PROJECT BLUE BOOK

P..OJECT 10073 RECORD
AAT TOME GROUP LOCATION
2Z/17 By-pass I70 Springfield, Ohio
SAUACE 10. CONCLUSION
- PROBABLE AIRCRAFT 3t
4. NUMBER OF OBJECTS The observers son said that it was a small iriven
- aircraft.
sne
5. LENGTH OF OSSERVATION 11. BRIEF SUMMARY AND ANALYSIS
three minutes
6. TYPE OF OBSERVATION 6. TYPE OF OBSERVATION a surfboard with a surfboard with a black black propellar propellar in front.
ground visual
7. COURSE
isouth isouth
. PHOTOS 6. PHOTOS
0 Yes
7No
2. PHYSICAL EVIDENCE
D Yes
No a1 No .
FORM
FTD SEP 63 0-329 (TDE) Previoua editions of this form may be uaed.
a

ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGNTING.
-
/
PAGE O OF 9 PAGES

DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT. FORCE BASE OHI0 43433
REPLY TO TDPT (UFO)
ATTN OF: JUL 18 1969
SUAJECT UFO Observation, 17 J.1y 1968
TOI
ton, Onio 45424
Reference your recent unidentified flying object sighting which
you reported to the Air Force. The information which we have
received is not sufficient for a scientific investigation. Request
addressed envelope. Thank reporting your obser rvation to
the Air Force.
HECTOR QUINTANILLA, Jr, Lt Colonel, USAF 1 Atch
Chief, Aerial Chief, Aer enomena lomena Office crflce AF Form 117 w/envelope AF Form Il7 w/envelope
Aerospace Technologies Aerospace Technologies Division Division
Production Directorate Production Directorate
.
-
.

AFR 80-17(C1)
DIRECTION TO THE PHENOMENON WHEN FIRST SEEN. PLACE A *B* ON THE COMPASS TO INDICATE THE DIRECTION TO
THE PHENOMCNON WHEN LAST SEEN.
U
NNW NNE
NW NE
WNW ENE
wSW ESE
SW SE
ssw SSE
7. IN THE SKETCH SELOW, PLACE AN A* AT THE POSITION OF THE PHENOMENON WHEN FIRST SEEN. AND A B* AT THE
POSITION 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.
OB
PAGE 2 OF 9 PAGES

AFR 80-17(C1)
SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE BUDGET PUREAU APPROVAL
NUUBER 21 3233
THIS QUESTIONNAIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE THE U.S AIR FORCE AS MUCH INFORMATION
ING THE UNIDENTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO
ANSWER ALL
YOUR
YOUR PERMISSIGN.
ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
I WHEN DID YOU SEE THE PHENOMENON?
DAY. MONTH YEAR
2 WHAT TIME DID YOU F IRST SIG H T E PH ENOMENON?
HOUR MINUTES DXA.M. C]P.M.
3 WHAT TIME DID YOU LAST SIGHT THE PHENOMENON?
HOUR MINUTES CA.M. P.M.
4 TIME ZONE DAYLIGHT SAVINGS 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 STANDING 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 F IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH, PLACE AN *A ON THE CURVED LINE TO SHOW HOW HIGH THE POINT SHOWN 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 PHENOMENON WAS ABOVE THE HORIZON. OR SKYLINE, WHEN FIRST SEEN. PLACE A 3 ON THE SAME CURVED LINE TO
SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
C 90
53 L L SL- SL-
I
I I
I
1
1
|
I
OBSERVER
AF$ FORM 117
AUG67

AFR 80-17(C1)
O. IF THSRE WERE MORL THAN ONE PHENOMENON,HOW MANY WERE HERE? DRAW A PICTURE TO SHOWJOM THEY WERE
ARPANGED. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING?
11. CoNOiTiONS (Check appropriute blocks.)
A. SKY B. WEATHER
DAY CUMULUS CLOUDS (LoW fluffY) FOG OR MIST
TWILIGHT CIRRUs CLouDS (High fleecy or Herring- HEAVY RAIN
NIGHT X bone) LIGHT RAIN OR ORIZZLE
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
NONS BRIGHT MOONLIGHT NO MOONLIGHT
A FEW MOON WITH HALO UNKNOWN
MANY MOON HIDDEN BY CLOUDS
UNKNOWN PARTIAL(New or quarter)
D. IF SIGHTING WAS IN DAYLIGHT. WAS THE SUN VISIBLE? YES NO. IF "YES.. WHERE WAS S THE SUN AS YOU FACED
THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT OVERHEAD (Newr 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
IT WAS SOLID OR TRANSPARENT, WHETHER EDGES WERE SHARP OR FUZZY. DESCRIBE THE SHAPE OR INDICATE IF IT
APPEAREO AS A POINT OF LIGHT. INDICATE COMPARISONS WITH OTHER OBSERVEO OBJECTS, LIKE STARS. A LIGHT OR
OTHEP OBJECT IN YOUR FIELD OF VIEW.
+ 12
Na Walt
Lan J ind D geye
AabthloN Lsx
latin
22 -1gecil
th he bont 1 ncke
simila
Wamomhss
oCo
sah
wm.
abrajght -wed which
AA Are shm
mulgs that
mt Cikey ent
CaM
PAGE 4 OF 9 PAGES

AFR 80-17(C1)
8 WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (Ckerk epuropriate blonks.d
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 FLYING OVER OPEN COUNTRY
OTHER
A IF YOU WERE IN VEHICLE, COMPL ETE THE FOLLOWING
WHAT DIRECTION HOW FAST WERE YOU MOVING?
NORTH EAST 70
SOUTH WEST DID YOU STOP ANYTIME WHILE OBSERVING THE
PHENOMENON?
NORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES NO
EXPLAIN WHETHER SUCH MOVEMENT AFFECTS YOUR SKETCHES IN ITEMS 5 AND 6
DESCRIBE TYPE 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
70
HOW MUCH o WAS THERET
DID YOU NOTICE ANY AIRPLANES? XYES NO. 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.
9. HOW LONG HOW IG WAS THE PHENOMENON IN SIGHT?
LENGTH LENGTH OF TIME CERTAIN OF TIME NOT VERY SURE V ERY SURE
3 FAIRLY FAIRLY CERTAIN JUST JUST A
GUESS
HOW WAS TIME HOW WAS TIME DETERMINED?
, Lipal kh a
2. ron nd
WAS THE FHENOMENON IN SIGHT CONTINUOUSLY WAS THE FHENOMENON IN SIGHT CONTINUOUSLY? lYES NO. IF *NO, INDICATE WHETHER THIS IS OUE TO YOUR NO. IF NO, INDICATE WHETHER THIS IS OUE TO YOUR
MOVEMENT OR THE BEHAVIOR OF THE PHENOMENON, AND DESCRIBE SUCH MOVEMENT OR SEHAVIOR. INDICATE DISAR
PEARANCES ON PREVIOUS SKETCHES. PEARANCES ON PREVIOUS SKETCHES.
Co Co
tn
e
al as e1e Ca Cs
Eact diratihy
an loct
whick
werhad the
1 2inl4
PAGE3OF9PAGES
4

SPIN LIKE A TOP?
MAKE A NOISE?
FLUTTER OR WOBBLE?
14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
A. HOW DID IT FINALLY A. HOW DID IT FINALLY DISAPPEAR? DISAPPEAR?
it a/
atetiCondf slatin. Condmef A
-qiltin
w hadthe Mhad the AY IY
B. DID THE PHENOMENON MOVE BEHIND OR IN FRONT OF SOMETHIN A CLOUD, TREE, OR BUILDING AT ANY TIME? A CLOUD. TRES, OR BUILDING SAT ANY TIME?
YES NO. XI IF YES," DESCRIBE. ES," DESCRIBE.
PAGE 5 OF 9 PAGES

AFR 80-17(C1)
1S. DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE AND LABEL ANY DETAILS THAT MIGHT
HAVE AFPEARED AS WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARROW THE
DIRECTION THE PHENOMENON WAS MOVING.
V
1211P
AIN
15. WHAT WAS THE ANGULAR SIZE? HOLD A MATCH AT ARM'S LENGTH IN FRONT OF A KNOWN OBJECT, SUCH AS A STREET 15 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 MOON. NOTE HOW MUCH OF THE OBJECT IS COVERED BY THE HEAD OF THE MATCH. NOW IF YOU HAD LAMP OR THE MOON. 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
PHENOMENON WOULD HAVE BEEN COVERED BY THE MATCH HEAD.
PAGE6 OF9PAGES

AFR 80-17(1)
I7. OID 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? O YES NO B. DO YOU USE READING GLASSES? NO
18 WHAT WAS YOUR IMPRESSION OF THE SPEED OF THE 19. WHAT WAS YOUR IMPRESSION OF THE OISTANCE OF THE.
PHENOMENON GIVE ESTIMATE OF SPEED C7 PHENOMENON? GIVE ESTIMATE OF DISTANCE
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 NOTEO THE PHENOMENON.
WOULD BEAR SOME RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OBJECT AND WHAT YOU SAW.
chils Loney
It Cokek Otsn
aiplie
Largee tha Ch
but mcd had
I Me
anlinde J
cirblaned
a tree
as
Cile
Tail
hp
Oebrlmk heDalmd
Eoty
setappear to one
21. DID YOU NOTICE ANY ODOR. NOISE, OR HEAT EMANATING FROM THE PHENOMENON OR ANY 21. DID YOU NOTICE ANY ODOR, NOISE, OR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECT YOURSELF.
ANIMALS OR MACHINERY IN THE VICINITY? ANIMALS OR MACHINERY IN THE VICINITY? YES YES 14 NO. IF *YES." DESCRIBE. "YES."DESCRIBE.
A. DID THE PHENOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. YES NO.
.IF*YES. DESCRIBE.
PAGE 7 OF 9 PAGES

ETTRLCBU
..
AFR 80-17(C1)
ZZ. HAVE YOU EVER SEEN THIS OR A SIMILAR PHENOMENON BEFORE? YES A NO. GIVE DATE AND
LOCATION.
23. WAS ANYONE WITH YOU AT TIME SA W THE PHENOMENON? KYES NO. IF ES. DID THEY SEEIT TOO
YES NO.
A. LIST THEIR ESSES
ton, hen
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST NAME, FIRST NAME, MIDDLE NAME
ADDRESS (Street, City, State gnd Zir
TELEPHONE (Area code and number) A
3 MALE X FEMALE
INDICATE ADDITIONAL INFORMATION INCLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
25. WH EN AND TO WHOM DID YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
C-Waaid DAY17 YEAR
NAME MONTH
25 DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY MONTH_ YEAR
PAGE 8 OF 9 PAGES

17Gul6s
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC) ②
WRIGHT-PATTERSON AIR FORCE BASE OHIO 4S433
REPLY TO
ATTN OF TDPT (UFO) 6 ANG 1680
SUBJECT UFO ation 17 Jul 68
TO
Dayton, Ohio 45427
Your name has been given to the Aerial Phenomena Office (Project
Blue Book) as being a witness to an unidentified flying object.
If you were e witness to an UFO sighting or 17 Jul 63
'ould you please complete the atteched AF Form ll7 and return it
in the envelope provided. If ' you were not a witness to this
sighting, would you please
attached form. The information which you provide will be used in
evaluoting this observe Thank you for ycur assistance in t this
matter.
HEOTOR KEOTOR CUINT NILLA, Jr, Lt Colonel, USAF 1 Atch
Chief, Aerial Chief, Aerial nomene Office Office AF Form 1l7 w/envelope
Aerospace Technologies Division
Production Directorate
-

DATE: 17 July 1968
TIME: 1100 hours, EDT
DURATION: Approximately two minutes
LOCATION: By-Pass Interstate 70, Springfield, Ohio
DESCRIPTION: The object looked flat and
object about loo ft in air. Just saw the object
a mile away. D a mile away. Didn't look like there W Didn't look like there was any room was any room
for anyone to sit up in the object. I There was
the time also (bother the time also (rother
for the
direction she was
- replied replied
that she didn't know her know her directions too directions too well.
There wasn't any noise.
if she would complete a questionnaire
Mrs. Is address isY
.

EASTERN CENTRAL MOUNTAIN PACIFIC OTHER
5 WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY. GIVE THE NEAPEST STREET ADDRESS AND INDICATE ON
A HANO DRAWN MAP WHERE YOU WERE STANDING WITH REFERENCE TO THE ADDRESS. IF IN THE COUNTRY, IOENTIFY THE
HIGHWAY YOU WERE ON OR NEAR ANO TRY TO FIX A DISTANCE AND DIRECTION FROM SOME RECOGNIZABLE LANDMARK
I do slot Conede the Oig it S, a
in Calt
6. IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH, PLACE AN *A" ON THE CURVEO LINE TO SHOW HOW HIGH THE CURVED LINE TO SHOW HOW HIGH THE
PHENOMENON WAS ABOVE THE HORIZON, OR SKYLINE WHEN FIRST SEEN. PHENOMENON WAS ABOVE THE HORIZON, OR SKYLINE WHEN FIRST SEEN. PLACE A PLACEA B*ON THE SAME CURVED LINE TO BONTHES SAME CURVED LINE TO
SHOW HOW HIGH ASOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
$90$ 90 15 SL
L
| 1
!
1 I
1 o, omn wmm w
!
1 15
OBSERVER
AF FORM 117
AUG 37

AFR 8O-I7(C1)
OPILLCILLD IIULILACILOILOLOIOR IINLIILIIITOLULINLLANLIINIRINN
BA NON IM-OINE YOUARE AYTHE CXHTSR OF TNL COHPAUASRLES. LAGE AN A*ON HECONPASS TO INDICATE THE
DIRECTION TO TNE PHENODEPON WHEN VIEST BEZN. PLAUE A OI ON THE CONRARS TO (AOICATE THE OIRZCTION TO
THE PHENOMENCN THEH LAST SEEN.
NMW NNE
NN N
WNW ENE
WSWW ESE
sw SE
SSW SSE
IN THE SXSTCH BELOW, PLACE AH "A" AT THE POSITION OF THE PHENOMENON WHEN FIRST SEEN, AND A *B" AT THE
POSITIOY OF THE PHENOMENON WHEN LAST SEEN. CONNECT THE A° AND B° WITH A LINE TO APOROXIMATE THE
MOVEMENT OF THE PHENOMENON SETWEEN "A" AND *B*. TMAT IS. SCHEMATICALLY SHOW WHETHER THE MOVEMENT
APPEARED TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW TO CONPLETE
THE LARGER NKETCH.
PAGE2 OF 9 PASES
.

AFE 50-17(C1)
LL02 W LUNNY h0
TO IF THERE WENE NONE THAN ONE PHENOMENON. HOM WANY WERE THERET DRAW A PICTURE TO THOW HON THEY WERE
ARNANGED DID THIS ARRANGSMINT CHANGE DURING THE SIGHTINGT
CONDITiONs (Chcck approprinte blocks.)
SKY 8. WEATHER
DAY CUMULUS OLOJDS(LOW flu/fY) FOG OR MIST
TWILIGHT CIRRus CLoubs (High fleccy or Herring MEAVY RAIN
NIGHT bone) LIGHT RAIN OR DRIZZLE
CLEAR NIMBUS CLOUDS (Ruin) HAIL
PARTLY CLOUDY CUNULONIMBUS CLOUDS SHOWORSLEET
COHPLETELY OVERCAST (Thunderstorms) UNXNOWN
HAZE OR SMOG NONS OF THE ABOVE
IF THE SIGHTING WAS AT TWILIGHT OR NIGHT. WHAT DID YOU NOTICE ABOUT THE STARS AND NOON?
(1) STARS (2) NOOH
NONE BRIGHT MOONLIGHT NO MOONLIGHT
AFEW MOON WITH HALO UNKNOWN
MANY MOON HIDDEH BY CLOUDS
UNKNONN PARTIAL(New Or quarter)
IF SIGHTING NAS IN DAYLIGHT. WAS THE SUN VISIBLEI YES HO. IF -YES." WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT OVERHEAD(NearnOON) OVERHEAD(Near nOON)
IN BACX OF YOU TO YOUR LEFT UNKNOWN
SPECIFY THE MAJOR SOURCE OF ILLUMINATIOM PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR SPECIFY THE MAJOR SOURCE OF ILLUMINATIOME PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR
STREET LAMP. ETC. STREZTLAMP.ETC. FOR TERRESTRIAL ILLUMINATION. SPECIFY OISTANCE TO LIGHT SOURCE. FOR TERRESTRIAL ILLUMINATION, SPECIFY OISTANCE TO LIGHT SOURCE.
12. GIVE A SRIEF DESCRIPTION OF THE PHENOMEMON, INDICATING WMETHER IT APPEAREO DARX OR LIGHT, WHETHER IT 12. GIVE A SRIEF DESCRIPTION OF THE PHENOMEMON, INDICATING WMETHER IT APPEAREO DARX OR LIGHT, WHETHER IT
REFLECTEO LIGHT OR WAS SELF-LUMINOUS ANO WHAT COLORS YOU NOTICED. DESCRIRE YOUR IMPRESSION OF WMETHER
IT WAS SOLID OR TRANSPARENT, WHETHER EDGES WERE SMARP OR FUZZY. DESCRIBE THE SHAPE OR INDICATE IF IT
APPEARED AS A POINT OF LIGHT. INDICATE COMPARISONS WITH OTHER OBSERVED OBJECTS, LIKE STARS, A LIGHT OR
OTHER OBJECT IN YOUR FIELD OF VIEW.
PAGE 4 OF 9 PAGES
-
-

AFR 80-17(C1)
e. WHERE WERE YOU WHEN YOU SAW THE PHENOMENCN? (Check appruprict- blocks.)
oU ITDOORS IN BUSINESS SECTION OF CITY
IN BUILDING IN RESIDENTIAL SECTION OF CITY
IN CAR AS DRIVER PASSENGER IN OPEN COUNTRYSIDE
IN BOAT NEAR AIRFIELD
IN AIRPLANE AS PILOT AS PASSENGER FLYING OVER CITY
OTHER FLYING OVER OPEN COUNTRY
OTHER
A. IF YOU WEREIN A VEHICLE. COMPLETE THE FOLLOWING:
WHAT DIRECTION WERE YOU MOVING? HOW FAST WERE YOU MOVING?
NORTH EAST
SOUTH WEST DID YOU STOP ANYTIME WHILE CBSERVING THE
PHENOMENON?
NORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES NO
EXPLAIN WHETHER SUCH MOVEMENT AFFECTS 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 OTHER TRAFFIC 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 AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
3. HOW LONG WAS THE HOW LONG WAS THE PHENOMENON IN SIGHT? PHENOMENON IN SIGHT?
LENGTH OF TIME CERTAIN CERTAIN OF TIME OF TIME NOT NOT VERY SURE SURE
FAIRLY CERTAIN JUST A GUESS A GUESS
HOW HOW WAS TIME DETERMINED?
WAS THE THE PHENOMENON IN SIGHT CONTINUOUSLY? PHENOMENON IN SIGHT CONTINUOUSLY? YES YES NO. IF NO," INOICATE WHETHER THIS IS DUE TO YOUR IF NO.INDICATE WHETHER THIS IS DUE TO YOUR
MOVEMENT OR THE BEHAVIOR OF THE PHENOMENON. AND DESCRIBE SUCH DESCRIBE SUCH MOVEMENT OR SEHAVIOR. INDICATE DISAR.
PEARANCES ON PREVIOUS SKETCHES.
PAGE3OF9 PAGES

14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
A. HOW DID IT FINALLY sM oDermAESTSSaPre DISAPPEAR?
B. DIO THE PHENOMENON MOVE BEHIND ORIN ORIN FRONT FRON LIXS A CLOUD, TREE, OR BUILOING AT ANY TINE? ACLOUD. TREE, OR BUILOINGAT ANY TINE?
YES NO. IF *YES," DESCRIBE. IF DESCRIBE.
PAGE 5 OF9 PAGES
ORO
+

AFR 30-17(C1)
HAYYYOU LVER SEEM TNI OHASIMILAH PH
LOCATION.
23. WAS ANYONE WITH YOU AT 11 SAW THE PHENOMENON? YZS NO. IF "YES, DID THEY SEE IT TOOI
YES NO.
A. LIST THEIR NAMES AMD ADORESSES
24. GIVE THE FOLLOWING INFORMATION A9OUT YOURSELF
LAST NAMS. FIRST NAME. MIODLE NAME
ADDRESS(S oreet.
TEL EP o and number)
AGE
MALE FEMALE
INDICATE ADDI TION AL 1N FORM ATION INCLUOING OCCUPATION AND AN EXPERIENCZ WMICH MAY BE PERTINENT.
PU
UTETOSET
ATEAN
25 WHEN AND o WHO M 010 YOU REPORT THAT YOU HAD SIGHTED THIS PHEHOMENON?
NAME DAY MONTH YEAR
26 DATE YOU COMPLETEO THIS QUESTIONHAIRE.
DAY MONTH YEAR
PAGE 9 OF 9 PAGES

AFR 80-1T(CD)
17. DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLIOWING? INCLUDE INFORMATION ON MODEL.
TYPE, FILTER, LENS PRESCRIPTION OR OTHER APPLICABLE DATA.
EYEGLASSES CAMERA VIEWER
SUNGLASSES BINOCULARS
WINDSHIELD TELESCOPE
SIDE WINDOW OF VEHICLE THEOOOLITE
WINDOWPANE OTHER
A. DO YOU ORDINARILY WEAR GLASSES? NO 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
PHENOMENON? GIVE ESTIMATE OF SPEED PHENOMENON GIVE ESTIMATE OF OISTANCE
20. 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 BEAR SOME RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OBJECT AND WHAT YOU SAW.
(
21. 21. DIO YOU DID YOU NOTICE ANY ODOR, NOISE. OR HEAT EMANATING FROM THE PHENOMENON NOTICE ANY ODOR, NOISE. OR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECT ON YOURSELF. ANY EFFECT ON YOURSELF.
ANIMALS OR MACHINERY IN THE VICINITYI ANIMALS OR MACHINERY IN THE VICINITYI YES NO. IF "YES,• DESCRIBE. IF "YES, DESCRIBE.
EEUOTT
A DID THE PHENOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. YES NO.
IFYES. DESCRIBE.
e
PAGE 7 OF 9 PAGES