PROJECT BLUE BOOK

The object changed colors the
6. TYPE OF OBSERVATION and blue). After a while a second object appeared near
This object appeared similar to a dim star. The object
Ground Visual first.
moved roughtly from the west to SSE.
7. COURSE
Comments: Although the Comments: Although the observer stated that he saw the obj- stated that he saw the obj-
see case see case ect on 5 Oct 67 on 5 Oct 67 at l800 hrs., the at 1800 hrs., the witness stated that he saw
ect is felt that is felt that
8. PHOTOS PHOTOS the object on 6 Oct 67 67 at 2000 hrs. at 2000 hrs. Although it
the observers were probable watching stars or planets, it is
Yos Yos e direction
2 No conflicting
9. PHYSICAL EVIDENCE Data.
date and time it is being listed as Conflicting
Yos
C No
FORM FORM Prevfous editions of thle form may be used. form may bo used.
FTD SCP 63 0-329 (TDE) Provfous editions of thie 0-329 (TDE)
.
4

22. HAVE YOU EVER SEEN THIS OR A SIMILAR PHE IENON BEFORE CTYES N IF *YES, " GIVE DATE AND
LOCATION.
23. WAS ANYONE WITH YOU AT THE TIME YOU SAW THE PHENOMENON? YES F7 NO. IF *YES,* DID THEY SEE IT TOO?
MIYES NO.
A. LIST THEIR NAMES AN DDRESSES
Liverpool W.9.
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST NAME FIRST MIDDLE NAME
ADDREss (Street, Ciby Stdte and ip Code)
hiveppan
TELEPHONE(Area code and numb AGE
14 MALE FEMALE
INDICATE ADDITIONALINFORMATION INCLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
Dima dent tn Dina dent Sh
MS
NEOETCTOXA
25. WHEN AND TO WHOM OID YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
0
NAME DAY MONTH YEAR
25. DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY 2 MONTH Jan. YEAR
PAGE 8OF 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.
conelingsmoosoa 3imde t mede tete-
PAGED 3 PAGES

ne andmoe alrtl pols
17C.
Luorpool, Megak tuopool, begak - 13088
0 0
P.S. dwould like an On
0
0

50oe7
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE BASE. OHIO 4S433 ②
REPLY TO TDPT/UFO
ATTN OF:
SURJECT: UFO Observation , 5 Oet 67
TO:
13008
Your name has been given to the Aerial Phenomena Branch (Project
Blue Book) as being a witness to an unidentified flying object.
would you please complete the attached AF Form il7 and return it -2
in the envelope provided. If you were not a witness tc this sighting,
would you please make would u please make a statement a statement to this effect on the attached form. to this effect on the attached form.
The information which you provide will be used in evaluating this 1 be used in evaluating this
observation. Thank you observatior your assistance in this matter. nce in this matter.
MES C. MANATT, Colonel, USAF MES C. MANATT, Colonel, USAF 1 Atch
virector oduction duction AF Form 117

it
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
ANSWER ALL OF THE OUESTO FORMATION YOU GIVE WILL BE USED FOR RESEARCH PURPOSES
N WITH ANY OF YOUR ST ITS OR CONCLUSIONS WITHOUT
SE INVESTIGATOR FOR ING TO FTD (TDETR), WRIGHT.
PATTERSON AFB, OHO 4S433, IAW SO-! ADDITIONAL SHEETS ARE NEEDI ED FOR NARRATIVE OR SKETCHES
ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
1. WHEN DID YOU SEE THE PHENOMENON?
DAY. MONTH
. WHAT TIME DID FIRST SIGHT THE PHENOMENON?
HOUR MINUTES A.M. P.M.
3.WHAT TIME DID YOU LAST SIGHT PHENOMENON?
HOUR MINUTES A.M. O P.M4.
4. TIME/ZONE DAYLIGHT SAVINGS STANDARD
EASTERN CENTRAL MOUNTAIN PACIFIC COTHER
5. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY, GIVE THE NEAREST STREET AODRESS AND INDICATE ON
A HAND DRAWN MAP WHERE YOU WERE STANDING WITH REFERENCE TO THE ADDRESS. IF IN THE COUNTRY, IOENTIFY THE
HIGHWAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE AND DIRECTION FROM SOME RECOGNIZABLE LANDHAPK
Takes
emerayn.
fay
Quckls Quekls
oDailo 0Duilo
syracure
6. IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH, PLACE AN "A*ON THE CURVED LINE TO SHON HOW HIGH THE
PHENOMENCN WAS ABOVE THE HORIZON, OR SKYLINE, VHEN FIRST SEEN. PLACE A "B" ON THE SAME CURVED LINE TO
SHOW HOW HIGH ASOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.
8
!
1
1 30
1 coe woimn  n
1
1 15
I
O3SERVER
AF FORM 117
AUG 67

SA. NOW IMAGINE YOU ARE AT THE CENTER OF THE COMPASS ROSE. PLACE AN *A°ON THE COMPASS TO INOICATZ THE
DIRECTION TO THE PHENCMENON WHEN FIRST SEEN. PLACE A B° ON THE CONPASS TO INDICATE THE DIRECTION TO
THIE PHENOMENON WHEH LAST SEEN.
N
NNW NNE
NW NE
A
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, ANO 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
APPEAREO TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW TO COMPLETE
THE LARGER SKETCH.
PAGE 2 OF3 PAGES

WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (CAECK aPPROPRlALE 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 AS PASSENGER FLYING OVER CITY
OTHER FLYING OVER OPEN COUNTRY
OTHER
A. IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING:
WHAT DIRECTION 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 EFFECTS YOUR SKETCHES IN ITEMS 5 AND 6.
DESCRISE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD, TERRAIN OR BODY OF WATER TRAVERSED DURING
THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HOW MUCH MUCH OTHER OTHER TRAFFIC TRAFFIC WAS WAS THERE? THERE?
DID YOU NOTICE ANY AIRPLANES? DID YOU NOTICE ANY AIRPLANES? YES NO. IF *YES, DESCRISE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME NO. IF YES, DESCRISE 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. OF SIGHTING THE PHENOMENON N AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
and
Itwas betwean 15+20minswhen
Seomed dicee below. below.+
9. HOW LONG WAS THE PHENOMENON IN SIGHT? THE PH ENOMENON IN SIGHT?
LENGTH LENGTHOE TIME OF TIME CERTAIN OF TIME NOT VERY SURE
Thour +20 mins. FAIRLY CERTAIN JUST A GUESS
HOW WAS TIME DETERMINEO?
. wnst ULI tenes
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 DESCRIBE SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAP.
PEARANCES ON PREVIOUS SKETCHES.
PAGE 3 OF 9 PAGES

IO. IF THERE WERE MORE THAN ONE PHENOMENON, HOW MANY WERE THERET ORAM A PICTURE TO SHOW HOW THEY WERL
ARRANGED. DID THIS ARRANGEMENT CHANGE DURING THE SIGHTING?
13. C. 3
Ye
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 ORIZZLE
CLEAR NIMBUS CLOUDS (Rain) HAIL
PARTLY CLOUDY CUMULONIMAUS CLOUDS SNOW OR SLEET
COMPLETELY OVERCAST (Thunderstorms) UNXNOWN
HAZE OR SMOG NONE OF THE ABOVE
C.IF THE SIGHTING WAS AT TWILIGHT OR NIGHT, WHAT DID YOU NOTICE ABOUT THES STARS AND MOON?
(1) STARS (2) MOON
NONE BRIGHT MOONLIGHT BRIGHT MOONLIGHT NO MOONLIGHT
A FEW A FEW MOON WITH HALO MOON WITH HALO UNKNOWN
MANY MOON HIDDEN BY CLOUDS MOON HIDDEN BY CLOUDS
UNKNOWN PARTIAL (New or quarter)
D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? 7 YES YES NO. IF YES," WHERE WAS THE SUN AS YOU FACED IF "YES." WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT TO YOUR RIGHT OVERHEAD(NeWr noon) OVERHEAD (Near noon)
IN BACK OF YOU TO YOUR LEFT UNKNOWN UNKNOWN
E. SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, MEADLIGHTS OR OR
STREET LAMP, ETC. FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE. STREET LAMP, ETC. FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE.
Tin iP 7
4
12. GIVE A BRIEF DESCRIPTION OF THE PHENOMENON, INDICATING WHETHER IT APPEAREO DARK OR LIGHT, WHETHER IT
REFLECTED LIGHT OR WAS SELF-LUMINOUS ANO 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
APPEARED AS A POINT OF LIGHT. INDICATE COMPARISONS WITH OTHER OBSERVED O3JECTS, LIKE STARS, A LIGHT OR
OTHER OBJECT IN YOUR FIELD OF VIEW.
A. Light
B.Self-lominous
C.
0 dond
W fuzeg
ct point O ot light
also
g. it was
Bigger
PAGE 4 OFO PAGES

CHANGE SHAPE?
FLASH OR FLICKER?
DISAPPEAR RAND REAPPEAR?
SPIN LIKE A TOP?
MAKE A NOISE?
FLUTTEROR WOBBLE?
14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
ITs Brigh S and mosenent
macaTeCY
A. HOW DID IT FINALLY DISAPPEAR? A. HOW DID IT FINALLY DISAPPEAR?
CondRaed Condlased oorrey
ISppeor Un 2
the heve
carth andstoyed
for h R
( of th e
124
3. DIO THE PHENOMENON MOVE BEHIND ORIN FRONT OF SOMETHING, LIKE A CLOUD, TREE, OR BUILDING AT ANY TIME?
YES NO. IF *YES," DESCRIBE.
The larger 3 ion
S Ae a C
PAGE5 OF 9 PAGES

15. DRAN A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE ANO 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. MouRmen
Smaller Spo
Becfuss
plane
noticed
15+ Smaller one
obsect appeared
5
4
then then i whentover wheentouer
O√ e e adscan't
1teadz + ead
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
SEEN 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.
Soll obct
PAGE 6OF9 PAGES

506O7
indig
TDPT (uF0) Maj Quintanilla/70916/mhs/28 Dec 67 DE0 29 1967
UFO vation
Liverpool, New York 13088
This replies to your correspondence e on your unidentified
observation. The information which you have submitted is
conflicting. Therefore, we would appreciate it if you
would complete the attached AF Form ll7 and return it in
the inclosed envelope.
ECTOR FTANILLA, Jr, MajOr, USAF 1 Atch
Chief, Aerial Phenomena Office AF Form 117 w/envelope
Aerospace Technologies Division
Production Directorate

17. OID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWINGT INCLUDE INPORMATION 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? YESNO
13. WHAT WAS YOUR IMPRESSION OF THE SPEEO OF THE 19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE
PHENONENON? GIVE ESTIMATE OF SPEEOLN wiD!e PHENOMENONT GIVE ESTIMATE OF DISTANCE.S2MC
C
2O. IN 'ORDER THAT WE MAY OBTAIN AS CLEAR A PICTURE AS POSSIBLE OF WHAT YOU SAW, DESCRIDE IN YOUR OWN WORDS
A CCMMON OBJECT OR OSJECTS WHICH, WHEN PLACEO IN THE SKY, SIMILAR TO WHERE YOU NOTED THE PHENOMENON,
WOULD BEAR SOME RESEMSLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE
COMMON OBJECT AND WHAT YOU SAW.
Spark O ec ause O7 the gnt
and S LZ
T
21. DID YOU NOTICE ANY ODOR, NOISE, OR HEAT EMANATING FROM THE PHENOMENON ORANY EFFECT ON YOURSELF,
ANIMALS OR MACHINERY IN THE VICINITY? YES NO. IF *YES,  DESCRIBE.
A. DID THE PHENOMENON DISTURB THE GROUNO OR LEAVE ANY PHYSICAL EVIDENCE. YES NO.
IF "YES, DESCRIBE.
PAGE7OF 9 PAGES

2R. HAVE YOU EVER SEEN T ASIMILAR PHEN BEFORE! ClYES GIVE DATE AND
LOCATION
T
23. WAS ANYONE WITH YOU AT THE TIME YOU SAW THE PHENOMENON? YES NO.IF *YES, DID THEY SEE IT TOO?
YES NO.
A. LIST THEIR NAMES AND ADDRESSES
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST NAME, FIRST NAME, MIDDLE NAME
ADOREss (Street, City, State and Zip Code)
TELEPHONE (Area code and number) AGE
121 MALE FEMALE
INDICATE ADDT URMATION OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT.
M
25. WHEN AND TO WHOM DID YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?
6 YEAR
NAMS DAY. MONTH
26. DATE YOU COMPLETED THIS QUESTIONNAIRE.
DAY2 MONTH YEAR
PAGE B OF 9 PAGES

the Ueo investigator at your nearest Air Force base inmedlately.
By so doing, you will have a wuch greater having your
aigiting identified.
In the meantire, we are In the meantire, we are aenddng dag you you raterial which which mey zey
help you deternine whst you saw. help you deterxine what you saw. We we hope you
intereating, as 198
Thank you vour Oren the project project ecncerning cencerning
unidentified uniden Plying (UFOs). JFOs).
Sincerely,
DAVID L. STILES
Major, USAP
Acting g Chier, Civil Branch
Community Relations Division
Office of Information
4 Attachmenta
Niye , New York 13068
Coord Cy-- SAF-OIC
Cmbk Cy - SAF-OIC
Activity Cy - SAF-OIC
Reader Cy - SAF-OIC
Stapback
SAF-OIC
cc: WPAFB
Serd a 47 tESORAN

Ir tt were sendint a moansase to .orc
one or ane-it .We next ro"bored sbout cur
fixe; oosition , we vore to find oul lhs
the sbjeot-had Moved gudet sblt buo vo.t e oopsr
ite oal tion conpared co the stl pos,
Lover Ietitnde,We dproxaraced 'hezv
Was lo bawteel thetto.S tndiude.ii. ot s
tite e i seered to "oved tr vor.
Chirou,L d pair 6. binoculars cllwo ts o-
llo: t vr.We also notiggsh that the oujeeva
wore now both rovin'.Rturt aajev Mi:lone
poan them 'he; botn suojeu 5V5 w  - s
wlLrled wlaled sroped cnanjing cofars.t- -o
as me jet Few Flew by The oujsuu- starred-p the oujsuu- starred-p
un conctuened sn.conctuened
countncned assosstesky.the Littieehe
"
C0x000 fromyou, and au fae hooket
ocaklets
thankyou very vAcch we
PS. Sorry abadspelling
ondpooe

18
Colorsoare
reg
green
891100
Orange
whitd ?
NO FUCIA.

-
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 possible concerning the unidentified gerial phenomenon that you have observed.
any questions as you possibly can. The information that you give will
be used for research purposes. Your name will not be used in connection with any stataments,
conclusions, or publications without your permission. We request this personal information so
that if it is deemed necessary, may contact you for further details.
1. When did you sae the object? 2.Time of day: 18 15
Hour Minutes
5 :137 (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone: 3. Time Zone:
(Circle One): (Circle One): ia. Eastern (Circle One): a. Daylight Saving
b. Central 6. Standard
c. Mountain
d. Pacific
e. e. Other
4. Where were you when you saw the object?
iverpool Onadaga
Nearest Postal City or Town State or County
5.How long was object in sight? (Total Duration) 1 HS ?
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certaia d. Just a guess
-
5.2 Was object in sight continuously? Yes No
6. What was the condition of the sky?
DAY NIGHT
a. Bright . Bright
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. Overheod
c. To your right f. Don't remember
ETO FORM 161

Page 2
8. IF you saw the object at NIGHT, what did you notice concerning the STAiS and MOON?
8.1 STARS (Circle One): 8.2 MOON (Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight - pitch dark
d. Don't remamber d. Don't remember
9. what were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
. Clear sky a. Dry
b. Hazy b. Fog, mist, or light rain
Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds Snow
e. Don't remember
10. The object appeared: (Circle One):
a. Solid d.As a light
b. Transparent b. Transparent e. Don't remember Don't remember
c. Vapor Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One): 11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same c. About the same
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
Sparko
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
b. Like a bright star
c. Sharply outlined
d. Don't remember
. Did the object: (Circle One for ecch 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 N\o Don't know
f. Change shape? Yes No Don't know
g. Flash or flicker? Yes No Don'tknow
h. Disappear and reappear? Yes No Don't know

Poge 3
NG
15. Did the obiect move behind samething at any time, porticularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
it moved behind:
16. Did the obiect move in front of something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of: _
17. Tel! in a few words the following things about the obiect:
a.Soundon
b. ColorShapgedcolars Fast(ncoprnge
18. We wish to know the angular size. Hold a match stick at arm's length in line with a known obiect and note how
much of the obiect 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 would have been covered by the match head?
ull
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 especially exhaust trails or vapor trails.
Place an arrow beside the drawing to show the direction the object was moving. 2 m.n
Din
-1
1 3. *
Between23
~
stopped. > 7
also lost.
answev 28,24

Poge 4
20. Do you think you can estimate tha speed of the object?
(Circle One) Yes No
IF you answered YES, then what spead would you estimate?
21. Do you think you can sstimate how far away from you the object was?
(Circle One) Yes (No
22. Where were you located d when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Inside a building b. In the residential section of a city?
b. In a car In open countryside?
Outdoors in a S-reut yard d. Near an airfield?
d. In an airplane (type) e. Flying over a city?
e. At sea e. At sea f. Flying over open country? f. Flying over opan country?
f. Other f. Other _ g. Other_ Other
24. IF you were MOViNG IN AN AUTOMOBILE or other vehicle at the time, then complete the following quastions:
24.1 What direction were you moving? (Circle One)
a. North c. East East e. South g. West West
b. Northeast b. 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 Yes No e. Binoculars
b. Sun glasses No f. Telescope Yes No trre
c. Windshisld g. Theodolite Yes No CO
d. Window glass Yes No h. Other
26. In 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 placod up in the sky, would give the same appearance as the object which you saw.
a SPacK f O e YigAt
Q
-

Paga 5
27. In the following sketch, imagine that yeu are at the point shown. Place ar "A' on the curvad 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.
60°
80 C
45 NW N3
not
quctQ
90 M
-15 33
28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the Draw 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. path, a "B" at the end of the path, and show any changes in direction during ths course.
AX in 19
29. IF there was MORE THAN ONE object, then how many were there? 2
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
1n1

B0B Nr 21-R258
SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE
THIS QUEST AIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE THE U.S AIR FORCE AS MUCH INFORMATION
AS POSSI BRAIACTE ONTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO
ANSWE! NEORMATION YOU GIVE WILL BE FOR RESEARCH PURPOSES.
YOUR TION WITH ANY OF YOUR STAT IS OR CONCLUSIONS WITHOUT
ORCE BASE INVESTIGATOR FOR FORWARDING TO FTD (TDETR), WRIGHT-
PATTERSON AFB, OHO 45433, IAW SO-I7. (IF ADDITIONAL SHEETS ARE NEEDED FOR NARRATTVE OR SKETCHES
ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH VOUR NAME FOR IDENTIFICATION.)
1. WHEN DID YOU SEE THE PHENOMENON?
DAY_ MONTH- YEAR19
2. WHAT TIME DID YOU FIRST SIGHT THE PHENOMENON?
HOUR MINUTES CA.M. P.M.
3. WHAT TIME DID YOU LAST SIGHT THE PHENCMENON?
HOUR MINUTES A.M. CP.M.
1. TIME/ZONE DAYLIGHT SAVINGS STANDARD
CENTRAL MOUNTAIN ]PACIFIC COTHER
S. WHBRE 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
HIGHNAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE AND DIRECTION FROM SOHE RECOGNIZABLE LANDMARK.
-7
victoria vctoria s0ecth
Handock
Sp+Tecfor Sp+Teafo →> Ap{t Apct
here icoleny jcolony 11 (fewon
here emeral emerald
Bails
m0.0
oymmemee
Seunl Senl
where he Buckey Buckley
T 2H01
Live Live
6. IMAGINE YOU ARE AT THE POINT SHOWNIN THE SKETCH PLACE AN A °ON THE CURVED LINE TO SHOW MOW 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.
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Page 6
30. Hava you evar sean this, or a similer objuct bafors. if so give dure or dates ond loection.
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3. Was anyone alse with you at the time you saw the object? (Circle One) Yas No
31.1 IF you answered YES, did thay sse the object too? (Circla One) Yes No
31.2 Ploasa list their names and addresses:
32. Please give the following information about yourself:
NAME
Last Name First Name
ADDR
Streat Streat City Zo Zo Stao
TELEPHONE NUMBE TELEPHONE NUMBE 3 AGE AGE4 L SEX SEX male
Indicate any aditional information about yourself, including any special axoarience, which might be pertinent.
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33. When and to whom did you report that you had seen the objecr?
Oet (0?
Day Month Yoar

1,
Page 7
34. Date you complatad this quastionnaire:
Day Month Yoor
35. Informaticn which you feel pertinent and which is not adequately covered in the spacific points of the
questionnaire or a narrative explanation of your sighting.
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This information was aled atona
Sinilar U.EO.FORM prevously

There were 2 objects .One about one as big as the other.
malle. object appeared from the We think ! )Because it wasnt
-07.5 WHEN IT WAS NEAR , a was going to collie
L:t big one. I curved around and came down agin a end hovered at leas
nn (We weren' observed any longer.)
Then the little one stopped the bigger one , start ed up and kept goin.
511 1t disappeared. It was going EAST.
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6A. NON IMAGINE YOU ARE AT THE CENTER OF THE COMPASS POSE. PLACE AN A° ON THE COMPASS TO INOICATE THE
DIRECTION TO THE PHENOMENON WHEN FIRST SEEN. PLACE A D ON THE COMPASS TO INDICATE THE DIRECTION TO
THE PHSNOMENON WHEN LASTSEEN.
NNW NNE
NW NE
ENE
wSW ESE
SW SE
SSW SSE EISMU
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
APPEAREO TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HON TO COWPLETE
THE LARGER SKETCH.
PAGE 2OF9 PAGES

IO. IF YNERE WERE NORE THAN ONE PHENOMENON, HOW MANY WERE THERE? DRAW A PICTURE TO SHDW HOY THEY WERE
ARRANGED. DID THIS APRANGEMENT CHANGE DURING THE SIGHTING?
1)
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11. CONDiTioNs(Check appropriat= blocks.)
A. SKY B. WEATHER 1
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
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) (1) STARS STARS (2) (2) MOON MOON
NONE BRIGHT BRIGHTI MOONLIGHT NO MOONLIGHT NO MOONLIGHT
AFEW MOON WITH HALO UNKNOWN
MANY MANY MOON HIDDEN BY CLOUDS
UNKNOWN UNKNOWN PARTIAL (New or quarter)
D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN D. IF SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? YES NO. IF YES, WHERE WAS THE SUN AS YOU FACED *YES, WHERE WAS THE SUN AS YOU FACED
THE PHENOMENON? THE PHENOMENON?
IN FRONT OF YOU TO YOUR RIGHT OVERHEAD (Nea nOON) OVERHEAD (New noon)
IN BACK OFY IN BACK OF YOU YOU TO YOUR LEFT UNKNOWN
E. SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR 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. STREET LAMP, ETC. FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE.
12. GIVE A BRIEF DESCRIPTION OF THE PHENOMENON, INDICATING WHETHER IT APPEAREO DARK OR LIGHT, WHETHER IT
REFLECTED 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 INOICATE IF IT
APPEARED AS A POINT OF LIGHT. INDICATE COMPARISONS WITH OTHER OBSERVED OSJECTS, LIKE STARS, A LIGHT OR
OTHER OSJECT IN YOUR FIELD OF VIEW.
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PAGE4OF9PAGES

OTHER
A. IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING:
WHAT DIRECTION WERE 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 5.
DESCRIBE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD, TERRAIN OR BODY OF WATER YOU SED DURING
THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
HOW MUCH OTHER TRAF FIC W AS 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 WHEFE THEY WERE IN RELATIVE TO POSITION OF THE PHENOMENON.
Glata Clata Concorxlothi concontgthis
9. HOW LONG WAS THE PHENOMENON IN SIGHT?
LENGTH OF TIME CERTAIN OF TIME NOT VERY SURE
145 FAIRLY CERTAIN JUST A GUESS
HOW WAS TIME DETERMINED?
WAS THE PHENOMENON IN SIGHT CONTINUOUSLY? YES NO. IF "NO, INOICATE WHETHER THIS IS DUE TO YOUR
MOVEMENT OR THE BEHAVIOR OF THE PHENOMENON, AND DESCRI3E SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAP.
PEARANCES ON PREVIOUS SKETCHES.
PAGE 3 OF 9 PAGES

DISAPPEAR AND REAPPEAR?
SPIN LIKE A TOP?
MAKE A NOISE?
FLUTTER OR WOBBLE?
14. WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
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A. HOW DID IT FINALLY DISAPPEAR?
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Note to page 8 note to pagef (thedlagrante-ans) (thedliaguanbeans)
9. DID THE PHENOMENON MOVE BEHIND OR IN FRONT OF SOMETHING, LIKE A CLOUD TREE, OR BUILDING AT ANY TIMET
YES S NO. IF *YES,DESCRIBE.
T
SISESTPSEP
PAGE 9 PAGES

IS. ORAY A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE AND LABEL ANY DETAILS THAT MIGHT HAVE APPEAREO AS VINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARROW THE
DIRECTION THE PHENOMENON WAS MOVING.
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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 MA CH. NOW IF YOU HAD
BEEN ABLE TO PERFORM THIS EXPERIMENT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE
PHENOMENON WOULO HAVE BEEN COVERED BY THE MATCH HEAD.
100?
PAGE S OF 9 PAGES

1Z DID VOU OBSERVE THE PHENOMANON THROUGH ANY OF THE FOLLOWING! INCLUOE INFORNATION 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? YES NO 3. DO YOU USE READING GLASSES? YES
18. WHAT WAS YOUR IMPRESSION OF THE S OFITHE 19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE
PHENOMENON? GIVE ESTIMATE OF SPE PHENOMENON? GIVE ESTIMATE OF DISTANCE
ZO. IN ORDER THAT WE MAY OBTAIN AS CL: AR A PICTURE AS POSSISLE OF WHAT YOU SAW, DESCRIBE IN YOUR ONN 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 OSJECT AND WHAT YOU SAW.
fut the
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21. DID YOU NOTICE ANY ODOR, NOISE, OR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECTON 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 CNO.
IF *YES."DESCRISE.
PAGE 7 PAGES