle One). Eastern b. Standard b.
b. Centrat c.
C. Mountain
d. Pacific
e. Other 11. If it
Where were you when you saw the object? PA.
PottstowN
State or County 11.1
Nearest Postal Address Cily or Town
O 3-5 Q
5. How long was object in sight? (Total Duration) Minutes Seconds
Hours 12. The
a. Certain C. Not very sure
Cb. Fairly certain
5.1 How was time in sight determined?
5.2 Was object in sight continuously? No
b. In back of you e. Overhead
c. To your right f. Don't remember
FORM 164 This form iupersdes PTD 1et, jut St, which is obsolete
FTD OCT 62
L

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
b. Hozy Fog, mist, or light rain
C. Scattered clouds c. Moderate or heavy rain
Thick or heavy clouds d. Snow
e. Don'tremember
0The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
C. Vapor
11.1 If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighteg c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common abject:
BYIGHT AS MOON
The edges of the object we
(Circle One): o. Fuzzy or blurred e. Other_
b. Like a brighrstar
c. Sharply outlined
d. Don't remember -

A
Official U.S. Air Force UF
Page 3
20. D
Did the object disappear while you were watching it? If so, how?
faded out
21. C
15. Did the object move behind something at any time, particularly a cloud?
No Don't know. IF you answered YES, then tell what -
(Circle One): 6
it moved behind:_.. 22. V
16. Did the object move in front of something at any time, particularly a cloud?
Yes No Don't know. IF you answered YES, then tell what
(Circle One):
in front of:
17. Tell in a few words the following things about the object: 24.
o.Sound2
b. Color_
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 mnatch head? the abject would have been covered by the rnatch head?
25.
19. Draw a picture that will show the shape of picture that will show the shape of t the object or objects. Label and include in your sketch any details of the object
19. Draw such as wings, protrusions, etc., and especially y exhaust trails or vapor trails. Place on arrow beside the drawing exhaust trails or vapor trails. Place an arrow beside the drawing
that you saw such as wings, protrusions, etc., and especially that you saw s
to show the direction the abject was moving. obiect was moving.
26
TRAIL
WINGS
1L
~ -
E

ce
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
VERYEAST
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) YesD No
IF you answered YES, then how far away would you say it was? 1 MILE Or more
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
g..In the business section of a city?
Inside a building b. In the residential section of a city?
b. In acar 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 AN AUTOMOSILE or other vehicle at the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
a. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
Sf the
chof 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
Did you observe the object through any of the foilowing?
a. Eyeglasses e. Binoculars Yes
object b. Sun glasses f. Telescope Yes 992
awing C. Windshield (No 9. Theodalite Yes
d. Window glass Yes No h. Other
oc.an

Page 1
U.S. AIR FORCE TECHNICAL INFORMATION 8. 1F yo
8.1
This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as possible concerning the unidentified aerial phenomenon that you have observed.
Please try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. Your name will not be used in connection with any statements,
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, we may cantact you for further details.
9. Wha
CLOL
1. When did you see the object? 2. Time of day: 20 o. C
Hours Minutes b.
IE
1 0ur 1937 (Circle One): (A.M) P.M.
or
Day Month Year
3. Time Zone: 3 10. The c
(Circle One): a Eastern (Circle One): a. Daylight Saving a. Sc
6. Central 6. Standard b. T1
C. Mountain c. V.
d. Pacific
e. Other
11. If it c
Where were you when you saw the object?
doravel Dispi
Nearest PostabAddress City or Town State or County 11.1
5.How long was object in (Total Duration) 0 T2 2
Hours Minutes Seconds
a. Certain a. Certain Not very sure 12. The 12.The
b. Fairly certain
7 ( ((
5.1 How was time in sight determined?
5.2 Was object in sight continuously? No.
6. What was the condition of the sky? 13. Did-
DAY CNIGHT
a. Bright Bright a.
b. Cloudy g. Cloudy b.
c.
d.
. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the abject? e.
(Circle One): a. In front of you d. To your left f.
b. In back of you a. Overhand 7.
c. To your right f. Don'tcemamber h.
FORM
FTD OCT 62 164 This form supersedes FTD 164. jul 61, which is obsolete.
U

C. Many c. No moonlight-pitch dark
d. Don't remember a Don'tremember
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
o.Clear sky Dry
b. Hazy b. Fog, mist, or light rain
Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds Snow
e. Don'tremember
10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
c. Vapor
1If it appeared as a light, was it brighter than the brightest stars? (Cirele One):
a. Brighter
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
12. The edges of the object were: The edges of the object were:
(Circle One): a. Fuzzy or blurred Other
G Like a bright star
C. C. Sharply outlined
d. Don't remember
3. Did the object: (Circle One for each question)
Appear to stand still ar any time? No Don'tknow
b. Suddeniy speed up and rush away at any time? 995, Don'tknow
c. Break up into parts or explode? Don't know
d. Give off smoke? Yes Don'tknow
e. Change brightness? Yes 2(2222)2 Don't know
f. Change shape? Don't know
g. Flash or flicker? Y Don't know
h. Disappear and reappear? Yes Don't know
A
1

A
Official U.S. Air Force
Page 3
.Did the object disappear while you were watching it? If so, how?
ys Sumed ts disppoor iisspae. TH
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: De small eliumfe 0042s 202t22
m
16. Did the object move in front af something at any time, particularly a cloud?
(Circle One): Yes No Doniknow IF you answered YES, then tell what
in front of
17. Tell in a few wards the failowing things about the object:
a. Sound Z 2
b. color Lngit ulite
18. We wish to know the angular size. Hoid a match stick at arm's length in line with a known abject 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 wauld have been covered by the match head? all lfit
2
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 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
———

proceeded first flashes were about as
west to easterly direction. The
bright as a bright star The last flashes diminished somewhat,
and then simply stopped about L50 the horizon. The flashes
seemed to be at regular time intervals but the distance intervals
varied greatly. There was a star we could use as orientation.
I have attached drawing. There were no colored lights, sounds,
etc. and none of us imagined it could be e any type of plane, balloon,
Ilare, e d ever seen. One of our pilot.
The only imagine, unless D some
kind of kind of test of high high altitude 1titude photography.
If you explanation I would appreciate hearing from you,
otherwise we will claim that we have seen a "UFO". Naturally, I
wanted to check this out before we feel sure we actually have
witnessed some thing that doesn't have a common technological
explanation.
Enc. Send 164
FHW:S
-
(

Page 4
20.Do you think you can estimate the speed of the object?
(Circle One) Yes No dipthy fair than misile
IF you answered YES, then what speed would you estimate?
21. Da you think you can estimate how far away from you the abject was?
(Circle One) Yes No Os far ao ters
IF you answered YEs, then how far away would you soy 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?
@ Inside a building 6 In the residantial 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. Ar sea f. Flying over open country?
f. g. Other
24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questians: 24. IF you were MOVING IN AN AUTOMOBiLE or other vehicle at the time, then complete the following questians:
24.1 What direction were you moving? (Circle One)
a. North o. North c. East c. East e. South e. South g. West
b. Nartheast 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 stap at any time while you were locking at the object?
(Circle One) Yes No
25. Did yau observe the abject thraugh any of the following?
a. Eyeglasses e. Binoculars e. Binoculars -
Eyeglasses Y9s Yes
b. Sun glasses b. Sun glasses f. Telescope Telescope Yes 999 99
AOGO Theodolite Yes
c. Windshield 9.
d. Window glass Yes h. Other.
. In arder that you can give as clear a picture as possible of what you saw, describe in your own words a common abject or ab-
jects which, when ploced up in the sky, would give the same cppeorance os the object which you saw.
a lald of sihits light
-
3

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the paint 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 "8" on the same curved line to show how high the object was
above the harizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a "B" an the com-
pass when you last saw the object.
90° 75 A
60 N
NW NE
30
w E
15 SW SE
o S
28. Draw a picture that will show the motion that the object or abjects made. Place an "A" at the beginning of the path, a "B"at 28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the path, a "B" at
the end of the path, and shaw any changes in direction during the course. the end of the path, and shaw any changes in direction n during the course.
a
29. IF there was MORE THAN ONE object, then how many were there?. 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. Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
&

-
UFO form cor ntinued
Page 6
31. Was anyane else with you at the time you saw the object? (Circle One) Yes N
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 'Please list their names ond addresses:
32.Please give tha formation about yourself:
NAME me Middle Nome
Maninulhs
ADDRE City Zone State
AGE AGE SEX Dereadde
TELEPHONE NUM
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and to whom did you report that you had seen the object?
11 n2m 144 rgardy
Doy Manth Year

MA Tal
Omed r onr es tis with the t
natill
Chad dirgtin and gors
-
1

Page 1
U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so that you can give the U.S. Air Force as much
information as possible concerning the unidentified aerial phenamenon 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 p 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.
When did you see the object? Time of day: 55
Hours Minutes
13 JONE 1247 (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One):(a. Eastern (Circle One): a. Daylight Saving
6. Central 5. Standard
Mountain
Pacific
e. Other
4. Where were you when you saw the object?
ADANSSILE ADAMSViLLE BROM=
Nearest Postal Address City ar Town Staterer County
CANADH
5. How long was abject in sight I Duration) 13
Hours Minutes Minutes Seconds
a. Certain o. Certain c. Not very sure c. Not very sure
D. Fairiy certain D. Fairiy certain d. Just a guess
5.1 How was time in sight determined? YEF WATCi
5.2 Was object in sight continuously? res No_-—
6. What wos the condition of the sky?
DAY NIGHT
o. Bright a. Bright
b. Cloudy 5. Cloudy
.IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the abject?
(Circle One): a. In frant of you d. To your left
b. In back of you Ovethead
c. To your right F. Don'tremember
FTD FORM 164 This form supersedes FTD 164. jul 61, which is obsolete.
OC 62

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):
o. Clear sky a. Dry
b. Hazy 6. Fog, mist, or light rain
C. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10.1 The object appeared:(Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
c. Vapor
1 If ir appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
Lie a Iwink ins RE DER
The edges of the object were:
(Circle One): a. Fuzzy or blurred e.OherISD
Like a brightstar 20-
c.Sharply outlined WERLINES TND SHo
d. Don't remember WEZEAP 21
c. Yes
d. Give off smoke? Yes Don't know
e. Change brightness? Yes 922 Don't know
f. Change shape? Yes Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know

TOWARDS THE WEST.THE INTERVAL WERE
3= ON: GECOND
15. Did the object move behind something at any time, particulariy 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: iTMAVED -OA 92ED
TENsiON LiNAVzR
TWEHAUE
17. Tell in a few words the following things about the object: SNTESERINO.
a. Sound ABSSrELy
b. Color R=RDiSM
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
abject 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?
WE WSOLD AVE SSEN 2 N LT
THE ASS
Draw a picture that will show the shape of the abject or bjects. Label and include in your sketch any details of the object
that you saw such as wings, pratrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the abject was moving.
RivER
KO

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) Fres No
IF you answered YEs, then how far away would you say it was? 100 2t-
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
oIn the business section of a city?
a. Inside a building b. In the residential section of a city?
b. In a cor C. In open countryside?
C. Outdoors 'd. Near an airfield?
d. In an airplane (type) e. flying over a city?
e. Atsea f. Flying aver open country?
f. Other g. Other
24. IF you were MOVING IN AN AUTOMOBILE or ather vehicle at the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
a. North c. East e. South 9. West
b. Northeast 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? 24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes Yes No No
25. Did yau abserve the abject through any of the following? 25. Did you abserve: the abject through any of the following?
a. Eyegiasses Eyegiasses Yes T e. Binoculars Yes No
b. Sun glasses Sun glasses No f. Telescope Yes Yes No No
c. Windshieid No g. 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, 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.
Lere 2 eplniding
1

Official U.S. Air Force
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 abject
was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show how high the object wes
above the horizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a a" on the com-
pass when you last saw the object.
90 75°
N
NW NE
30°
24
BBs E
15° SS SE
o S
28. Draw a picture that will show the motion that the object or objects made. Place an "A at the beginning of the path, a "B" at
the end of the path, and show any changes in direction during the course.
O
SRALAS
IC
29. IF there was MORE THAN. ONE obiect, then how many were there?
Draw a picture of haw they,were arranged, and put an arrow to show the direction that they were traveling.

34. Date you completed this questionnaire: Day Month
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.
RivEt WAS TRAUELLING TOWARDS
U S AND SODDENLY As
NEARED US, IT NEERED S HRR-
WE
PLY TO THE AND DOSAP.
C 0
PEARED 6RADUALLY 6 RADUALLY O 0
AS iTwENT AS ALONGTH ALONGTHE THt TH
POWER.LiNE(WE POWER.LINE W 5 BELEEVE IT BE! BEI
WAS WAS LOAD LOADING ITSeLe ITSCLF TO-RETURN TO-RETURN 1
0F 0
TO THE MOTHER stre) IT LEGULARLY Por
DISLOADED GREAT
SPARKS FRIGHTENING HERD V F
O F CRTTLE IN Toe Na WE
SAVC

briglt ② 0
June 17,1967 2bout 20-30 0 O
About 10:30 PM EDT flasles ( eti
Clear- very few cloods- < ete
pautial moon fainter2 eD
204 Geovgetoun, Md.
SASSAFRAS RIUER
Marsh Pr ⇒→ Easterly
ts
Not to scale
)

Paga6
30. Have you ver seen this, or a similar objeck before. If so give date ar dates and location.
NEVEAEVEN EKPECTED To
SEE ONE.
Wasanyone else with you at the time you saw the object? (Circle One) No
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
MRS.
- DAMSUILLE
CO.BRGME P.QUE.
CNAA
32. Please give the following information about yourself: P
Last Name First Name Middle Name
ADDRESS ADAMSdiLE BROME
Street City Zone
TELEPHONE NUMBER AGE_ 17 SEX MALE P.Q
CAN.
Indicate any additional information about yourself, Including any special experience, which might be pertinent.

US 7 SUDDENLY EERED
DUE WEST
WE WERE out FOR A SHORT WALK IN TIE
COOL OF THG EVENING. ACLWAS VERY
QHET THEN ON THE OPPOSITE BANK OF
THE RIVER I SUDDENLY TOMYSURPKISE
BEHELD 3 Beantiful 9 REAT SHOWER
SPARKS FALL AROUND THE 3
E WACKEP NERMER THERE WAS NO-ONE THEKE
NAS DAKKL THE FIELD WAS ESERTED
SAVE FOR COWS. TeN WE SA THE
(Shed) MKS 11
A

Omiciar U.S. Air Force UF
Page 5
30. H
above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show haw high the object was
above the horizon (skyline) when you last saw it. Place an "A" an the compass when you first saw it. Place a "B" on the com. was
pass when you last saw the object.
90° 750A 31. V
60 N
3
B(I'm Not Sure e
NW NE
E
15 SV SE
32.
5
0
Draw a picture that will show the motion that the o object or objects made. Place an "A" at the beginning of the path, a "B" at
28. duringt the course.
the end of the path, and show any changes in direction
13
Draw a picture of how were
Né→ Né→s

ce UFO form continued
Page6
yes, con't rememler.
30. Have you ever seen this, or a similar object before. If so give date ar dates and location.
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 abject too? (Circle One) Ye No
31.2 Please list their names gnd.g
32. Please give the following informatian about yourself:
Last Name Name
Portland 91213 Osegon
ADDRESS Street City Zone $\{}$
AGE 14SEX femade
TELEPHONE
Indicate any addilional information about yourself, including any special experience, which might be pertinent.
33. When and to whom did you report that you had seen the object? Our parents
-

called
1 other per
seen 24F newt I heard
on channel was
thing we saw
the then
2
*

eqse.
Vancorersh. Sinerclly Yyours,

information as possible concerning the unidentified gerial 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 connecticn with any statements,
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, e may contact you for further details.
When did you see the object? 2. Time of day: 10 45
Hours Minutes
1n Lune 19107 (Circle One): A.M. F.M)
or
Day Month Year
3. Time Zone:
(Circle One): a. Eastern (Circle One):a. Daylight Saving
Central b. Standard
Mountain
dPacific
e. Omer .
Where were you when you saw the object?
Portland Dreaon
Nearest Postal Address City or Town State or County
5How long was object in sight? (Total Duration) 3-4
Hours Minutes Seconds
a. Certain ud Not very sure
5. Fairly certain Just a guess
5.1 How was time in sight derermined? doakecd at cod bekore
5.2 Was object in sight continuously? YesX No_
DAY
a. Bright Brigh
b. Cloudy b. Cloudy
7. IF you saw the object during DArLIGHT, where was the SUN located as you looked at the abject?
(Circle One): a. In front of you d. To your left
b. In back of you Overhead
c. To your right Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164. jul 6l, which is obsolete.

8 IF you saw the object at NiGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
a. None a. Bright maonlight
b. A few b. Dull moonlight
C. Many c. No moonlight--pitch dork
d. Don'tremember d. Don't remember
E
9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): WEATHER (Circle One):
O. Claarsky 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
e. Don'tremember
10. The object appeared: (Circle One):
a. Solid d. As a light
Trunsparent e. Don't remember
c. Vapor
11. I If it appeared as a light, was is brighter than the. brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
Drightent star.
The edges of the object were:
(Circle Ona): a. Fuzzyorblurred e. Other.
6.Likea bright sta
c. Sharply outlined
d. Don'tremember
Did the object: (Circle One for each question)

A
Official U.S. Air Force l
Page 3
to the Horison
15. Did the abject move behind something at any time, particularly a cloud?
(Circle One): Yes No Don't know. IF you answered YES, then tell what
it moved behind:
Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't know. IF you answered YES, then tell what
in front of
1Z. Tell in a few words the following things about the object:
a. Sound none
18. We wish to know the angular size, Hald 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 wauld have been covered by the match head?
10 I show the shape of the object or objects. Label and include in your sketch any details of the ob
light

UFO form continued -
Page 4
20. Do you think you can estimate the speed of the abject?
(Circle One) ges No
2Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One): a. 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?
c. Outdoors Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea f. Flying aver open country?
f. Other 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? (Circle One)
a. North C Eas' . 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 loo'ing at the object?
(Circle One) Yes No
.Did you observe the object through any of the following?
a. Eyeglasses Yes Binoculars No
b. Sun glasses Yes f. Telescope C
c. Windshield Yes 0090 g. Theodolite N
d. Window glass Yes h. Other.
a frotall
M

4. Where were you
C
City or Town State or County
(Total Duration) .' 10.to30 seconds
Hours Minutes Soconds
a. Certain c. Not very sure
. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuously? Yes _ NoX-(flashing),
f .

angle turn.
- F
-

in the back dIf  k f in the back,I ji f
pheare serd it to me. pheave serd iet to me. fomation fomition
Beavr, Pas Beavr, Pas
. 15009 4
.
-

ND CASE oNLY
Page 1
U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so that you can give the U.5. Air Force as much
information as possible concerning the unidentified aerial phenomenon that you have observed.
Please try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. Your name will not be used in connection with any statements,
conclusions, or publications without your perrnission. 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? .Time of day:
Hours Minutes
1le JUNE 1467 (Circle One):
A.M. or P.M.
Day Month Year
3. Time Zore:
(Circle Onea. Eastero (Circle One):a. Daylight Saving.
5. Central b. Standard
uo Mountain
Pacific
e. Other
Wh you saw the object?
Deamer a Beae unt
Idress City or Town State or County
5. How long was object in sight? (Total Duration) 15 I5
Hours Minutes Seconds Seconds
a. Certain c. Not very sure
b. Fairly certain b. Fairly certain d. Just a guess
5.1 How was time in sight determined?/ bepethand timed t
5.2 Was object in sight continuously? Yes - No
6. What was the condition of the sky?
DAY NIGHL
a. Bright 3 Bright
b. Cloudy b. Cloudy
7. IF you sew the object during DAYLiGHT, where was the SUN located as you looked at the-bjeat?
(Circle One): In front of you d. To your felf
b. In bock of you . Overhead.
c. To your right. f. Don'tremember
FORM
FTD 0CT62 164 This torm supersedes FTD 104. jut 61, which is obsolete.
C

b. Hazy b. Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
Don'tremember
10. The object appeared:(Circle One):
. Solid d. As o light
b. Transparent e. Don'tremember
Vapor
1. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common abject:
I Eas sli nd brighter than the plart
Drmus.
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
b. Like a bright stae
C. Sharply outlined
D. woke
Did the object: (Circle One for each question)
a: Appear to stand still at any time? Ys No Don't know
b. Suddenly speed up and rush away at any time? Yes No Don'tknow
C. Break up into parts or explode? Yes (No) Don'tknow
d. Give off smoke? Yes No Don't know
e. Change brightness? Yes No Don'tinnw
f. Change shape? Yes No
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes) No Don't know

at a diffeint anfle. eere
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
Did the object move in front of smething 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:
ito
18. We wish to know the angular size. Hold a match stick at arm's length in line with a known abject and note how much of the
object is covered by the head of the match. If you had performed this experiment a! the time of the sighting, how much of
the abject would have been covered by the match head? all
19. Draw a picture that will show the shape of the object or objects. Label and include in your sketch n 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

-,
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Imside a building b. In the residential section of a city?
b. In a car .r oben 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. 9. Other
24.1 What directlon-were you moving? (Circle One)
a. North c. East e. South g. West
b. Northeast d. Southeast Southwest h. Northwest
24.2 How fast were you moving? miles per hour.
24.3 Did you stop at any time while you were luoking at the object?
(Circle One) Yes No
glaszes
Dd you serve the object hrough any of te folowing? μe
a. Eyeglasses Yos e. Binoculars Yes
b. Sun glasses Yes f. Telescope 303
Windshield 2003
C. g. Theodalite Yes
d. Window glass Yes h. Other.
"{ C

"
Official U.S. A
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
was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to show haw 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
4
NW NE
30
w E
BRAS
15 SE
Draw a picture that will show the motion that the object or objects made. Place an "A" gt the beginning of the path, a B"a!
the end of the path, and show any changes in direction during the course. N sieseinl lut
the path wor
eiratic,
+
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.

Dookson ,
organiyation.

line;it
1
L

18 - 25 JUNE 1967 SIGHTINGS
OBSERVER EVALUATION
DATE LOCATION yTOS) Sighting: Other (REFLECTION)
18 Colorado Phot: Other (FEFLECTION)
Sighting: Astro (VENUS/JUPITE)
.19 Excelsior, Minnesota Phote: Astro (VENUS/JUPITE)
c Satellite (ECHO I)
20 Denver, Iowa Satellite (ECHO I)
20 Dayton, Chio AIRCRAFT
20 Madawaska Laks, Maine AIRCRAFT
21 Saratoga Springs, New York Multiple INSUFFICIENT DATA
21 Tulsa, Oklahcma AIRCRAFT
21 Las Vegas, Nevada Satellite (ECHo I)
22 Las Vegas, Nevada Multiple INSUFFICIENT DATA
23 Manchester, Pennsylvania Other (CONFLICTING DATA)
Cloverdale, Indiana Multiple Satellite (ECHo I)
23 Multiple
23 r: Mauvco, Illinoia AIRCRAFT
23 Cakgrove, Oregon HOTOS)Sighting (AIRCRAFT)
23 Saratoga, New York Photo DATA)
- AIRCRAFT
Manchester, Pennsylvania Multipls DATA
23-30 INSUFFICIENT
Fort Lupton, Colorado UNIDENTIFIED
Austin, Texas INSUFFICIENT DATA
Van Nuys, California INSUFFICIENT DATA
Bristol, Tennessee Multiple DATA
INSUFFICIENT
2 Dagget, California asoov.sus.
ADDITIONAL ADDITIONAL ED SIGHTINGS SIGHTINGS (NOT CASES) (NOT CASES)
LOCATION SOURCE EVALUATION
DATE DATE ANB. New York New York Fhone
19 Suffolk County AFB,
Lima, Ohio Green
19 Green M
20 Erie, Pennsylvania 164, 164.
Hamburg, New York New York Green Green
20 Maine Maine NICAP NICAP Report
24 Trenton, Green Green
20 South Bend, Indiana
4

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 6. Dry )
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):
o. Solid d.As a light
b. Transparent e. Don't remember
c. Vapor
f 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 atfivst Brighter atfivst c. About the same
b. Dimmer atclose b. Dimmer atclose d. Don't know
11.1 Compare brightness to some common object:
The edges of the object were: 12.The edges of the object were:
(Circle One): a. Fuzzy or_blurred (Circle One): a. Fuzzy_or_blurred e. 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 No Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know
+
=

AbouT Same Smallev - Size
of Venus to$ start
. 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.
like a bright star
—
-