PROJECT BLUE BOOK

PROJECT 1.07S RECCND
ME GROUP LOCATION
31 20002 Delaware Nemer.
10. CONCLUSION
Insufficient date for evaluasis. Insufficient date for evaluasisn
FOBJECTS
OFCSSERVATION OF CBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
-OBSERVATION Observer watched a round shaped oar Observer watched a round shaped
certain height then move toward the west
.sua tance then went up out of sight the same
The object's coler was that of a sts c
at high speeds and went at thothee
The observer was not sure of the ex ct t
Tos only say that it was the first wesk ef Loser
Without a more specific date a detailsd stu
possible.
:CAL EVIDENCE

APPEIDIX R
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 aerial phenomenon that you have observed.
Plaase try to answer as many questions as you possibly can. The information that you give will
be used for research purposes. Your nama 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 datails.
1. When did you see the object? 2. Time of day:. 3PM
Hour Minutes
tptleck Lxtleck 12 66 (Circle One):
A.M. or P.M.
Day Month Month Yoar
3. Time Zone:
(Circle One): a.(Eastern (Circle One): a. Daylight Saving (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
DEl, River DEL,xN.J.
Naarest Postal Address City or Town Srote or County
5. How long was object in sight? (Total Duration) a buit. 10
Hours Minutes Saconds
a. Certain c. Not vary sura
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? omy Icl leg.npeiit
5.2 Was object in sight continuously? Yos
6. What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
a. Bright
b. Cloudy
7. IF you sow the object during DAYLIGHT, whare was the SUN located as you looked at the object? 7. IF you sow the object during DAYLIGHT, where was the SUN located as you looked at the objact?
(Circla One): a. In front of you (Circle One): a. In front of you d. To your loft d. To your loft
b. In back ofyou b. In back of you .Overhead . Overhead
c. To your right f. Don't remomber
FTD 0CT 42 164 FORM Reproduced by Library of Congress, Legislative Reference Service
This form auperaedes PTD 154, jul 51, which le obeolete. May.1966

Page 2
8. IF you saw the object at NIGHT, what did you notice co-cerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON(Circle One):
a. None a. Bright monnlight
b. A few b. Dull monnlight
c. Many c. No moonlight - pitch dark
d. Don't remember
9. What were the wenther conditions at the time you saw the object?
CLOUDS (Ciréle One): WEATHER(Circle One):
a.(Clear sky 0. Dry
b. Hazy b.-Fog,rist, or light rain
c. Scattered clouds c. Moderat~ or heavy rain
d. Thick or heavy clouds d. Snow
e. Don': remember
10. The object appeared: (Cirsle One): 10. The object apbeared: (Cirsle One):
a. Solid d. As a light d. As a light
b. Transparent e. Don't remember
c. Vapor
11. If it appeared as a light, was it brighter then the brightest stors? (Circle One):
a. Brighter c. About the some
b. Dimmer d. Don't know
11.1 Compare brightmoss ro some common object:
12. The edges of the obiect were:
(Circle Onne): a. Fuzzy or blurred c. Other
b. Like bright star
c. Starply outlined
d. Dor' remember
13. Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes No No Don't know
b. Suddenly speed up and rush away at any time? Yes Yes No No Don't know
c. Break up into parts or exolode? Yrs Yrs No No Don't know Don't know
d. Give off smoikn? d. Give aff smoikn? Yes Yes No No Don't know
e. Change brightaass? Yes No No Don't know
f. Change shope? Yes Yes No No Don't know
g. Flash or flicker? Yes No No Don't know
h. Disappear and rrappecr? Yes Yes No No Don't know

Page 3
doune to a Centine Hight thin went a Short distinice west
and them n mt up out of Sight the Som that it
a ppiand
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
it moved behind:
16. Did the object 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:
i7. Tell in a few words the following things about the object: i7. Tell in a few words the following things about the object:
a. Sound
b. Color Fenxeet Ronnd and Color Sinias Steek Firreox RommIad lolor Sne eteee
18. We wish to 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 would have been covered by the match head?
19. 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 espacially exhaust trails or vapor trails.
Piace an arrow beside the drawing to show the direction the object was moving. 小
DN DN =]
Kdn WEST WEST
PERFECT Round PERFECT.Round

Poge 4
20. Do you think you can estimate the speed of the objact?
(Circle One) Yes No
IF you onswered YES, then whar speed would you estimate?
21. Do you think you can estimate how lar away from you the object was?
(Circle One) Yes No
22, Where were you locared when you sow 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 b. In a car c. in open countryside? c. in open countryside?
c. Ouidoors d. Near an airfield?
d. In an airplone (type) d. In an airplone (type) e. Flying over a city?
e, At sea e. At sea f. Flying over open country?
f. Other f. Other 9. Other Car a Briileg 9. Other Cor a Briileg
24. IF you were MOVING IN AN AUTOMOBILE or other vehicle ot the time, then complate the following questions:
24.1 What direction were you moving? (Cirele One) 24.1What direction were you moving? (Circle One)
a. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fost were you moving? 25 ___miles per hour.
24.3 Did you stop at any time while you were looking at the object?
(Circle One) Yas N
25. "Did you observe the object through ony of the foilowing?
b. Eyeglasses Yes e. Binoculars Yos No
b. Sun glasses Yes No f. Telescope Yes No
Windshield Yes g. Theodolite Yos No
d. Window glass Yos No h. Other _
26. In order thar y on give as clear a picture as possible of what you sow, describe in your own words a common 2ó. In order thar y an give as clear a picture as possible of what you saw, describe in your own words a common
ablect or objacts which, whan ploced up in the sky, would give the same appecrance as the object which you sow. ablect or objacts which, when pleced up in the sky, would give the same appecrance as the object which you saw.
as a Rund Dic an a Rund Dic,

Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 abovs the horizon (skyline) when you last saw it. Place an "A" on the compass
when you first sow it. Place a "B" on the compass where you last saw the object.
90° 75°
60°
45°
30°
15 15° Sw sw
ss sC
S S
0
28. 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 sliun ny changes in direction during the course.
B JA
29. IF there was MORE THAN.ONE object, then how many were there?
Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling.
On are

Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyone else with you at the time you saw the object? (Circle One) Yes No
31.! !F you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
32. Ploase give the following informatien about yourself: 32. Please give the following informatien about yourself:
NAME
Losp Nomw LospNomw First Nams First Nams Middle Nome Middie Nomo
ADDRESS
Straet City Zone Ste
TELEPHONE NUMBER AGE SEX
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and to whom did you report that you had seen the abject? 33. When and to whom did you report thot you had seen the abject?
Doy Day Month Year

Page 7
34. Date you completed this questionnaire: 8 1967
Day Month Year
35.nm  y  ee n w  l e in quastionnaire or a narrative explanation of your sighting.
Del nist and goiny Sost
It as leaniing
as for roe I liy lar × Selt as for roe I liry lar xSelt
I am makng. I am making.
/,
my Mame i
MANTW17 N.J.
M
N.J.