PROJECT BLUE BOOK

- eee ee ee em ee

1. DATE » TIME GROUP

18 Nov 67
3. SOURCE

ivilian

— ee eee

4. NUMBER OF OBJECTS

Ll
; 5. LENGTH OF OBSERVATION

conflicting

é. TYPE OF OBSERVATION
bcagiai Visual

& COURSE

SE To NNE
S$ PHOTOS

O Yes
‘o, No

9. PHYSICAL EVIDENCE

0 Yes
33 No

FORM

10, CONCLUSION

BRIEF SUMMARY AND ANALYSIS

PROJECT 10073 RECORD

2. LOCATION

Walcott, Iowa

IS FIO .
probable: ( METEOR )

Observer sighted a blue white object. The okect was slight-
ly brighter than Venus; the edges of the object were fuzzy,
it appeared to travel at fantastic speed, and had a smoke
trail. It vanished at an ele. of about 30 degrees.

Comments: In the originial letter the observer indicated
that she saw it at 5:15 pm on 17 Nov. On Form 117 she
indicated that she saw it at 6:15 on 18 Nov 67. The obser-
ver is only 11 yrs old. Witness was contacted but did not
return the 117s. It appears that the object was a fire-
ball or bright meteor.

FTD sép 63 0-329 (TD =) Previous editions of this form may be used,

re ae a nn te nn ee a te Se Ce
— —_—— -_—

——-

BOB Nr 21-R258
SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE

THIS QUESTIONNAIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE THE U.S. AIR FORCE AS MUCH INFORMATION
AS POSSIBLE CONCERNING THE UNIDENTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO
ANSWER ALL OF THE QUESTIONS. THE INFORMATION YOU GIVE WILL BE USED FOR RESEARCH PURPOSES.
YOUR NAME WILL NOT BE USED IN CONNECTION WITH ANY OF YOUR STATEMENTS OR CONCLUSIONS WITHOUT
YOUR PERMISSION. RETURN TO AIR FORCE BASE INVESTIGATOR FOR FORWARDING TO FTD (TDETR), WRIGHT-
PATTERSON AFB, OHIO 45433, IAW 80-17. (iF ADDITIONAL SHEETS ARE NEEDED FOR NARRATIVE OR SKETCHES
ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)

1. WHEN OID YOU SEE THE PHENOMENON?

me Sa Se MONTH November, EAR

2. WHAT TIME OID YOU FIRST SIGHT THE PHENOMENON?

; ne ae 2 (] a.m. oem.
3. WHAT TIME DID YOU LAST SIGHT THE PHENOMENON? (=
wour it. minutes 4 (J A.M. (HP.m.

4. TIME/ ZONE [_] DAYLIGHT SAVINGS i/\ STANDARD
[_] EASTERN CENTRAL [_] MOUNTAIN [_] PAciFic [ OTHER

5. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY, GIVE THE NEAREST STREET ADDRESS AND INDICATE ON
A HAND DRAWN MAP WHERE YOU WERE STANOING WITH REFERENCE TO THE ADDRESS. IF IN THE COUNTRY, IDENTIFY THE
HIGHWAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE AND DIRECTION FROM SOME RECOGNIZABLE LANDMARK.

6. IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH, PLACE AN “A” ON THE CURVED LINE TO SHOW HOW HIGH THE

PHENOMENON WAS ASOVE THE HORIZON, OR SKYLINE, WHEN FIRST SEEN. PLACE A "B® ON THE SAME CURVED LINE TO
SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.

oesenven ——"

AF aeer 117 a :
we. ae z

Soe” Qa se A Bay oo | e~ R J

—————

-

6A. NOW IMAGINE YOU ARE AT THE CENTER OF THE COMPASS ROSE. PLACE AN *A*® ON THE COMPASS TO INDICATE THE

DIRECTION TO THE PHENOMENON WHEN FIAST SEEN. PLACE A *B* ON THE COMPASS TO INDICATE THE DIRECTION TO
THE PHENOMENON WHEN LAST SEEN.

—_———

a - -

7. IN THE SKETCH BELOW, PLACE AN "A”® AT THE POSITION OF THE PHENOMENON WHEN FIRST SEEN, AND A “SS” AT THE
POSITION OF THE PHENOMENON WHEN LAST SEEN. CONNECT THE “A® AND °8* WITH ALINE TO APPROXIMATE THE
MOVEMENT OF THE PHENOMENON BETWEEN “A* AND “8". THAT IS, SCHEMATICALLY SHOW WHETHER THE MOVEMENT

APPEAPED TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW TO COMPLETE
THE LARGE®? SKETCH.

PAGE 20F 9 PAGES

sR erect etn me a

el m1) seal if

IN CAR AS DRIVER AS PASSENGER IN OPEN COUNTRYSIDE
IN BOAT NEAR AIRFIELD
IN AIRPLANE AS PILOT AS PASSENGER FLYING OVER CITY
OTHER FLYING OVER OPEN COUNTRY
Edge of Small Town.
OTHER
A. IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING:
WHAT DIRECTION WERE YOU MOVING? HOW FAST WERE YOU MOVING?
NORTH EAST
SOUTH WEST DID YOU STOP ANYTIME WHILE OBSERVING THE
PHENOMENON?
NORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES NO
EXPLAIN WHETHER SUCH MOVEMENT EFFECTS YOUR SKETCHES IN ITEMS 5 AND 6.
& wts Berst en pe X shown on sketch,
B shown ahetch.t
DESCRIBE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD, TERRAIN OR BODY OF WATER YOU
THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HOW MUCH OTHER TRAFFIC WAS THERE? HOW MUCH OTHER TRAFFIC WAS THERE?
DID YOU NOTICE ANY AIRPLANES? YES V NO. IF *YES," DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME VNO. IF *YES, DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME
OF SIGHTING THE PHENOMENON AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
3. HOW LONG HOW LONG WAS THE PHENQI MENON IN SIGHT?
LENGTH OF TIME LENGTH OF TIME CERTAIN OF TIME NOT VERY SURE
10 seconds 10 seconds FAIRLY CERTAIN FAIRLY CERTAIN JUST A GUESS
HOW WAS TIME DETERMINED?
.
WAS THE PHENOMENON IN SIGHT CONTINUOUSLY? VYES NO. IF *NO, INDICATE WHETHER THIS IS DUE TO YOUR
MOVEMENT CR THE BEHAVIOR OF THE PHENOMENON, AND DESCRIBE SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAP-
PEARANCES ON PREVIOUS SKETCHES.
PAGE 3 OF 9 PAGES

1O. IF THERE WERE MORE THAN ONE PHENOMENON, HOW MANY WERE THERE? DRAW A PICTURE TO SHOW HOW THEY WERE
ARRANGED. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING?
11. CONDITiONs (Check appropriate blocks.)
A. SKY 8. WEATHER I
DAY CUMULUS CLoUDS(Low fluffy) FOG OR MIST
TWILIGHT Alaost comples CIRRUs CLOUDS (High fleecy or Herring- HEAVY RAIN
NIGHT Dacks bbone) LIGHT RAIN OR DRIZZLE
CLEAR NIMBUS CLOUDS (Rain) HAIL
PARTLY CLOUDY CUMULONIMBUS CLOUDS SNOW OR SLEET
COMPLETELY OVERCAST (Thunderstorms) UNKNOWN
HAZE OR SMOG NONE OF THE ABOVE
C. IF THE SIGHTING WAS AT TWILIGHT OR NIGHT, WHAT DID YOU NOTICE ABOUT THE STARS AND MOON?
(1) STARS (2) MOON
NONE BRIGHT MOONLIGHT NO MOONLIGHT
A FEW MOON WITH HALO Tellow Haze UNKNOWN
MANY MOON HIDDEN BY CLOUDS
UNKNOWN PARTIAL (New or quarter)
D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? YES WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT OVERHEAD (New noon)
IN BACK OF YOU TO YOUR LEFT UNXNOWN
E. SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE S SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR
STREET LAMP, ETC.FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE,TO LIGHT SOURCE.
svti 2102 in
-
ti me of cRe a
12. GIVE A BRIEF DESCRIPTION OF THE PHENOMENON, INDICATING WHETHER IT APPEARED DARK OR LIGHT, WHETHER IT
ICHT OP WASSELEL MINOUSAND wHAT COLORS YOUL NOTICED. Descaia JUMPRESSIONOE WHETHER
Rthe
a eielde
a distano of oboct 100 sjards.
PAGE 4 OF 9 PAGES

MAKE A NOISE? lit least we one uttnese said thy. Roard
FLUTTER OR WOBBLE? abeny deund i
14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
dis tastié speed, brightness lightts, and smoie
twail.
A. HOW DID IT FINALLY DISAPPEAR?
oves oer ot oc
seen seen
the
T
B. DID THE OF SOMETHING, LIKE A CLOUD, TREE, OR BUILDING AT ANY TIME?
YES M NO. IF *YES," DESCRIBE.
/
PAGE 5 OF 9 PAGES

1S. DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE AND LABEL ANY DETAILS THAT MIGHT HAVE APPEARED AS WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARROW THE
DIRECTION THE PHENOMENON WAS MOVING.
VAPOR TRAIL
O
16. WHAT WAS THE ANGULAR SIZE? HOLD A MATCH AT ARM'S LENGTH IN FRONT OF A KNOWN OBJECT, SUCH AS A STREET LAMP OR THE MOCN. NOTE HOW MUCH OF THE OBJECT IS COVERED BY THE HEAD OF THE MATCH. NOW IF YOU HAD
BEEN ABLE TO PERFORM THIS EXPERIMENT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE PHENOMENCN WOULD HAVE BEEN COVERED BY THE MATCH HEAD.
hove covered xhe mated
hiad held at arms length.
PAGE 6 OF 9 PAGES

I7. DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWING? INCLUDE INFORMATION ON MODEL,
TYPE, FILTER, LENS PRESCRIPTION OR OTHER APPLICABLE DATA.
EYEGLASSES CAMERA VIEWER
SUNGLASSES BINOCULARS
WINDSHIELD TELESCOPE
SIDE WINDOW OF VEHICLE THEODOLITE
WINDOWPANE OTHER
A. DO YOU ORDINARILY WEAR GLASSES? YESNO B. DO YOU USE READING GLASSES? YES NO
18. WHAT WAS YOUR IMPRESSION OF THE SPEED OF THE 19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE
GIVE ESTIMATE OF SPEED 1,5AAM.P.1t.. PHENOMENON? GIVE ESTIMATE OF DISTANCE. LMELE
2O. IN ORDER THAT WE MAY OBTAIN AS CLEAR A PICTURE AS POSSIBLE OF WHAT YOU SAW, DESCRIBE IN YOUR OWN WORDS
A COMMON OBJECT OR OBJECTS WHICH, WHEN PLACED IN THE SKY, SIMILAR TO WHERE YOU NOTED THE PHENOMENON,
WOULD SEAR SOME RESEMSLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OSJECT AND WHAT YOU SAW.
epcept sthis U.F.O. hod a
a street light
larger and much fastor.
but slightly
.
R
21. DID YOU NOTICE ANY ODOR, NOISE, OR HEAT EMANATING FROM THE PHENOMENON OR ANY ON YOURSELF,
ANIMALS OR MACHINERY IN THE VICINITY?  YES NO.IF YES,DESCRIBE.
Peter goner said Re Reard a buyping sound
the sig gAting.
during
A. DID THE PHENOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. YES NO.
IF *YES,DESCRIBE.
PAGE 7 OF 9 PAGES

22. HAVE YOU EVER SEEN THIS OR A SIMILAR PHENOMENON BEFORE? YES NO. IF *YES, GIVE DATE AND
LOCATION.
23. WAS ANYONE WITH YOU AT THE TIME Y ou PHENOMENON? YES NO. IF TOO?
MYES NO.
IST THEIR NAMES AND ADDRESSES
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST FIRST NAME MIDDLE NAME
ADDREss (Srcet, City, State and Zip Code)
TELEPHONE/Area COd
MALE FEMALE
INDICATE ADDITIONAL INFORMATION INCLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
.
25. WHEN AND TO WHOM DID YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
18 MonTH Noveinber YEAR. 1967
NAME
26. DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY_. ZD2?MONTH NoveINbELYEAR 19GR
PAGE 8 OF 9 PAGES

27. INFORMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT ADEQUATELY COVERED IN THIS QUESTIONNAIRE, ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGHTING.
tihe objeet
sick fastor than ajet.
Contact sfe avipost at molire dllinois and
ask if sthg
for novembesis, 1907
.
L
PAGE 9 OF 9 PAGES

17067
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE ASE. OHIO 45433
REPLY TO TDPT/UFO
ATTN OP:
SUBJECT: UFO Observation, 17 November 1967
DEC 1 9 1967
TO:
Walcott, 52173
Your name has been given to the Aerial Phenomena Branch (Project
Blue Bookas being a witness to an unidentified flying object.
- If you were a witness to an UFo sighting on 17 November 1967
would you please complete the attached AF Form 1l7 and r return it
in the envelope provided. If you were not a witness to this sighting,
would you please make a statement to this effect on the attached form.
The information which you provide will be used in evaluating The information which you provide be used in evaluating this this
observation. Thank you for your assistance in this matter. observation. Thank you f your assistance in this matter.
JAMES C. MANATT, ColOnel, USAF JAMES C. MANATT, COlOnel, USAF 1 Atch
Director Production roduction AF Form 117
-

BOB Nr 2l-R258
SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE
THIS QUESTIONNAIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE THE U.S. AIR FORCE AS MUCH INFORMATION
AS POSSIBLE CONCERNING THE UNIDENTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO
ANSWER ALL OF THE QUESTIONS. INFORMATION YOU GIVE WILL USED FOR RESEARCH PURPOSES.
YOUR NAME WILL NOT BE USED AnY OF YOuR ST TS OR CONCLUSIONS WITHOUT
YOUR PERMISSION. RETURN T NVESTIGATOR FOR DING TO FTD (TDETR), WRIGHT-
PATTERSON AFB, OHIO 45433, IAW 80-1 ADDITIONAL SHEETS ARE NEEL ED FOR NARRATIVE OR SKETCHES
ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
1. WNEN DID YOU SEE THE PHENOMENON?
DAY 18 MONTH NoverberYeaR 196?
2. WHAT TIME OID YOU FIRST SIGHT THE PHENOMENON?
HOUR 5 MINUTES_ 15A.M. TP.M.
3. WHAT TIME DID YOU LAST SIGHT THE PHENOMENON? 5 16
HOUR MINUTES TP.M.
4. TIME/ZONE 7 DAYLIGHT SAVINGS STANDARD
M CENTRAL PACIFIC OTHER
5. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY, GIVE THE NEAREST STREET ADDRESS AND INDICATE ON
A HAND DRAWN MAP WHERE YOU WERE STANOING WITH REFERENCE TO THE ADDRESS. IF IN THE COUNTRY, IDENTIFY THE
HIGHWAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE ANR DIRECTION FROM SOME RECOGNIZABLE LANDMARK.
House
Then here Then here
Finst here Finst here
/
Groud Driveway Graud Driveway
6. IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH, PLACE AN *A* ON THE CURVED LINE TO SHOW HOW HIGH THE 6. IMAGINE YOU ARE AT THE POINT SHCWN IN THE SKETCH, PLACE AN A* ON THE CURVED LINE TO SHOW HOW HIGH THE
PHENOMENON WAS ABOVE THE HORIZON, OR SKYLINE, WHEN FIRST SEEN. PLACE A B ON THE SAME CURVED LINE TO PHENOMENON WAS ABOVE THE HORIZON, OR SKYLINE, WHEN FIRST SEEN. PLACE A *B° ON THE SAME CURVED LINE TO
SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
90 15
1
1
1
1
1
1
- 15
1
OBSERVER
AF FORM 117
AUG 67
Conrceteobcrtan

6A. NOW IMAGINE YOU ARE AT THE CENTER OF THE COMPASS ROSE. PLACE AN A° ON THE COMPASS TO INDICATE THE
DIRECTION TO THE PHENOMENON WHEN FIRST SEEN. PLACE A *B° ON THE COMPASS TO INOICATE THE DIRECTION TO
THE PHENOMENON WHEN LAST SEEN.
N
NNW NNE
NW NE
WNW ENE
WSW ESE
SW SE
sSW SSE
7. IN THE SXETCH BELOW, PLACE AN *A° AT THE POSITION OF THE PHENOMENON WHEN FIRST SEEN, AND A B° AT THE
PESITION OF THE PHENOMENON WHEN LAST SEEN. CONNECT THE *A° AND B° WITH A LINE TO APPROXIMATE THE
MOVEMENT OF THE PHENOMENON BETWEEN A* AND B. THAT IS, SCHEMATICALLY SHOW WHETHER THE MOVEMENT
APPEARED TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW TO COMPLETE
THE LARGER SKETCH.
B
PAGE 2 OF 9 PAGES

/
B. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (CheCk aPPTOPRlate blOcKS.)
OUTDOORS IN BUSINESS SECTION OF CITY
IN BUILDING IN RESIDENTIAL SECTION OF CITY
IN CAR AS DRIVER AS PASSENGER IN OPEN COUNTRYSIDE
IN BOAT NEAR AIRFIELD
IN AIRPLANE AS PILOT AS PASSENGER FLYING OVER CITY
OTHER own. FLYING OVER OPEN COUNTRY
OTHER
A. IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING:
WHAT DIRE CTION WERE YOU MOVINGT HOW FAST WERE YOU MOVING?
NORTH EAST
SOUTH WEST DID YOU STOP ANYTIMS WHILE OBSERVING THE
PHENOMENON?
NORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES NO
EXPLAIN WHETHER SUCH MOVEMENT EFFECTS YOUR SKETCHES IN ITEMS 5 AND 6.
DESCRIBE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD, TERRAIN OR BODY OF WATER YOU TRAVERSED DURING
THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HOW MUCH o T H ER TRAF FIC WAS THERE?
DID YOU NOTICE ANY AIRPLANES? YES NO. IF YES, DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME
OF SIGHTING THE PHENOMENON OF SIGHTING THE PHENOMENON AND WHERE AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON. THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
9. HOW LONG WAS THE PHEN MENON IN SIGHT? WAS THE PHEN MENON IN SIGHT?
LENGTH OF TIME CERTAIN OF TIME NOT VERY SURE NOT VERY SURE
- minute
FAIRLY CERTAIN JUST A GUESS
HOW WAS TIME HOW WAS TIME DETERMINED? head
By myself, mny
WAS THE PHENOMENON IN SIGHT CONTINUOUSLY? YES NO. IF NO, INDICATE WHETHER THIS IS DUE TO YOUR
MOVEMENT OR THE BEHAVIOR OF THE PHENOMENON, AND DESCRISE SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAP-
PEARANCES ON PREVIOUS SKETCHES.
PAGE 3OF 9 PAGES

1O. IF THERE WERE MORE THAN ONE PHENOMENON, HOW MANY WERE THERE? DRAW A PICTURZ TO SHOW HOW THEY WERE
ARRANGED. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING?
i
11. CoNDiTioNs(Check appropriate blocks.)
A. SXY B. WEATHER 1
DAY CUMULUS CLOUDS(Low fluffy) FOG OR MIST
TWILIGHT CiRRus CLouDs (High fleecy or Herring- HEAVY RAIN
V NIGHT bbone) LIGHT RAIN OR DRIZZLE
CLEAR NIMBUS CLOUDS (Rain) HAIL
PARTLY CLOUDY CUMULONIMBUS CLOUDS SNOW OR SLEET
COMPLETELY OVERCAST (Thunderstorms) UNKNOWN
HAZE OR SMOG NONE OF THE ABOVE
C. IF THE SIGHTING WAS AT TWILIGHT OR NIGHT, WHAT DID YOU NOTICE ABOUT THE STARS AND MOON?
(1) STARS (2) MOON
NONE BRIGHT MOONLIGHT NO MOONLIGHT
V A FEW V MOON WITH HALO UNKNOWN
MANY MOON HIDDEN BY CLOUDS
UNKNOWN PARTIAL (New or quarter)
O. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? YES NO. IF YES, WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT OVERHEAD (NeW noon)
IN BACK OF YOU TO YOUR LEFT UNKNOWN
E. SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR
STREET LAMP, ETC. FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE.
12. GIVE A BRIEF DESCRIPTION OF THE PHENOMENON, INDICATING WHETHER IT APPEARED DARK OR LIGHT, WHETHER IT
REFLECTEO LIGHT OR WAS SELF-LUMINOUS AND WHAT COLORS YOU NOTICED. DESCRIBE YOUR IMPRESSION OF WHETHER
a Mrine bght.dtwas abourgas erjgho welding ichi
C
Cdt c Nena.
L
PAGE 4 OF 9 PAGES

CHANGE COLOR?
GIVE OFF SMOKE?
CHANGE BRIGHTNESS?
CHANGE SHAPE?
FLASH OR FLICKER?
DISAPPEAR RND REAPPEAR?
SPIN LIKE A TOP? V
MAKE aNose: at least cne btnen repontd a buei sound V
FLUTTeRorwoBBLE cuiig ti seshtng-Zat citnesuas.
14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON? Siter weginer?mimizeal fead ai
Epeed. 52773
A. HOW DID IT FINALLY DISAPPEAR? watchig it.for stabont Imnute
tsfer ofter
it t(the light) gist lent oet afeer loent oet afer
the line of the line of
B. DID THE PHENO
YES NO. 1F YES,DESCRIBE.
PAGE 5 OF 9 PAGES

15. DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE AND LABEL ANY DETAILS THAT MIGHT HAVE APPEARED AS WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARROW THE
DIRECTION THE PHENOMENON WAS MOVING.
arrow pertaining to she directen
teobjerx e0
<no2ih
OBJECT
7 7
SMOKE TRAIL
:6. WHAT WAS THE AMGULAR SIZE? HOLD A MATCH AT ARM'S LENGTH IN FRONT OF A KNOWN OBJECT, SUCH AS A STREET LAMP OR THE MOON. NOTE HOW MUCH OF THE OBJECT IS COVERED BY THE HEAD OF THE MA "CH. NOW IF YOU HAD
BEEN ABLE TO PERFORM THIS EXPERIMENT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE PHENOMENCN WOULD HAVE BEEN COVERED BY THE MATCH HEAD.
alou 90%o oo of the otject would have been
eovered by the mated Read.
L
PAGE 6 OF 9 PAGES

17. DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWING? INCLUDE INFORMATION ON MODEL,
TYPE, FILTER, LENS PRESCRIPTION OR OTHER APPLICABLE DATA.
EYEGLASSES CAMERA VIEWER
SUNGLASSES BINOCULARS
WINDSHIELD TELESCOPE
SIDE WINDOW OF VEHICLE THEODOLITE
WINDDWPANE OTHER
A. DO YOU ORDINARILY WEAR GLASSES? NO B. DO YOU USE READING GLASSES? YES NO
1B. WHAT WAS YOUR IMPRESSION OF THE SPEED OF THE 19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE
PHENOMENCN? GIVE ESTIMATE OF SPEED_ 5OCMP.1. PHENOMENON? GIVE ESTIMATE OF DISTANCE. LMnle
2O. IN ORCER THAT WE MAY OBTAIN AS CLEAR A PICTURE AS POSSIBLE OF WHAT YOU SAW, DESCRIBE IN YOUR OWN WORDS
A COMMCN OBJECT OR OBJECTS WHICH, WHEN PLACED IN THE SKY, SIMILAR TO WHERE YOU NOTED THE PHENOMENON,
WOULO BEAR SOME RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OBJECT AND WHAT YOU SAW.
torel aboet 100 yarde
a stret lamp or welding crer the
woruld about
seje of ake otjict.
21. DID YOU NOTICE ANY ODOR, NOISE, OR HEAT ANATING FROM THE PHENOMENON OR ANY EFFECT YOURSELF,
ANIMALS OR MACHINERY IN THE VICINITY?  YES NO. IF YES,DESCRIBE.
form, at least
reposted a Bugging sotind
one h ritneis
Drng tke. sighttng.
A.DID THE PHEHOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. O YES NO.
IF *YES, DESCRIBE.
+
,
PAGE 7 OF 9 PAGES

2. HAVE YOU EVER SEEN THIS OR A SIMILAR PHENOMENON BEFORE? YES  NO. IF *YES, GIVE DATE AND
LOCATION.
23. WAS ANYONE WITH YOU AT THE TIME YOU SAW THE PHENOMENON? YES 0 NO. IF YES, DID THEY SEE IT TOO?
YES NO.
A. LIST THEI
I
24. GIVE THE FOLLOWING INFORMA HION ABOUT YOURSEL
LAST NAME, FIRST NAME, MIDDLE NAME
ADDREss (Street, City, State and Zip Code)
TELEPHONE (Area cOde and number) AGE
11 MALE FEMALE
INDICATE ADDITIONAL INFORMATION INCLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
.
25. WHEN AND TO WHOM DID PORT THAT YOU HAD SIGHTED THIS PHENOMENON?
NAM
26. DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY. 8 MONTH December Year 1967
PAGE 8 OF 9 PAGES

27. INFORMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT ADEQUATELY COVERED IN THIS QUESTIONNAIRE, ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGHTING.
the c jit and
tret muck
This obgeer went from north to Lveth,tle
Leen a lot f jecte before belt d dlost
resirules one moving fromdeith
tink d lves
4 to norh.
INcIeATes INcIeATes otj
5tN
ping conghty
PAGE 9 OF 9 PAGES

ther over because of insuficiant
informa
and twe of he form it says
places in the forn, Iovever, I think
I map have sstock it udere it
AR" 1( 11
I thought it said to ploce both
ltrers
anherever designated df this is
wtatd hed done wrong y than interpret
instead of
A E wherever ABis wittlen.df
ihis is not the oly mistoke than
tillme

DEPART MENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE BASE. OHIO 43433
REPLY TO ATTN OF: TDPT/UFO
BUBJECT: UFO Observation, 17 November 1967
DEC 19 1967
TO:
Waloott, L 0W 52773
Your name has been given to the Aerial Phenomena Branch (Project
Blue Book) as being a witness to an unidentified flying object.
- If you were a witness to an UFO sighting on 17 November 1967
would you please complete the attached AF Form ll7 and return it
in the envelope provided. If you were not a witness to this sighting,
would you please make a statement to this effect on the attached form.
The information which you provide will be used in evaluating this
observation. Thank you for your assistance in this matter. Thank you Tor your assistance In this matter.
JAMES C. MANATT, COlOnel, USAF 1 Atch
Eirector of Production Birector Production AF Form 117
T

that it choes not
tell ther in the tilipkne book.
Walcott, Iowa Waleott, Iowa
52>73 52>73
.

. . 2
Important:
abont a week ogo I sent you
three U.F. 0 reporte uhct were S
Do not send me any forms to do
ther over because of ansuliciant
information because d think I know
what I may have done wrong one what a may have done wrong one
one or more of them. On pager one one or more ofthen. On pager one
and tvo of she form it says and ewo of she form it says
place she letters place the letters "A" and"B on certain "A" and"Bon certain
places in the form, Hovever, I think places in the form, Hovever, I think
ete. 11
I thought it suid to place both
wherever designated of this is
what d had dove wong than interpret
it as saying jiust B"insted of
AB wherever "8Bis witten.df
this is not the only mistake than
tell me what aI did wrong andd telmeuka
will do the form or forms over or you will do the form or forms overor you

1 A
strect numbers of the ictnesses
that is becaure it doer not
tell them in the telephne book.
Sigred; Sigred;
EugenetBluedorn
343 5.Grove 5t. 343 S.Crove 5t.
Wa/cott, Iowa Wa/cott, Iowa
52773

Production Directorate 3
Baa Ea 2
Sud'ts mitree
(The tori wwith coplte
odriaes dyhare a)
beide the

172/00.67
TDPT/UFO
Walcott, Iowa 52773
Reference your recent unidentified flying object sighting which
you reported to the Air Force. T The information which we have
received is not sufficient for a scientific investigation. Request
you complete the attached AF Form ll7 and return it in the self-
addressed envelope. Please include the complete nanes and addresses
of witnesses. Thank you fo your obser vation to the
Air Force.
HEOTOR QU HATOR QUIN JINTANILLA, Jr, Major USAF NTANILLA, Jr, Major USAF 1 Atch
Chief, Aerial Phenomena Office AF Form 117 AF Form 117
Aerospace Technologies Division
Production Directorate .
sewd 117 tobive
and any =

Hours
a.Certain c.Not Very Sure
b.Fairly Certain d.Just A Guess Minutes
--10_--
5. IHow was time in sight determined? SELE__- Seconds
Yes_ No
6.What was 6.What was the the condi ion of the sky? on of the sky?
Day Night Night
a.Eright a.Eright C.Bright
b.Cloudy d.Cloudy
7.If you sighte the object during the object during DAYLIGHT,where was
the SuN located as you looked at the SUN located a you looked at the object? ject?
(Circle One):a.In front of d.To your let+. lee+.
you right
b.In back of you e.Overhead
c.To your right f.Don,t remember
8.If you saw the object at NIGHT,what did you
concerning the STARS and MOON?
8.1 STARS(Circle Cne) 8.2 MooN(Circle One)
a. None a.I Bright moonlight
D. A few b. Düll moonlight IYELLOW,MOON WAS COMIIVE
c. No moonlight-pitch dark "p)
remember d. Don't remember
(Next Page)

a. Solid d.As a light)
b. Transparent e.Don't remember
c. Vapor
II.If it appeared as a light,was it brighter than the brightest
stars?
righter c. About the same
Dimmer d. Don't know
II.I Compare brightness to some common object:is brighe asa
8201003504 bect anay.
I2. The edges of the obiectwere:
e. Other
Like a bright star Likea oright-star
c. c. Sharply outlined
d. Don't remember
I3. Did the object: (Circle Cne for each question) (Circle One for each question)
a. Appear to stand still at any time? YesNoDon't know at any time? YesMoDon't know
b. Suddenly speed up and rush away at rush away at
any time? any time? Yes No Donlt know Donlt know
c. Break up into parts or Break up into parts explode? (NO NO Don't know. know
a. a. Give off Smoke? Give off smoke? Yes No Don't know
e. e. Change brightness? Change brightness? Yes NoDon't No Don't know.
f. Change shape? Yes NO Don't Don't know.
E. Flash or flicker? Yes NO Don't know.
h. Disappear ar eappear? Yes NO Don't know.
I4. Did the object disappear while you were watching it?If
how?
ildnd
alr nhilei
iatand
I5. Did the cbject move behind. something at any time,particu-
larly a eloud?(Circle One) Yes No Don't know.
If you snswered YEs,then tell what it moved behind:
(Next Page) 4
.
.
^
.

lenth in line with a known object and note how much of the
object is covered by the head of the match.If you had per-
formed xperiment at the time of the sighting,how much
of the object would have been covered by the match head?
19.1 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 es-
pecially exhaust trails or vapor trails.Place an arrow be-
side the drawing to show the direction the object was moving.
SMOKE TRAIL
MUCH THAN
20. Do you think you can estimate the speed of the object? SLOWER METEOR,
(Circle One)' Yes No BUT MUCH FASTER THAN
2I. Do you think,you cah estimate how far away 21. Do you nk,you can estimate how far away from you the object from vou the object
was? (Circle One) Yes No
If you answered YEs,then how far away would you say it was?/MILE.
22. Where located when you saw the object? et
(Circle Or
a. Inside a 1 building
b. In a car
C.Outdcors
d. In an airplane(type)
e. At sea
f. Other
23. Were you(Circle One)
a. In the business section of a city?
b. In the residential section of a city?
c. In open countryside?
d. Near an airfield?
e. Flying over a city?
f. Flying open country?
g. Other ON 11
(Next Page)

what you saw,descr own
jects which,when placed up in the sky,would give the same ap-
pearance which Closia txke
xhat
Cpdtrri
iftrn lke
smilarly)
27. In the following sketch,imagine that you are at the point sho-
wn.Place anlA"on the same curved line to show how high the
object was above the horizon(skyline)when you last saw it.
Place an"A compass when you first saw it.Place a"B"on a"B"on
the compass when you last saw it.
750 75°
60
.45
20
7 W
7
7 2*
Cerser 7
28. Draw a piicture that will show the motion that the object or
objects made.Place an"A"at the beggining of e path,a"B"at
the end of the path,and any changes in direction during
the course. ACURVE
B
29. If was THAN CNE object, then how many were there?_
Draw a they were arranged, an arrow to show
the direction that they were traveling.
(NEYT PASE)