PROJECT BLUE BOOK

.
1
PROJECT 10073 RECORD
1. GROUP 2. LOCATION
10/20cb
10 Janua 1960 11/o1dz Gerriantown. Chio
3. SOURCE OORCS 0. CONCLUSION IO. CONCLUSION
2i-iian 24uiian Astro (VENUS)
4. NUMBER OBJECTS
Coe
5. LENGTH OF OBSERVATION LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS BRIEF SUMMARY AND ANALYSIS
20 Mnutes .
20 Minutes Observers Observers sighted bright star like object in western sky. sighted bright
6. TYPE OF TYPE OF OBSERVATION OBSERVATION
Gromd-Visual Groumi-Visual
7. COURSE
west sky
8. PHOTOS
DYos
C.No
9. PHYSICAL VIDENCE
Yes
J.No
FORM
FTD SEP 63 0-309 (TDE) Previous editions of thls form may be used.
:
du

fier
AFR 80-17(C1)
SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE BUDGET BUREAU APPROVAL
NUMBEX 21-R238
THIS QUESTIONNAIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE THE U.S. AIR FORCE AS MUCH INFORMATION
AS POSSIBLE UNIDENTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO
ANSWER THE INFORMATION YOU GIVE WILL BE USED FOR RESEARCH PURPOSES
NOT BEU
YOUR PERMISSION.RETURN AIR FORCE BASE INVESTIGATOR FOR FORWARDING TO FTD (TDETR). WRIGHT-
PATTERSCN AFB, OHIO 45433, IAW AFR 8O-I7. (IF ADDITIONAL SHEETS ARE NEEDED FOR NARRATIVE OR SKETCHES
ATTACH SECURELY TO THI RM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
1. WHEN THE P IENOMENON?
DAY /6 J.AN YEAR 6 9
MONTH
WHAT M E DID FIRS T SIG H T THE PHENOMENON?
HOUR Po MINUTES OO_A.M. D.P.M.
3. WHAT DIO YOU LAST SIGHT THE PH ENOMENON? still
HOUR MINUTES A.M. XP.M.
4. TIME'ZONE DAYLIGHT SAVINGS
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 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.
iv106 of Home Home
ERMAN TOWN TOwN , 0H10 , 0H10
E IMAGINE OU ARE AT 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 B* ON THE SAME CURVED LINE TO
SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
9L0 15
I
I
1
30
1
1
1 5
|
OBSERVER
AF FORM 117
AUG 67

AFR 80-17(C1)
.
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 INDICATE THE DIRECTION TO
THE PHENOMENON WHEN LAST SEEN.
1
N
NNW NNE
NW NE
WNW ENE
AOW
WSW ESE
SW SE
sSW SSE
7. IN THE SKETCH BELOW, 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.
PAGE 2 OF 9 PAGES

AFR 80-17(C1)
3. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (Ch-Ck aPPrOPTIaT blOCkS.)
OUTDOORS IN BUSINESS SECTION OF CITY
IN BUILDING IN RESIDENTIAL SECTION OF CITY
IN CAR AS DRIVER 0 AS PASSENGER - IN OPEN COUNTRYSIDE
IN BOAT NEAR AIRFIELD
IN AIRPLANE AS PILOT 0 AS PASSENGER FLYING OVER CITY
OTHER FLYING OVER OPEN COUNTRY
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?
HORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES NO
EXPLAIN WHETHER SUCH MOVEMENT AFFECTS YOUR SKETCHES IN ITEMS 5 AND 6
DESCRIBE TYPE OF VEHICLE YOU WEREIN AND TYPE OF F ROAD. TERRAIN OR BODY OF WATER DURING
THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HOW MUC 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.
PAGE 3 OF 9 PAGES

AFR 80-17(C1)
TO. IF THERE WERE MORE THAN ONE PHENOMENOM, HOW MANY WERE THERE? DRAW A PICTURE TO SHOW HOW THEY WERE
ARRANGED. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING?
ONLY ONC
11. CONDiTioNs(Check appropriate blocks.)
A. SKY B. WEATHER
DAY CUMULUS CLOUDS(Low fluffy) FOG OR MIST
TWILIGHT CIRRUs CLoUDS(High fleecy or Herring- HEAVY RAIN
NIGHT bone) LIGHT RAIN OR DRIZZLE
CLEAR NIMBUS CLOUDS( (Rain) HAIL
PARTLY CLOUDY CUMULONIMBUS CLOUDS SNOW OR SLEET
COHPLETELY 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 VERT LOTLE
NONE BRIGHT MOONLIGHT NO MOONLIGHT
AFEW MOON WITH HALO UNKNOWN
HANY MOON HIDDEN BY CLOUDS
JUNKNONN PARTIAL (New or quarter)
D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? YES NO. IF YES WHERE WAS THE SUN AS YOU FACED
THE PHENOMENCN?
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
STRZETLAHP FORTEARESTRLALILLUNINATION SPECIEYDISTANCETOLISHTSOURCE
PAGE 4 OF 9 PAGES

FLASH OR FLICKER?
DISAPPEAR AND REAPPEAR?
SPIN LIKE A TOP?
MAKE A NOISE?
FLUTTER OR WOBBLE?
14. WHAT CREW YOUR ATTENTION TO THE PHENOMENON?
WIFE Nticed it sohin Al bshid onA
wvindor -
A. HOW DID IT FINALLY DISAPPEAR?
STICC STIlL THOE THOE
B.DID THE ENO HENON MOVE BEHINDORIN FRONT OF SONETHING, LIKE A CLOUD, TREE, OR BUILDING AT ANY TIME?
YES NO IFYES,"DESCRIBE.
!
PAGE 5 OF 9 PAGES

-
AFR 80-17(C1)
15. DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE ANO LABEL ANY DETAILS THAT MIGHT
MAVE APPEARED AS WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOM TRAILS. INDICATE BY AN ARROW THE
DIRECTION THE PHENOMENON WAS MOVING.
A
16. 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 MOCN. NOTE HOW MUCH OF THE OBJECT IS COVEREO BY THE HEAD OF THE MATCH. NOW IF YOU HAD
BEEN ABLE TO PEZCRM THIS EXPERIMENT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE
PHENOMENON WOULD HAVE BEEN COVERED BY THE MATCH HEAD.
PAGE 6OF9PAGES

&
AFR 80-1R(C1)
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 NOOWOF VEHICLE THEODOLITE
WINDONPANS OTHER
A. DO YOU ORDINARILY WEAR GLASSES? YES INO B. DO YOU USE READING GLASSES? N0
18. WHAT WAS YOUR IMPRESSION OF THE SPEEDF THE 19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE
PHENOMENON? GIVE ESTIMATE OF SPEED
2O. IN ORDE 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 RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OEJECT AND WHAT YOU SAW.
STAR
Mch brgith than a sta than d sta
Much brigiti
(
21. DID VOU NOTICE ANY ODOR, NOISE. OR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECT ON YOURSELF,
ANIMALS OR MACHINERY IN THE VICINITY? YES NO. IF "YES,DESCRIBE.
A. DID THE PHENOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. YES XNO.
IFOYES,"DESCRIBE.
(
PAGE7OF9 PAGES

AFR 80-17(C1)
22. MAVE YOU EVER SEZN THIS OR A SINILAR PHEMOMENO ES
LOCATION.
23. WAS ANYONE WITM YOU AT THE TINE YOU SAW THE PHENOMZNONT VYES YES,* DID THEY SEE IT TOO'
YYES NO.
A. LIST THE
24 GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST NAMR,
45327
TELEPHONE TELEPHONG e
MALE NALE FEMALE
INDICATE INDICA ON MMICLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT. N MICLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
25. WHEN AHD T o 3 YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
NAME DAY MONTH YEAR
26. DATE YOU COMPLETED QUESTIONNAIRE.
DAY_ MONTH YEAR
PAGE B OF9 PAGES

-.
AFR 80-17(C1)
27. INFOPMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT ADEQUATELY COVEREU IN THIS QUESTIONNAIRE, JUNM
ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGHTING.
ELECTFICITY 15 Off 10 THE ACEA,
LI6HT5 WERE
1e
GERAHN RLL
1
.-N NN
.
PAGE 9 OF 9 PAGES

FRBO-I7. (IF ADDITIONAL SHEETS ARE NEEDED FOR NARRATIVE OR SKETCHES
ATTACH SECURELY TO T RM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
1.WHEN 0ID YOU SEE THE PHENOMENON?
DAY /0 MONTH.. Tou YEAR 69
2. WHAT SIGHT THE PHENOMENON?
HOUR 26 MINUTES /6 A.M. DIP.N.
3. WHAT E DID LAST SIGHT THE PHENOMENON?
HOUR (0.M.
4. TIME/ZONE 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 5. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY, GIVE THE NEAREST STREET ADDRESS AND INDICATE ON
A HAND ORAWN 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. HIGHWAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE AND DIRECTION FROM SOME RECOGNIZABLE LANDMARK.
Living Liiing CER
Rood
Dimastoun, Chis
6 IMAGINE VOU ARE AT 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 B* ON THE SAME CURVED LINE TO
SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
90 A5
|
1
I
1 30
1
1 15
OBSERVER
AF$ FORM 117
AUG 67

AFR 80-17(C1)
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 TRE COMPASS TO INDICATE THE DIRECTION TO
THE PHENOMENON WHEN LAST SEEN.
N
NNW NNE
NW NE
WNW ENE
WSW ESE
SW SE
sSw SSE
L-o-ce
7. IN THE SKETCH BELOW, 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.
PAGE 2 OF 9 PAGES

AFR 80-17(C1)
WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (ChCCK aPprOpRICte blOCKS.)
OUTDOORS IN BUSINESS SECTION OF CITY
14 BUILDING IN RESIDENTIAL SECTION OF CITY
IN CAR AS DRIVER 0 AS PASSENGER IN OPEN COUNTRYSIDE
IN B04T NEAR AIRFIELD
IN AIRPLANE AS PILOT AS PASSENGER FLYING OVER CITY
OTHER FLYING OVER OPEN COUNTRY
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
PHENOMENON?
NORTHEAST SOUTHEAST
NORTHWEST SOUTHWEST YES No
EXPLAIN WHETHER SUCH MOVEMENT AFFECTS YOUR R SKETCHES IN ITEMS S ANO 5.
DESCRISE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD. TERRAIN OR BODY OF IN ANDTYPEOP ROAD.TERRAINOR BOUY OF WATER YOU TRAVERSED DURGNG WATER YOU TRAVERSED DURING
THE THE SIGH SIGHTING. TING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HON HON MUC L o HER TRAF FIC WAS THERE?
DID YOU NOTICE ANY AIRPLANES? DID YOU NOTICE ANY AIRPLANES? YES XNO. IF YES DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME NO. IF YES, DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME
OF SIGHTING THE PHENOMENON OF SIGHTING THE PHENOMENON AND WHERE THEY WERE AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
9. HOWLONG WAS THE PHENOMENON IN SIGHT?
LENGTH OF TIME CERTAIN OF TIME NOT VERY SURE
FAIRLY CERTAIN JUST A GUESS
HOM WAS TIME DETERMINED?
WAS STHE PHENOMENON IN SIGHT CONTINUOUSLY? YES NO. IF NO. INDICATE WHETHER THIS IS DUE TO YOUR
MOVEMENT OR THE BEHAVIOR OF THE PHEHOMENON, AND DESCRIBE SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAP.
PEARANCES ON PREVIOUS SKETCHES.
WULL
PAGE3OF9 PAGES

AFR 80-17(C1)
1O. IF TNEMZ WERE WORE THAN ONE PHENOMENON, HOW MANY WERE THERE? DRAW A PICTURE TO SHOW HOW THEY WERE
ARRANGID. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING!
Onlyone
11. CONDITiONs (Check appropriate blocks.)
A. SXY B. WEATHER
DAY CUNULUS CLOUDS(LOW fluffY) FOG OR MIST
TWILIGHT Ciraus CLouDs (Nigh fleecy or Herring- HEAVY RAIN
NIGHT bone) LIGHT RAIN OR DRIZZLE
CLEAR NIMBUS CLOUDS (Rain) HAIL
PARTLY CLOUDY CUMULONIMBUS CLOUDS SNOW OR SLEET
COMPLETELY CVERCAST (Thunderstorms) UNKNOWN
HAZE OR SMOG NONE OF THE ABOVE
C. IF TNE 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 UNKNOWN
NANY MOON HIDDEN BY CLOUDS
UNKHOHN PARTIAL(New or quarter)
D. IF SIGHTIMG WAS IN DAYLIGHT, WAS THE SUN VISIBLE? YES IF WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON?
TIN FRONT OF YOU TO YOUR RIGHT OVERHEAD(NeW noON)
TH BACK OF YOU TO YOUR LEFT UNKNOWN
E. SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE S SUN, HEADLIGHTS OR
U3
G biglt ala bigk8
White Colon likea
light
bulte. I'obed bile it
hi
PAGE 4 OF 9 PAGES

FLASH OR FLICKER?
DISAPPEAP AND REAPPEAR?
SPIN LIKE A TOPI
MAKE A NOISE? BT
FLUTTER CP WOBBLE?
14. WHAT OREW YOUR ATTENTION TO THE PHENOMENON?
lights evtst
off.
A. HOW DID IT FIN DISAPPEAR?
-
!
PAGE 5 OF 9 PAGES

AFR 80-17(C1)
17. DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWING' INCLUDE INFORMATION ON MODEL,
TYPE. FILTER. LENS PRESCRIPTION OR OTHER A APPLICABLE DATA.
EYEGLASSES CAMERA VIEWER
SUNOLASSES BINOCULARS
WINOSHIELD TELESCOPE
SIDE WINDON OF VEHICLE THEODOLITE
WINDOWPANE OTHER
A. DO YOU OPDINARILY WEAR GLASSES? 0 YES X NO B. DO YOU USE READING GLASSES? YIUNO
18 WHAT WA! 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 DISTANCE
20 IN CRDER THAT WE MAY OUTAIN 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 DID YOU NOTICE ANY ODOR, NOISE, CR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECT ON YOURSELF.
ANIMALS OR MACHINERY IN THE VICINITY? YES XNO. IF *YES, DESCRIBE.
A. DID THE PHENOMENON OISTURB THE GROUN OR LEAVE ANY PHYSICAL EVIDENCE. IYES NO.
IF "YES,* DESCRIBE.
Unbnn
(
PAGE 7 OF 9 PAGES

.
—
AFR 80-17(C1)
22. HAVK YOU EVEA BEEN THIS OR A SIMILAR PHEMOMENON DZFONE? ]YE3  NO.IP *YES GIVE DATE AND
LOCATION.
23 WAS ANYON WITH YOU AT THE IME YOU SAW COMENON? YES NO. IT TOO?
YES HO.
A. LIST THEL 3545
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
TELEPHONS TELSPHON AGE
MALE FEMALE
OCCUPATION AND ANY EXPERIEHCE WHICH MAY BE PERTINENT. PATION AND ANY EXPERIEMCE WHICH MAY BE PERTINENT.
25. WHEN ANO TO WHOM YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
NAME DAY MONTH YEAR
26. DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY MONTH YEAR
PAGE 8 OF 9 PAGES

27. INFORMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT AOEQUATELY COVERED IN THIS QUESTIONNAIRE, AFR 80-17(C1)
ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGHTING.
"Moved from Gesontan to Miamisbiany
in about5 minutes. 11
Dt had ady ane eight ighet bludbig
24
like a kup. li fab wame otait
lift.
PAGE S OF 9 PAGES