PROJECT BLUE BOOK

PROJECT 19073 RECORD
TIML'CROUP 2. LOCATION
463705 Cacalina Cato
3. 10. CONCLUSION
Civil4 Insufficient D
4. NUMBER OF OBJECTS 164 rot. received
ar requested
Cra
S. LENGTH OF CBSERVATION 11. BRIEF SUMMARY AND ANALYSIS
10 winucen
SES CASS AL
6. TYPE OF OBSERVATION
Jraund Vicual
7. COURSE 7. CCURSE
N/A
8. PHOTOS
Yes Yes
n No
9. PHYSICAL EVIDENCE
Yo: 0 Yo:
NO
FORM
FTD 57.43 C-119 (708) Prevtoax edvona

3 May 67
INCUFFDATA
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT-PATTERSON AIR FORCE BA3E. OHIO43433
REPLY TO ATTN OF TDET/UFO 24 May 1967
SUBJECT UFO Cbservation, 3 May 1967
hlos TO
et
Cblerlin, Ohio 44074
Reference your unidentified observation. The information which
we have received is not sufficient for a scientific evaluation.
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 JAMES C. MANATT, Colonel, USAF 1 Atch 1 Atch
Director of Technology end Subsystems FTD Form 164 w/envelope
TD/LFo TOELLE

MAJ.
Q
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.
Please try to answer as many 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, we may contact you for further details.
1. When did you see the object? 2. Time of day: _// 10
Hour Minutes
5 mAY 67 (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One): a. Eastern (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object? 4. Where were you when you saw the object?
OBLERLIN OH10
Nearest Postal Address City or Town State or County
5. How long was object in sight?(Totol Duration) 10
Hours Minutes Saconds
a. Certain c. Not very sure
5. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuously? Yes No
6. What was the condition of the sky?
DAY (NIGHT — Some donda
a. Bright
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
Send 164
FORM
FTD OCT 62 164 This form supermedes FTD 164, Jul 61, which is obaolete.

Paga 2
8. IF you saw the object at NIGHT, what did you notice conceming 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
c. Many c. No moonlight - pitch dork
d. Don't remember d. Don't remembar
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry
b. Hazy b. Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy roin
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared: (Circle One):
a. Solid d. As o light
b. Transparent e. Don't remember
c..Vapor c..Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
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
13. Did the object: (Circle One for ench 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 ofi smoke? Yes No Don't know
e. Change brightness? Yes No Don't know
f. Change shape? Yes No Don't know
g. Flash or flicker? Yes No Den't know
h. Disappear and reappear? Yes No Don't know

Poge 3
14. Did the object disappoar while you were watching it? If so, how?
15. Did the obiect 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 ebiect move in front of something at ony time, particularly a cloud?
(Circle One): Yes No Don't Know. IF you answered YES, then tell what
in front of:
17. Tell in a few words the following things about the object: 17. Tell in a few words the following things about the object:
a. Sound
b. Color
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? 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 obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails.
Place an erro- beside the drawing to show the direction the object was moving.

Poge 4
20. Do you think you can estimate the speed of the object?
(Circla One) Yes No
IF you answared 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 would you say it was?
22. Where were you located 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 cor c. In open countryside?
c. Outdoors d. Near an airfield?
d. In an airplane (type) d. In an airplane (type) e. Flying over a city?
e. At sea e. At sec f. Flying over open country?
f. Other g. Other
24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, than complete the following questions: 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions:
24.1 What 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 fast were you moving? _miles per hour. milooooe bous
24.3 Did you stop at any time while you were looking at the objact?
(Circle One) Yos No
25. Did you observe the object through any of the following?
a. Eyeglosses e. Binoculars Yes No
b. Sun glesses Yes No f. Telescope Yes No
c. Windshiold Yes No g. Theodolite Yes No
d. Window glass Yes No h. Other
26. In order that you cun give as clear a picture as possible of what you saw, dascribe 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

Pogo5
27. In the following sketch, imagine that you are at the point shown. Place on "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 compuss
when you first saw it. Place a "B"on the compass where you last saw the object.
90° 75°
60°
N
45 NW NE
30° w
E
15° SW
SE
3 S
o 0°
28. Draw a picture that will show the motion that the object or objects made. Place an "A" at the beginning of the
poth, a "B" at the end of the path, and show any changes in direction during the course. poth, a "B" at the end of the path, and show any changes in direction during ths course.
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.

Paga 6
30. Have you evar saen this, or a similor objact bafore. If so giva date or dates and location.
31. Was anyone else with you at the time you saw the objact? (Circle One) Yo No
31.1 IF you answered YES, did they see the object loo? (Circle One) Yas No
31.2 Please list their names and addresses:
J witnisses
32. Please give the following information about yourself:
NAME
Last Name Last Nome First Home Middla Nome
ADDRESS WEST COLLECE WEST COLLELE ST.
Streat OBLERLIN, 017% Zone Stae
44094 44094
TELEPHONE NUMBER AGE SEX SEX M
Indicate any additional informotion about yourself, including any special axporiance, which might be partinent.
33. When and to whom did you roport that you had seen the object?
Day Month Your

Page 7
3D u Day Month Year
35me quastionnaire or a narrative explanation of your sighting.
sbsomers watchid an vange glow
tronel slomily touand the last -
The light stipped then started
moing tonand the west intel moinn tonand the west intel
it lisappeened it disappeened
The oange lifht was hanging The wrange lifht was changing
mitenaity as it moved. mitenaity as it moned.
At moved elomer at first jist refore
it disappeared
in the west.