PROJECT BLUE BOOK

PROJECT 10073 RECORD
1. DAYE- TIME GROUP 2. LOCATION
7J01 07 08/02037 M. Carroliton, Chio
FOURCE 10. CONCLUSION
Civilian g
1. NUIBER OF OBJECTS Echo vas over 6)W-hoN at O202z traveling towari SS3 aleo
L
1 1 -ime of sighting. -ime or sighting.
S. LENOTH OF OBSERVATION 5. LENOTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS BRIEF SUMMARY AND ANALYSIS
5 aintes Observer stated object resembled star in mocion. Observer stated ob,ect resembled star in mocion. Only
information given.
. TYPE OF OBSERVATION
Ground Visual
7. COURSE COURSE
NE-SS
3. PHOTOS FRHOTOS
n Yes
M No
2. PHYSICAL EVIDENCE
07 Yes
No
FORA
PTD SEP 63 0-329 (TDE) Previoua editions of this form may be used.

SATEUITE/ECHOI) :: ..
EcHoI OVER 69WJ-Y0N1 AT 02022
TRAVELING TONARD 55E.
U.S. AIR FORCE TECHNICAL INFORMATION
-
This questionnair has been prepared so that you can give the U.S. Air Force as much
information as pos ncerning the unidentified aerial phenomenon that you have observed.
Please try qusstions as you possibly can. The information that you give will
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necess may contact you for further details.
.When did you see the object? Time of day: 10 03
Hour Minutes
7 Judy 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 Standard
c. C. Mountain
d. Pacific
e. Other
Where were you when you saw the object? Where were you when you saw the object?
ST W.IMRROLLTCN W.IMBROLLTCN 0H1O CH1O
Nearest Postal Address City or Town State or County 115449
5. How long was object in sight? (Total Duration) 5
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? _ heohesali
5.2 Was object in sight continuously? Yes No_-
6. What was the condition of the sky?
DAY NIGHT
a. Bright 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 f. Don't remember
FORM

Pogn 7
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): 7
a. None a.Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight - pitch dark
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
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't remember
10. The object appeared: (Circle One):
Solid as at
a. d. As a light d. As a light
b. Transparent e. Don't remember e. Don't remember
c. c. Vapor
1. 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 a. Brighter c. About the same
b. Dimmer b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
aveg an
1.The edges of the object were:
(Circle One): a. Fuzzy or blu:red e. Other
b. Like a bright stars
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

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14. Did the obinct disappear while you were watching it? If so, how?
1
Yeu whil mifi.
.Did the object mova bahind somathing at any time, particularly a cloud?
(Circle One): Yes $N\o 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 answared YES, then tell what
in front of: .
17.Tell in a few words the following things about the object: 17. Tell in a faw words the following things about the object:
a. Sound2 a. Sound2
b. Color_ b. Color bihe  o
We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how 8.We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how
much of the object is covered by the head of the match. If you had performed this expariment at ths 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?
proddad .
. Draw a picture that will show the shape of the object or objects. Label and include in your skatch 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.
in nal
IL

(Circla 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):
a. In the business section of a city?
.Inside a building In the residential section of a city?
b.In a car c. In open countryside?
c. Outdoone d.) Near an airfiald?
d. In an airplene (type) d. In an airplane (type) e. e. Flying over a city? Flying over a city?
e. At sea f. f. Flying over open country? Flying over open country?
f. Other — f. Other_ g. Other
2.IF you ware MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24. IF you ware 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? (C Circle One) Circle One)
a. North a. North c. East c. East 1 e. South e. South g. Wost
b. Northeast b. Northeast d. Southeast d. Southeast f. Southwest f. Southwest h. Northwest
24.2 How fast were you moving? — miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No
matin cedeis
a. Eyeglasses e. Binoculars Yes No
b. Sun glasses Yes No f. Telescope Yes No
c. Windshield g. Theodolite Yes No
d. Window glass. Yes No h. Other
object or objects which, when placed up in the sky, would give the same appearance as the object which you saw.

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. In the following sketch, imagine that you are at the point shown. Place or "A"" on the curved line to show how
high the object was above the horizon (skyline) when you first sow 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 the object.
90°
12 5.
NW NS
15° 3w
Lraw 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.
A / 7 7
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.

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3. Have you ever saen this, or a similar objact before, If so give date or datas and location.
.
3. Was anyone else with you at the time you saw the object? (Circle One) No
31.1 IF you answerod YES, did they see the object too? (Circle One) CYe
No
31.2 Please list their names and addresses:
(9900
of Wife
32. Please give the following information about yourself: 32. Please give the following information about yourself:
NAME
Last Name First Name Middl Name
ADDRESS CAAACLZ6N 454UG CARAELZ0N 454UG OHO OHHO
Street City Zone State State
TELEPH TELEPH ONE NUM AGE 34 AGE 3 SEX MAL SEX
Indicate any additional information about yourself, including any special experience, which might be pertinent.
NCR asseler
33. When and to whom did you report that you had seen the object? 17 D
104 1967 C
Day Month Year

230lh Page 7
questionnaire: 67
Day Month Yoar
35. Information which you feel pertinent and which is not adequately covered in the he specific points of the
questionnaire or a narrative explanation of your sighting.
I this o et lie h
I

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1
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