PROJECT BLUE BOOK

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PROJECT 1CO73 RECORD
YATF.TIME GROUP .LOCATION
Varied Massapequa, New York
3. ADCE 10. CONCLUSION
Civilion Civilton
.. NIPDER OF OBJECTS ". NPDER OF OBJECTS INSU INSUF DATA POR EVALUATION
Varled Varled
. .. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS SUMMARY AND ANALYSIS
Rone Stated
TYPE OF OBSERVATION TYPE OF OBSERVATION SEB CASE FILE SEE CASE FILE
Grona Vietal
t 7. COURSE
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Mone Steced
5 PHOTOS
E. n1 Yes
X No
9. PHYSICAL EVIDENCE
n Yas
2 No
FORM
P7D ) SEP63 0-329 - Previoua editions of thie form may be used.
.
.

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Page 5
. In the following sketch, imagine that you are at the point shown. Place an "A" on the curved line to show how
high the object was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to
show how high the object was above the horizon (skyline) when you last saw it. Place an "A"" on the compass
when you first saw it. Place a "B' on the compass where you last saw the object.
90° 75°
60°
o NW
E
15° 15 SW
SE
Oraw a pitre that will show the mation that the object or objects made. Place an "A t the beginning of the
path, a "" at the end of the path, and show any changes in direction during the course.
2
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
IL

Yes muan Ipt daten 3n 6 )
1
Was anyone slse with you at the time you saw the objoct? (Circle One) Yos 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:
N.Y
32. Please give the following information about yourself: 32. Please give the following information about yourself:
NAME
FirstName First Name Middle Name
NY 1253 N.YS.
ADDR
Street City Zone State
TELEPHONE NUMB AGE SEX gid
Indicate any additional information about yourself, including any special experience, which might be pertinent.
.When and to whom did you report that you had seen the object? 33. When and to whom did you report that you had seen the object? 172y parent parenti.
16 16 116.7 1167
Day Month Year tt
K

Page 7
34. Date you completed this questionnaire: 24
Day Month Year
Informatin hich u  pertinent nd which is ot adequatey covered n the specc points o the questionnaire or a narrative explanation of your sighting.
Weheneven die. sein the t
ofject Q the step sig n we
mean stat ap sgmie wise wese
meal stoit veggling s bitte. wocggling a itte.

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HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AF3C) DEPARTMENT OF THE AIR FORCE
WRIGHT-PATTERSON AIR FORCE BASE. OHIO 45433 irut
ATTN OF: REPLY TO TDET/UFO
15 March 1967
SUBJECT: Observation, 24 b 67
34Jet ANST
6
TO: Mias 1a-20p
Massapequa ,New York 11758 i
we have received is not sufficient for a scientific evaluation. Reference your unidentified observation. The information which
the envelope provided. Thank you for reporting your observation Request you complete the attached FTD Form 164 and return it in Request you complete the attached FTD Form 164 and return it in the envelope provided, Thank you for reporting your observation
to the Air Force.
JAMES C. MANATT, COlOnel, USAF Director of 1 Atch
rechnology and Subsystems FTD Form 164 w/envelop
1
INSUFFICIENT DATA BECAUSE WASD'-
RECEIVED 164
UNTIC LATE JUNE 1967.
AN

Lang Lshem
- 11758
8 finow 17
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203 no N
ths :
Jain.6, D 267
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ADDRESS iS
2deland, 1
24,1967
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241667
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT.PATTERSON AIR FORCE BA9E.OH1O 43433
REPLY TO ATTN OF TDET/UFO 15 March 1967
SUBJECT UFO Observation, 24 Fab 67
TO.
Hassepequs, New York 11758
Reference your unidentified observation. The information which Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation. we have received is not sufficient for a scientific evaluation.
Reguest you complete the attached FTD Form 164 and return it in
ADOD EIII IVIOLL the envelope provided, Thank you for reporting your observation
to the Air Force.
ADOD BIIE IVIOIO OEN/IEAL
JAMES C. MANATT, COlOnel, USAF 1 Atch
Director of Technology and Subsystems FTD Form 164 w/envelope
a

i
.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 possibl ple concerning the unidentified aerial phenomenon that you have observed.
Please try to answer as many questions as you possibly can. formation that you give will
be used for research purposes. Your name will not be used in connection with any statements,
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, we may contact you for further details.
1. When did you see the object? 1. When did you see the object? Timne of day: Timne of day: 6.30-20 30
Hour Hour Minutes
D sntale the data in with 2 sntale the data in with
(Circle One): A.M. or or P.M.
Doy Doy let Month letMorth Year Year
3. Time Zone: 3. Time Zone:
(Circle One): a. Eastern) a.Eastern) (Circle One): (a.)Daylight Saving (Circle One): a. Daylight Saving
b. Central Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
Masi pequa NeY state
Nearest Postal Address City or Tovn State or County
5.how long was object in sight? (Total Duration) O 3 O
Hours Minutes Seconds
a. Certain c. Not very sure
Fairly certain d. Just a guess
5.1 How was time in sight determined? isiit y witch
5.2 Was object in sight continuously? (Yes Yes e
6. What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
uall wall a. a. Bright Bright
b. b. Cloudy b. Cloudy
7.IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? 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
C3 To your right f. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164, Jul 61, which is obsolete.

Puge 2
IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
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):
07 Clear sky a. Dry
b. Hazy Hazy b. Fog, mist, or light rain b. Fog, mist, or light rain
Scattered clouds Scattered clouds c. Moderate or heavy rain Moderate or heavy rain
Thick or heavy clouds d. Snow Snow
e. e. Don't remember
1. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a Solid Solid d. As a light d. As a light
b. Transparent Transparent e. Don't remember
c. Vapor
1If i: appeared as a light, was it brighter than the brightest stars? (Circle One):
c. Brighter c. About the same
b. Dimmer d. Don't know
11.1 Compere brightness to some common object:
(d
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
g. Like a bright stor
S. Sharply ourlined 4
d. Don't remember
Did the object: .Did the object: (Circle One for each question)
a. Appear to stond still at any time? Yes No Don't know
b. Suddenly speed up and rush away at any time? Yes Yes No Don't know
c. Break up into parts or explode? Break up into parts or explode? Yes UN UNo Don't know
d. Give off smoke? Yes No Don't know
e. Change brightness? Yes (Yes) No No Don't know Don't know
f. Change shape? Yes Yes- No. No. Don't know
g. Flash or flicker? Yes Yes N No Don't know
h. Disappear and reappear? N\o Don't know

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14. Did the object disappear while you were watching it? If so, how?
NO
1.Did the object move behind something at any time, particularly a cloud?
(Circle One): Don't Know. IF you answered YES, then tell what
it moved behind: A
dAldewrdean
.Did the object move in front of something at any time, particularly a cloud? 1. Did the object move in front of something at any time, particularly a cloud?
(Circle One): Yes No No Don't Know. IF you answered YES, then tell what IF you answered YES, then tell what
in front of: _ in front of: _ : :
17. Tell in  few words the following things about the object:
b. Color_
We wish t 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 wou!d have been covered by the match head?
d0n dudit do
Draw a picture that will show the shape of the object or objects. Label and include in your sketch any details
of the objes that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. of the objec that you saw s wings, protrusions, etc. ally exhaust trails or vapor trails.
Place an arrow beside the drawing to show the direction the object was moving. Place an arrow beside the drawing to show the direction the object was moving. waunt want
)
moving moving
windows
O
Ke
L ring

20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you answered YEs, then what speed would you estimate? .
21. Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
IF you answered YES, then how far away woul
22. Where were you located when you saw the object? 22. Where were you located when you saw the object? Were you (Circle One) 23. Were you (Circle One)
(Circle One): (Circle One):
a. In the business section of a city?
a. Inside a building a. Inside a building b. In the residential section of a city? b.In the residential section of a city?
b.1 b. In a car c. In open countryside?
c. Outdoors Outdoors d. Near an airfield?
d. In an airplane (type) d. In an airplane (type) e. Flying over a city? Flying over a city?
e. At sea e. .At sea f. Flying over open country?
f. Other f. Other g. a. Other si Dios camcn
24.1 What direction were you moving? (Circle One)
a. North c. East e. South g. West
. Northeast d. . Southeast f. Southwest h. Northwest
24.2 How fast were you moving? — __miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yes No
25. Did you observe the object through any of the following?
a. Eyeglasses No .Binoculars Yes No
b. Sun glasses No f. Telescope Yes
c. Windshield No g. Theodolite Yes No
d. Window gless Yes No h. Other _
2In 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.
Lang plates on tog ther