PROJECT BLUE BOOK

RECORD
TMB GROUP L. LOCATION
APPLMMGOD, COLORADX
10. CONCLUSION
INSUFFICIENT DATA FOR EVALUATION
RER OF OBJECTS FTD Forh l64 sent to witness; not meturneà after mary
days. Will re-evaluase if received.
ENGTH OF O3SERVATION 11. BRIEF SUMMARY AND ANALYSIS
Information in report incomplets. Need additional inio.
E OF OSSERVATION See Case file.
visua.
" COURSE COURSE
STOS
..CALEV.DENC. ..CAL EV.DENCE
FCR.
29 (TDE)Previos aditione of thie form mey be used.

: UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) fes No
F you answered YEs, then what speed would you estimate?5 n∠ A o
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?A  a  T 25 PEET4 WAY
22. Where were you located 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?
(57 In a car c.In open cauntryside?
c. Outdoors c. Outdoors d. Near an airfield? d. Near an airfield?
d. In an airplane (type) d. In an airplane (type) e: Flying over a city?
e. At sea e. At sea f Flying over open country? Flying over open country?
f. Other f.Other_ g. Other. g. Other
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 a. North East e. South g. West
b. Northeast b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving? /0 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 Yes
b. Sun glasses No f. Telescope Yes
Windshield Yes No g. Theodolite
d. Window glass Yes No h. Other_
26. In arder that you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jeett wrich, when placed up in the sky, would give the same appearance as the object which you saw.
ITWAS RED HAD LIEE DOS MOVINIG VERY SLOW
IN THE SKY WHITE BOTTON AHD AND VAPAR TRAILS
JUSTHEARIT

Official U.S. Air Force
Page 5
27. in the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NW NE
30°
w h E
15° SW SE
0° S
23. 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.
LLCcmiMCDOCyiNACnR LLCcmiCDOCyiNACnR
TOHた OのRにCす
TOHER HELR STOP POR AWHILE HELR SToP POn AWHILE
R0AD LOKBACKTOWHRIT LOCKBACKTOSWHRにIT
DOER WENTAND IT UAS GCHR WPNTANbITASCHR
FOWLOWMEDON OWLOwMEDON
OHTECTUERP 171cL
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.
5

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
x
31. Was anyone eise with you at the time ycu saw the object? (Circle One) Yes No
X
31.1 iF you answered YES, did they see the object too? (Circle One) No
31.2 Please list their names and addresses:
32. Please give the following information about yourself:
NAME NAME
Last Name First Name Middle Name
ADDRES 7Ai2Fi5LD 7AIRFIELD CO从M CC从H
Street City Zone Zone State State
TELEPHONE NUMBE TELEPHONE NUMBE AGE52SEX_M4∠ AGE52SEXM4∠
Indicate any additional information about yourself, including any special-experience, which might be pertinent. Indicate any additional information about yourself, including any special-experience, which might be pertinent.
NO4
33. When and to wnom did you report that you had seen the object? † in (尽
TUES ly4kcit 1467
Day Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: TUES Day 72-25 Month 1967 Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting.
TWAS GOING TO O2k OWTHR 11-7 SIHIRT
/4人10/FA1
OP AND SAW THE OJACT STOP IN THE SKY  ITWAS UP AND SAW THE OJACT STOP IN THE SKY  ITWAS
ACLRANCT ACLRALNICHT WAS wAS
GOIALG TO GET OUT OFP THB CAN BUT IW OULD BR GOIALG TO GET OUT OFP THB CAH BUT IW OULD BR
LATB POR WORK SO I WANT DOWN THE AILL LATE POR WORK SO I WENT DOWN THE AILL
LOCK PACK UP IN TIHE SKY AND IT WAS
GO HE OUTORR SIGHTINEVERSAWANY
THING LIKE IT FIRST I THOULH I WAS APLANE
WITH RED LIG-IHTS ON GOIN FORA LANDING IWAS
NO PLAHE WHATISAW WAS A U FO
THATS ALL I HAUE TO SAY ITAROOGH YOU
WOULD LIKE TO KHOW WIHATISAW INTHE
SKY THAT NTGHT HOPE IT CANBE OFR SOME
HELP TO YOU IM RRPORT IT TO YOU

UFO form continued
Page 8

OFFICIALU.S.AIR
Page 1
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 nof 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 details.
1. When did you see the object? 2. Time of day: 90025
Hours Minutes
Meansy March Moancy March 1967 1967 (Circle One): (Circle One): A.M.or P.M. A.M. or P.M.
Day Month Month Year
3. Time Zone: 3. Time Zone:
(Circle One): a. Eastern (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain c. Mountain
d. Pacific
e. Other e. Other.
4. Where were you when you saw the object? 4. Where were you when you saw the object?
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) CO
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was obiect in sight continuously? res No___
6. What was the condition of the sky?
DAY NIGHT
a. Bright a. Bright
b. Cloudy 6. 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. Overhead
c. To your right f. Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164, jul 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you sow the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS(Circle One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
B.Afew b. Dull moonlight
c. Many c. No moonlight-pitch dark
d. Don'tremember d. Don't remember
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. Hozy) b. Fog, mist, or lighfrain)
c.- Scartered clouds c. Scartered clouds c. Moderate or heavy rain c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember e. Don'tremember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid d. As a light QND A SOLID OBSECT LIGHT CWas AND ASOLID OBSECT LIGHT CUaS
b. Transparent b. Tronsparent e. Don'tremember SOOFONDINGST SOOFONDING ST
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:
lightbulbs
12. The adges of the object were:
(Circie One): a. Fuzzy or blurred e. Other.
b. Like a bright star
c. Sharply outlined
d. Don'tremember
13. Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes No Don't know
b. Suddeniy 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 (Ne Don't know
f. Change shape? Yes (No Don't know
g. Flash or flicker? Yes (N) Don't know
h. Disappear and reappear? res No Don't know

44
Official U.S. Air Force
Page 3
int eight + sped aweary
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): YesNo Don't know. IF you answered YES, then tell what
it moved behind:
1. 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:
17. Tell in a few words the following things about the object: 17. Tell in a few words the following things about thej object:
a. sound ilt had a buum a. sound ilt had a blum
b. color lt cocis greyesle b. color It cotis greyesle
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 13. 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 obiect would have been covered by the match head? the object would have been covered by the match head?
about  of the object
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.
ALL LiEhT

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) YesNo
21. Do you think you can estimate how far away from you the object was?
(Circle One) Yes No
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 car c. In open countryside?
Outdoors Outdoors d. Near an airfield? d. Near an airfield?
d. in an airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other g. Other
24. iF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24. iF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions:
24.) What direction were you moving? (Circle One)
a. North c. East e. South e. South g. West
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? 34 a Did.onton atanntimorhie mowmolookioaatthoobioat?
(Circle One) Yes No
25. Did you observe the object through any of the following?
c. Eyeglasses e. Binoculars Yes No
b. Sun glasses f. Telescope Yes No
c. Windshield Yes No g. Theodolite Yes (Na
d. Window glass Yes No h. OtherHUmav EYes
26. in oraer mat yeu can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jects which, when placed up in the sky, would givethe same appearance as the object which you saw.
PUT To Gether

Official U.S.Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75° B
60° N
AAB
45°
NW NE
30°
w E
15° SW SE
S
23. 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.
A↓ AL↓
B B
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.
5

Gylewss Cals 08/03202
7Man67
DEPARTMENT OF THE AIR FORCE
HEADQUARTERS FOREIGN TECHNOLOGY DIVISION (AFSC)
WRIGHT.PATTERSON AIR FORCE BASE, OHIO 45433
ATTN OF: REPLY TO TDET/UFO 14 Apri1 1967
SUBJECT: UFO Observation, Mar 67
TO:
Denver, Colorado 80207
copy
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 and Subsystems FTD Form 164 w/envelope
TDET/CFO

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location. Yes
Jan 10.1967
31. Was anyone else with you at the time you saw the object? (Circle One) Yes No
31.1IF you answered YES, did they see the object too?(Circle One) Yes No
31.2 Please list their names and addresses:
BrockLYN 3C NY
BrOOKLYN 30, NY
32. Please give the following information about yourself:
NAME
Last Name First Name Middle Name Middle Name
ADDRESS ADDRESS New York 30 NY
Sfreef City City Zone Zone State
TELEPHONE NUMBER TELEPHONE NUMBER AGE13 SEx BaY AGE 13 SEx BaY
Indicate any additional information about yourself, including any special experience, which might be pertinent. Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and ro whom did you report that you had seen the object? To mY FaTher
Heareunaymarch 1967 AMD. FrlenG
Day Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: M Wed. March 67
Day Month Year
35. nformation which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting.
The UFo Came Back 3 Times
BUT I HAVENT SEEN IT N The
Lust month
The Glow was Sometming The Glow was Sometmino
sike Tuis
π
Ship Ship
GLow
IT CameOutonall FounSiDes

OFFICIAL U.S. AIR
Page 1
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 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 details.
2. Time of day: 24
1. When did you see the object?
Hours Minutes
Ss Manch1967 Manch 1967 (Circle One): (Circle One): A.M. or A.M. or P.M. P.M.
Day Month Year
3. Time Zone:
(Circle One): a.Eastern (Circle One): a. Eastern (Circle One): a, Daylight Saving (Circle One): a. Daylight Saving
b. Central b. Central (b) Standard
c. Mountain
d. Pacific Q
e. Other.
4. Where were you object?
New fondon New fuondonConn Conn
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 5
Hours Minutes Seconds
a. Certain c. Not very sure
Fairly certain d. Just a guess
5.1 How was time in sight determined? mimeo
5.2 Was osject in sight continuously? Yes No√
6. What was the conditien of the sky?
DAY NIGHT
a. Bright 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. Overhead
c. To your right f. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164. ju1 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you saw the abject at NIGHT, what did you notice concerning 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 dark
d. Don'tremember d. Don'tremember
9. What were he weather conditions at the time you saw the object?
CLOUDS(Circie One): WEATHER (Circle One):
aClearsky a. Dry
5. Hazy b. Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember e. Don't remember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
Solid Solld d. As a light
b. Transparent e. Don'tremember e. Don'tremember
c. 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
bDimmer b. Dimmer d. Don'tknow 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
Snarply outlined
d. Dan'tremember
13. Did the object: (Circle One for each 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 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 Don't know
h. Disappear and reappear? (Yes) No Don't know

44
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how?
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:
1o. Did the object move in front of something at any time, particularly a cloud?
(Circle One): YesNo Don't know. IF you answered YES, then tell what
in front of: in front of:
17. Tell in a few words the following things about the object:
a. Sound.
b. Color b. Color silver with a wttte rod liaht silver with a tlte rod liaht
13. 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 13. 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 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? the object would have been covered by the match head?
19. Draw a picture that wili 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 abject was moving.

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you answered 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? 5mibes
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Inside a building a.jinsideaDuliding (b. In the residential section of a city? b. In the residential section of a city?
b. In a car 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 seo f. Flying over open country?
f. Other g. Other
24. IF you. were MOVING IN AN AUTOMOBILE or other vehicle ot the time, then complete the following questions: 24. IF you. were MOVING IN AN AUTOMOBILE or other vehicle ot the time, then complete the following questions:
24.1 What direction were you moving? (Circle One) 24.1 What direction were you moving? (Circle One)
a. North a. North c. East c. East e. South g. West
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?
Eyeglasses e. Binoculars Yes No
b. Sun glasses Yes f. Telescope Yes No
c. Windshield Yes g. Theodolite Yes No
d. Window gloss Yes 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 ob-
jects which, when placed up in the sky, would give the same appearance as the object which you saw.
A silrer dicc phaped ofjecdt with a
little red light in the center.

Official U.S. Air Force
Page 5
27. In the fallowing sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NE
30°
W E
15° SW SE
S
23. 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.
P
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.
55

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyone eise with you at the time you saw the object? (Circle One) Yes No
31.1 iF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
New London, Cown.
32.Please give the following information abour yourself:
NAME NAME
Last Name Last Name First Name First Name Middle Name Middle Name
neafond New Londs
ADDRESS
Street City Zone State
TELEPHONE NUMBER TELEPHONE NUMBER AGE 1 SEx mole AGE sEx mal
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and to wnem did you report that you had seen the object?
Doy Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire:
Day Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting.

Kan6
，
AUG 1 4 1967
Proposed reply to letter from Jul 10, 67 (Sighting March 1967)
Dear
Reference your recent letter concerning your observation of an
unidentified flying object in March 1967.
We are hesitant in offering any explanation for the sighting
without additional information such as detailed flight characteristics,
and angular velocities.
Our responsibility does not cover the investigation of sightings
outside the continental limits of the United States; therefore, we are outside the continental limits of the United States; therefore, we are
unable to perform a comprehensive investigation. Your information
will, however, be added to the present data base.
Thank you for reporting your observation to the United States
Air Force.

LOWRY TECHNICAL AIR TRAINING CENTER (ATC)
UNITED STATES AIR FORCE
LOWRY AIR FORCE BASE, 8O23O, Colorado
REPLY TO 241867
ATTN OF: XPCP Date
SUBJECT: Unidentified Flying Objects (UFO)
TO: 9th Aerospace Division
Int AFB, Colorado Springs, Colorado 80912
When unidentified flying objects (UFO) are reported, the following infomation
will be filled in and then forwarded immediately to Plans/Program attention
XPCP.
a. Description of the Cbject(s):
(1) Shape. Round
(2) Size compared to a known object (use one of the following terms:
Head ofa pin, pea, dime, nickel, quarter, half dollar, silver dollar, baseball, Head ofa pin, pea, dime, nickel, quarter, half dollar, silver dollar, baseball,
grapefruit, or basketball) held in the hand at about arm's length.
quester querter
(3) Color. Crange
(4) Number. 0n(1) 0(1)
(5) Formation, if more than one. n/A
(6) Any discrenible features or details. B/A
(7) Tail, trail, or exhaust, including size of same compared to size
of object(s).
(8) Sound. If heard, describe sound. to
(9) Other pertinent or unusual features Comething under it looked
like a platrorm.
sone 164

Pierrefonds, Quebec,
Canada,
July 1ó, 1967.
Project Blue Book Office
Air Force Research and Development Command
Wright-Patterson AFB
Dayton, Ohio
Dear Sir:
The following is a report of a UFO seen in the sky approxim-
ately within a radius of 3 miles from that of my residence. In
giving the data that I collected immediately after witnessing this
phenomena, I will try to follow-ae closely the form of the 'official
U.S. Air Force UFO Form'.
The following is a trenscript of all observations I made dur-
ing or immediately afterward the above-mentioned sighting
1. Date of sighting: uncertain, march, 1967 uncertain, harch, 1967
2. Time of day: 10 hours, 20 minutes(22:20) P..
3. Time zone: eastern standard
4. Location at time of sighting: above iven address
5. Length of time in sight: 0 hours, 15 minutes, ?seconds(fairly
determined by wrist watch certain)
in sight almost continuously
6. Condition of sky: night... clear and bright
7. Stars: many
oon: bright moonlight
8. Weather conditions: clouds... clear sky
9. Appearance of object: weather... snow on ground
as a light
brighter than brihtest stars
similar intensity to that of high intensity
light source found at edge of airport
runways
10. The edges were: fuszy or blurred
11. The object: did appear to stand still(once)
" flicker and change colour it flicker and change colour
dian't suddenly speed up and rush away 11
11 break up into paits or explode
I1 give off smoke
11 change brightness or shape
disappear end reappear
12. Movetent: the ohject moved behind trees and houses
didn't move in front of anything didn't move in front of anything
13. Charecteristics: 13. Charecteristics: no sound
colour changed from red to white to red contin-
uously
13. Angular size: holdin; a match stick in line with the object, the
natch head would have covered approximately
the whole of the objeet
14. Sketch:
15. Velocity of object: similar to that of a helicopter at a distance
of approximately 1 mile
16. Distance of object: seemed to range from 3 to 5-8 miles
17. My location: in a car, outdoors, inside e buildin;
in residential section on west end of islend of
Lontreal approximately 4 niles from Dorval
International Airport
18. Located in car: moviny in roughly a westerly direetion at approx-
imately 20 miles ner hour
stopped twice while olserving(stop sins)

Page 2
19. Observation made throu;h: windshield, window glass, binoculars
(7 + 35)
20. Comparison: the only object similar to that which I observed
would be a large, high intensity li;ht placed
up in the sky
21. Hight: when first observed, the object was approximately 10-12
degrees above the horizon and 7 derees above when last
observed
21. Similar observances: I have never seen this or a similar object be
fore Lore
22. Other observers: one also observed the object.....
Pierrefonds, Quebec
Canada
23. Personal information: (WANEEs (WavE:
EN
Pierrefonds, Quebec
Canada Canada
tel.no age 18 sex M
-have lived near airports and/or air force bases for last 10
years
-my father works for the airline Air Canada
-an familiar with many types of aireraft plus most types of
correreially used aircraft
-have studdied a number of books on aircraft identification
(RAF and RCAF types of books) per year
-have flown an average of at least 1000 miles since I was two
months old
24. Jate completed: 11,July, 1967
25. Jurther pertinent information: the following three sightingsand
related informavion were noted from three different locations;
returning home in a car, outdoors upon disembarkation from car,
and indoors inside place of residence
first sightint- object seened approx. 3miles distana
- heading fron rough direction of Dorval airport area
- from my point of view, objeet was bearing approx. - from my point of view, objeet was bearing approx.
due east
- proceeded to move in a straight line(seemingly) to - proceeded to move in a straight line(seemin ly) to
a point bearing SSE 160 degrees approx.
second sightin:- two minutes later second sightin:- two minutes later
- went from last mentioned point to bearing SW 230
degrees in what seemed to be an arcing path
third cighting- proeeeded on a course arcing away to bearing WhW thind sighting- proeeeded on a course arcing away to bearing WEW
290 degrees(all the while objeet was growing
dimmer) dimmer)
- tile was 22:25 ±i33322:25
-objeet seened to stay in general area of last pen-
tioned sighting for 2-3 minutes(when viewed
through binoeulars, objeet appeared to be moy-
ing up and down a slijht alount very ranidly)
-appeared to reverse direction(course) all the while
exhibiting rapid un and dowm motion
- finally lost sight of objeet when it movei le ind
roof of ei;hbour's house
- last seen at about 22:55 with a :necs at between
5-8 miles distant
- temperature was 25 degrees F
一 when restin; in area(3rd sighting),
object was about 13" above hor-
izon when looking 8 at 6" ruler
held at arn's length
- when first seen, was much brighter
than 1st magmitude star( ade mo
imnediately think of high inten-
sity light souree)
- from second notation of second
sightin (above) to last notation
under thirl sighting, Intonelty

rage 3
decreased to that of 3rd magnitude
star brightness
- when colour of light changed from
red to white to red ete., each
colour lasted for approximately
1 second
- from second notation of second
sighting, the length that each
colour remained visible changed
to approximately t second(stayed
this way up to end of sightin)
- only comparative brightuess(when
first sighted) of light, was that
of the warning light(somewhat
dimmer) of an Air Canada Viscount
passing directly overhead(approx. passing direetly overhead(approx.
1500')~at 22:23 1500') at 22:23
- only applicable term would be that 一 only applicable term would be that
of a flickering light(no physical
shape was diseernable) shape was discernable)
-the only reason thet I was attracted
to notice the object was because
of its (to me) unusual physical
appearance(ie. hrightness of the
object, such slow speed... winds
were against it, and non pro-
duction of sound on such a clear
sound carrying night... could
hear diesel train horns from
approx. 3 miles distent)
- for the above reasons(exhibiting
heavier-than-air machine charac-
teristics while not exhibiting
others), I felt that it was reas-
onable to brin: this to your at-
tention as a UFO sighting
- below is a sketch(not to scale) of
what I believed the fli ht plan of
the object to be
DPPROK. HEASNG OP
O escs's Puas PLay Oeseer's PLAN VisCcONT VASCCONT
My :ssiDence My:sSIDEIcE
DORVAL
WNW 290 2
SSW 280
Sacnt

No Case Info only
OFFICIALU.S.AIR
March 61 Page 1
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 uniclentified 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 statements, be used for research purposes. Your name 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 details.
1. When did you see the object? 2. Time of day:
Hours Hours Minutes
mach 194.7 ch194.7 (Circle One): A.M. or P.M.
Day Month Year Year
3. Time Zone:
(Circle One): a. Eastern (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
citu or Toron
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Totai Duration) 10
Hours Minutes Seconds
a. Certain c. Not very sure
5. Fairly certain d. Justa guess lookddat th
5.T How was time in sight determined?
5.2 Was coject in sight continuously? Yes NO
6. What was he condition of the sky? 5. Whar was me condition of the sky?
DAY NIGHT
a. Bright a.) Bright
b. 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. Overhead e. Overhead
c. To your right f. Don't remember
FORM
FTD OCT 62 164 This form supersedes FTD 164, jul 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you sow the object at NIGHT, what did you notice concerning 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 dark
d. Don't remember d. Don'tremember
9. What were the weather conditions at the lime you saw the object? 9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): CLOUDS(Circle One): WEATHER (Circle One):
a. Clearsky a. Dry a. Dry
b. Hozy b. Hezy b. Fog, mist, or light rain
c. Scattered clouds c. Scattered clouds c. Moderate or heavy rain c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don'tremember
10. The object appeared: (Circle One): 10. The object appeared:(Circle One):
a.. Solld d. As a light
b. Transparent e. Don'tremember
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
11.1Compare 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'tremember
13. Did the object: (Circle One for each 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 Don't know
c. Break up into parts or explode? c. Break up into parts or explode? Yes No Don't know
d. Give off smoke? Yes No Don't know
e. Change brightness? e. Change brighiness? Yes No No Don't know Don't know
f. Changeshape? f. Change shape? Yes (No) Don't know
g. Flash or flicker? g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes Yes No Don't know

4
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how?
15. Did the object move behind something at-any time, particularly a cloud?
(Circle One): (CrcleOne): 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): (Circle One): Yes No No Don't know. IF you answered YES, then tell what IF you answered YES, then tell what
in front of:
17. Tell in a few words the following things about the object:
a. Sound
b. Color
18. We wish to know the angular size. Hoid a match stick at arm's length in line with a known object 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 cbject would have been covered by the match head? 05pocT
19. Drow 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 scw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show he direction the object was moving.
AFTER APTER
IT WOHT ITWCHT
back
TAPAT
SkyThd
Vapen aPp

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you enswered YES, then what speed would you estimate?
21. Do you think you can estimate how far away from you the object was? 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? IF you answered YES, then how far away would you say it was?.
22. Where were you located when you saw the object? 22. Where were you located when you saw the object? 23.Were you (Circle One)
(Circle One):
a. In the business section of a city? a. In the business section of a city?
a. Inside a building a. Inside a building b. In the residential section of a city? b. In the residential section of a city?
b. In a car c. In open countryside?
c., Outdoors d. Near an airfield? 112
d. In an airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other g. Other
24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions:
24.1 Whet 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.
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?
c. Eyeglasses Yes e. Binoculars Yes No
b. Sun glasses Yes No f. Telescope No
c. Windshierd c. Windshierd Yes No No g. Theodolite No
d. Window glass d. Window gless Yes Yes No h. Other 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 ob-
jects which, when placed up in the sky, would give the same appearance as the object which you saw.
A w
争

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NW NE
30°
W E E
15° 15° SW SW SE
B4 B→A
S
0°
23. 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.
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.

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
NO
31. Was anyone else with you at the time you saw the object? (Circle One) Yes No
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
Hinghan
02043
32. Prease give the following information about yourself: 32. Please give the following information about yourself:
NAM
Last Name First Name Middle Name
ADDR ADDR
City Zone Zone State
TELEPHONENUMBER AGE 4 SEX MLe
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33. When and to wnom did you report that you had seen the object? 33. When and to wnom did you report that you had seen the object?
Day Day Month Month Year

Official U.S.Air Force
Page 7
34. Date you completed this questionnaire: 30 1917
Day Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting.
L
L
W

b. - Description of course of Object(s):
(1) What first called the attention of observer(s) to the object(s)?
Lookedup
(2) Angle or elamatiigiand azimuth of the object(s) when first
observed.
(3) Angle or elevation and azimuth of object(s) upon disappearance.
Unkenown
(L) Description of flight path and maneuvers of object(s).
Fortheast
(5) How did the object(s) disappear? (Instantaneously to the north, etc.)
Vaniohed to the northeass Vaniobed to the northeass
(6) dow long was the object(s) visible. (Be specific, 5 minutes, 1 hour, etc)
One and ons half minutes On9 and ons half minutes
c. Manner of Observation: c. Manner of Observation:
(1) Use one or any combination of the following items: Ground-visual,
ground - electronic, air electronic. ( If electronic, specify type of radar.)
2/
(2) Statement as to optical fds (telescopes, binoculars, and so forth)
used and deseription thereof.
(3) If the sighting is made while airborne, give type of aircraft,
identification mumber, altitude, heading, speed, and home station.
d. Time and date of sighting: 020%
(1) Zulu time-date-group of sighting.
2

Neo Cace Uxfo Oxly Maik 67
DEPARTMENT OF THE AIR FORCE
WASHINGTON 20330
OFFICE OF THE SECRETARY
September 19, 1967
Dear
This replies to your recent letter concerning the obser-
vation of an unidentifiedflying object (UFO). vation of an unidentified flying object (UFO).
Without essential information, such as detailed flight
characteristics, angular velocities, or weather information,
we are unable to undertake a scientific investigation. Had we are unable to undertake a scientific investigation. Had
you contacted the UFo investigator at your nearest Air Force
base immediately, an on-the-spot investigation would have been
possible.
We hope the inclosed Project Blue Book report may be of
helpto you in identifying your observation.
Thank you for reporting your observation to the Air Force.
Sincerely,
Chief, Civil Branch
Community Relations Division
Office of Information
Attachment
Frojeet Blue Book Report
N。
7404 7404
Bothell, washington 98011 Bothell, washington 98oll
apy oftr sent t Unir yloo.

Proposed reply to letter from July 30, 1967
Dear
Reference your recent letter regarding an unidentified flying
object (UFO) which your grandmother observed in March 1967.
With the information submitted, it would be extremely difficult
to offer much of an explanation. Essential data such as flight
characterisitcs, maneuvers, and duration of sighting are quite characterisitcs, maneuvers, and duration of sighting are quite
important in a comprehensive evaluation. If your grandmother had
reported her observation to the nearest military installation at
the time, an evaluation would have been possible. The local UFO
investigator is in a far better position to conduct an on-the-spot
investigation. Your information will be added to our present data
base.
The inclosed brochure on the Air Force project on UFOs may
be of interest to you. Thank you for bringing the observation to
our attention.

July 30, 1967
Major Hector Quintanilla, Jr.
#
Director,Project Blue Book,
Wright-Patterson Air Force Base,
Dayton,Ohio
Dear Major Hector Quintanilla, Jr.
I am typing this for my Grandma.Sometime in March I967 about 2:15
A.M. my Grandma heard the two big dogs Tarzan and Rex barking.
She got up to let Cindy our small dog out and quite the big
dogs down,when my Grandma opened the door Cindy jumped out dogs down,when my Grandma opened the door Cindy jumped out
and ran up the road barking,my Grandma looked up the road and
saw a large dome with red,yellow and blue lights that was
hovering over an orchard about a  of a mile away,she went
back to bed because she was scared,about twenty minutes Iater she back to bed because she was scared,about twenty minutes Iater she
looked again and it was gone looked again and it was gone.
Bothell,Washington-98oII
P.S.My Grandma lives in Yakima,Wash.

OFFICIALU.S.AIR
Page 1
U.S. AIR FORCETECHNICAL 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 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 details.
1. When did you see the object? 2. Time of day: 7 30
Hours Minutes
MAR 67 67 A.M. or A.M.
(Circle One): P.M.
Day Month Year
3. Time Zone:
(Circle One): a. Eastern (Circle One): a./Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
BLOOMINGTON INDIANA
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 30
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuously? 5.2 Was objec: in sight continuously? resX Yes_X No No
6. What was the condition of the sky?
DAY NIGHT
a. Bright Ca. Brigh <a. Brigh
b. Cloudy b. Cloudy
7. IF you saw the object during DAYLIGHT, where was the SUiN located as you looked at the object?
(Circle One): a. In front of you d. To your left
b. In back of you bt.b. e. Overhead owobond
c. To your right f. Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164. jul 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you saw the object at NIGHT, what did you notice concerniny the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
KErATeW b. Dull moonlight
c. Many c. iNo moonlight-pitch dark
d. Don't remember d. Don'tremember
9. Whar were the weather conditions at the time you saw the object? 9. Whar were the weather conditions at the time you saw the object?
CLOUDS (Circle One): CLOUDS (Circle One): WEATHER (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry a. Dry
b. Hazy b. Fog, mist, or light rain b. Fog, mist, or light rain
Scatered clouds Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
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'tknow
11.1 Compare brightness to some common object:
A 50WART LIGHT BULD
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other.
b. Like a bright star
c. Sharply outlined
a. Don'fremamber
13. Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes No Don't know Don't know
b. Suddeniy speed up and rush away at any time? Yes Yes No Don't know Don't know
c. Break up into parts or explode? Yes No Don't know
d. Give off smake? Yes No Don't know
e. Change brightness? Yes No No Don't know Don't know
f. Change shape? Yes Yes No No Don't know
g. Flash or flicker? g. Flash or flicker? Yes Yes No Don't know Don't know
h. Disappear and reappear? h. Disappear and reappear? Yes Yes No. No. Don't know

4
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how? Mes
it vent arrosso The Aby
→a mininte fan wentont
15. Did the object move behind something at any time, particularly a cloud? 15. Did the object move behind something at any time, particularly a cloud?
(Circle One): (Circle One): Yes No Don't know. 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. Yes Ng Don't know. IF you answered YES, then tell what
in frontof: Meves story
17. Tell in a few words the following things about the object:
Sound
b. Color N1e
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? 1
3
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 19. Drew 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 that yau 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.
0E1 ODZECT
7
7
SMA<C

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Cirdle One) Yes No
IF you answered 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 No
IF you answered YES, then how far away would you say it was?
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
a. In the business section of a city?
a. Inside a building a. Inside a building b In the residential section of a city?
b. In a car . In open countryside?
Ourdoors d. Near an airfield?
J. In an airplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other g. Other._
24. IF you were MOViNG IN AN AUTOMOBILE or other vehicle a the time, then complete the following questions:
24.1 What direction were you moving? (Circle One)
o. North c. East e. Suuth g. West
b. Northeast d.Southeast f. Sosthwest 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?
(Circie One) Yes No
25. Did you observe the abject through any of the following?
a. Eyegiasses Yes Yes e. Binoculars Yes No
b. Sun giasses b. Sun glasses Yes No f. Te'escope Yes No
c. Windshield c. Windshieid No No g. Theodolite g. Theodolite Yes Yes
d. Window glass Yes Yes No h. Other.
26. In order that you can give as clear a picture as possible of wha, you saw, describe in your own words a common object or ob- 26. In order that you can give as clear a picture as possible of wha, you saw, describe in your own words a common object or ob.
jects which, when placed up in the sky, would give the same appearance as the object which you saw.
a rore rore oc a whhile
vitamin artousin pelle pellet
7

Poge 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NW NE
30°
W U
15° 15° SW SE
S
23. 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.
A
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.
69 55
2

Page 6
30. Have you ever seen this, or a similar object befure. If so give date or dates and location. 1962
yes I renpeber
Idoit Know then conation, But
was at
31. Was anyone eise with you at the time you saw the object? (Circle One) Yes No a
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
unknourr
32. Please give the following information about yourself: 32. Please give the following information about yourself:
NAME NAME Firsf Name Middle Name
Last Name Middle Name
LOOMINGTONIND
ADDRESS
City Zone State
TELEPHONE NUMBER AGE 13 SEX M
Indicate any additional information about yourself, including any special experience, which might be pertinent.
I have papen rorrte
a
for The Bloomington
Tribrume
33. When and to whom did you report that you had sean the object? 33. When and to wham did you report that you had sean the object? ITOLD MY PARENTS ITOLD MY PARENTS
MARCH67 MARCH67
Day Month Year Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: 3 24 67
Day Month Year
35. information which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting. questionnaire or a narrative explanation of your sighting.
1.4

(2) Light conditions. (use on of the following terms: Night, day,
(dawn, dusk) Night
e. Location of Observer(s). Exact latitude and longitude of each observer,
and/or geographical position. A position with reference to a known landmark
also should be given in electrical reports, such as "2mi N of Deeville; "3mi
SW of Blue Lake". Typographical errors or "garbling" often results in electrically
transmitted messages; making location plots difficult or impossible.
EXAMPLE: 89 45N, 192 71W for 39 45N, 102 21W.
coolawood Colo
f. Identifying Information on Observer(s):
(1) Civilian - Name aga mailing address, occupation, and estimate of
reliability.
(2) Military - Name, grade, organization, duty, and estimate of
reliability. reliability.
g. Weather and winds -- Aloft conditions at time and place of sightings:
1500ogroes at 9 Knota 1500mgraes at 7 Knota
(1) Observer(s) account of weather conditions.
C3.087
(2) Renort from nearest AWS or U.S. Weather Bureau Office of wind
diection and velocity indegrees and knots at surface, 6,000', 10,000', 16,000',
20,000', 30,000',50,000', and 80,000' if availab1e.
as 02 03562
(3) Ceiling. 16,000Brokon
(4) Visibility. 20 =61a»
(5) Amount of cloud cover. ligh overeast
(6) Thunderstonms in area ad quadrant in which located. Non
3

OFFICIALU.S.AIR
Page 1
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 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 nof 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 details.
1. When did you see the object? 1. When did you see the object? 2. Time of day:/8 2. Time of day: 18 30
Hours Hours Minutes
3 67 67 (Circle One): A.M. or P.M.
Doy Dax Month Month Year Year
3. Time Zone:
(Circle One): af Eastern (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the object?
hampsansille, Connes ticat
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 36
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How wos timein sight determined? filwenl o t 7:3o dt a f, ro f M. 5.1 How was time in sight determined? 071.
5.2 Was obiect in sight continuously? res No_____
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 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. Overhead
c. To your right f. Don'tremember
FORM
FTDOCT 62 164 This form supersedes FTD 164. jul 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you saw the coiect at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circie One): 8.2 MOON(Circle One):
o. None a. Bright moonlight
b. A few b. Dull moonlight
Cc. Many c. No moonlight-pitch dark
d. Don'tremember d. Don't remember
9. What were the weather conditions at the time you saw the object? 9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Clear sky a. Dry
b. Hazy b. Fog, mist, or light rain X
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don't remember
10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don't remember
c. Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
5. Dimmer d. Don't know
11.1 Compare brightness to some common object:
cam it compeare, extemh  lright
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'tremember
13. Did the object: (Circle One for each question)
a. Appear to stand stil at any time? Yes No Don't know
b. Suddenly speed up and rush away at any time? b. Suddenly speea up and rush away at any time? Yes No Don'tknow
c. Break up into parts or explode? Yes -Yes No Don'tknow
d. Give off smoke? Yes No -Don'tknow
e. Change brightness? Yes No Don't know
f. Change shape? Yes Yes No No. Don'tknow
g. Flash or flicker? g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? -Yes No No Don'rknow

499
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how?
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: it moved behind:
16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): (Circle One): Yes No Don't know. IF you answered YES, then tell what IF you answered YES, then tell what
in front of: in front of:
17. Tell in a few words the following things about the object:
a. sound Tihire was. hmowisorolateel
b. color it cvas a pulsei illawitoange t ed
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 sow 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.
arounal anal up aral cho arounal anal u aal clor
ariel isialeaways crriel isialeaways

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you answered YES, then what speed would you estimate?
21. Da 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?  elu(I5 n
22. Where were you located when you saw the object? 23. Were you (Circle One) 23. Were you (Circle One)
(Circle One):
a. In the business section of a city? a. In the business section of a city?
a. Inside a building (b. In the residential section of a city? (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. Outdoors c. Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city? e. Flying over a city?
e. At sea f. Flying over open country?
f. Other_ g. Other
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)
o. North c. East e. South g. West
b. Northeast d. Southeast f. Southwest h. Northwest
24.2 How fast were you moving?35 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 foilowing?
a. Eyeglasses Yes No e. Binoculars Yes No
b. Sun glasses NO f. Telescope Yes No
c. Windshield Yes No g. Theodolite Yes
d. Window giass d. Window glass Yes Yes No No h. other slu toiale cauh h.Other
he makil eye hemakilere
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 ab-
jects which, when placed up in the sky, would give the same appearance as the object which you saw. jects which, when placed up in the sky, would givethe same appearance as the object which you saw.
the ilridhtest stor iy the iky, cchongeng
colors about as chighos the stars toIas colors alboutas chighos the stars toes
eauch.

Official U.S.Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 herizon (skyline) when you last saw it. Place an "A" on the compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
N
45°
NE
30°
W W E E
15° SW SW SE
S
26. 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.
A
aftuB it went sthoight ant-
like tehind the B
29. IF there was MORE THAN ONE object, then how many were there? 7
Draw a picture of haw they were arranged, and put an arrow to show the direetian that they were traveling.
I.
B B
5

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyane eise with you at the time you saw the object? (Circle One) Yes No
31.1 iF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
Muss " cael
Thonpsoveele.
mis Connectint. Connectiant.
my
32.Pease give  following information about yourse 32. Please give the following information about yourself:
NAME NAME
Last Name First Name First Name Middle Name Middle Name
ADDRESS Thampsonoille 11 Conn
Street City Zone State
TELEPHONE NUMBE AGE /F SEX_MA/e
Indicate any additional information about yoursel, including any special experience, which might be pertinent.
I live mat fer fron Birably Fielel, I chung
Crounet thene yor abont 3 yeors annd gat wery
airplone.
33. When and to whom did you report that you had seen the object? 33. When and to whom did you report that you had seen the object?
Day Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: Day 3 Month 67 Year
35. infomaton which you feel pertinent and which is no adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting.
Ut the ctime f ithe first isighting at the time of ithe ifirst sighting
we were just storing at cehs ofijert, we were just istoring at coh ofjet,
in the sky cinel moticeal a csecaral
abjict, mat as ebritlart clut
chaneling ut a itrenctous unte
I speect, it ctroveled from East ito
West, lut begre it neacherl a
point where we cault unt isee
it pit changedt caunse anl hearled
Morth. I knawn it worint f plone.
a tremoloa speed.). a tremoloa speed.).

OFFICIALU.S.AIR
Page 1
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 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 details.
1. When did you see the object? 2. Time of day: 2. Time of day: 32
Hours Minutes
1 Morch 67 MarchG7 (Circle One): A.M. or P.M.
Day Month Year
3. Time Zone:
(Circle One):  Eastern (Circle One): a. Daylight Saving
b. Central Standard
c. Mountain
d. Pecific
e. Other
4. Where were you when you saw the object?
Paterson Naw Jursay
St Postal Address City or Town State or County
5. How long was object in sight? (Totai Duration) 45
Hours Minutes Seconds
c. Certain c. Not very sure
b. Fairly certain d. Just a guess
watcth guess cheshod watch with
5.1 How was time in sight determined? radio
ra
5.2 Was object in sight continuously? Yes No No Z:00 AM.) Z:00 AM.)
6. What wes the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
a. Bright
b. Cloudy Cloudy Cloudy
7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circle One): a. ln front of vou (Circle One): a. In front of you d. To your left
b. In back of you e. Overhead
c. To your right f. Don'tremember
FTDOCT 62 164 This form supersedes FTD 164, ju1 61, which is obsolete. FORM

FORCE UFO FORM
Page 2
8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON(Circle One):
None None a. Bright moonlight
b. A few Dull moonlight
c. Many c. No moonlight-pitch dark c. No moonlight-pitch dark
d. Don'tremember d. Don't remember
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 Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
Thickorbeaxxclouds Thick or heavy clouds d Snow d. Snow
e. Don'tremember
10. The object appeared: (Circle One):
a. Solld As a light
b. Transparent e. Don't remember
c. Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
a. Brighter c. About the same
Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
25w0t+ l.ght bul6 1n a 23'x2s'vo0m
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: 13. Did the object: (Circle One for each question) (Circle One for each question)
a. Appear to stand still at any time? a. Appear to stand still at any time? Yes D Don't know
b. Suddenly speed up and rush away at any time? b. Suddenly speed up and rush away at any time? Yes 0000 Don't know Don't know
c. Break up into parts or explode? Yes Don't know Don't know
d. Give off smoke? d. Give off smoke? Yes Don't know
e. Change brightness? N .No Don't know
f. Change shape? fChonaoobono2 Yes B Don't know Don'thooe
g. Flash or flicker? No Don't know
h. Disappear and reappear? No Don't know

44
Official U.S. Air Force
Page 3
the clonds
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): Yes NoDon't know. IF you answered YES, then tell what
irmovedbehnd: It move banind heavy davk
clous(cuissulus) clouds( cuiszulus) 7
16. Did the object move in front of something at any time, particularly a cloud? 16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): (Circle One): No Don't know. IF you answered YES, then tell what
in front of:louds
17. Teli in a few words the fallowing things about the object: 17. Tell in a few words the following things about the object:
c. Sound Nond
b. colorYellowish-white
13. 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?
Approximutly 9og
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 especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving. dark
eLight replextion
+Light +Light
一

h. Any other unusual activity or condition, meteorological, astronomical, 1)
or otherwise, which might account for the sighting.
Hone
i. Interception of identification action taken (such action may be taken
whenever feasible, complying with existing Air Defense directives).
Hone
j. Location, approximate altitude, and general direction of flight of any
air traffic in the area at time of sighting.
Kone
k. Position title and comments of the preparing officer, including his
preliminary analysis of the possible cause of the sighting(s).
1. Existence of physical evidence, such as materials and photographs.
Cone Lone
RaFur Rai ny Faman, Yr, USA Y/CT, USA
D/O E. VIGE3, JO. O3AP EDWAVO E. VIGES, Major. OSAP
Chie?, Cporations Sarvices Avision
4

: UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes
IF you answered 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
IF you answered YES, then how far away would you say it was?
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One):
In the business section of a city?
a. Inside a building a. Inside a building b. In the residential section of a city?
b. In a car c. In open countryside?
Outdoors d. Near an airfield?
d. In an cirplane (type) e. Flying over a city?
e. At sea f. Flying over open country?
f. Other_ g. Other
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.
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 e. Binoculars Yes
b. Sun glasses Yes f. Telescope Yes
c. Windshield Yes 0000 g. Theodolite Yes
d. Window glass Yes 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 ob- 26. In order that vou can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jects which, when placed up in the sky, would givethe same appearance as the object which you saw.
Balloon with a light hanging about Balloon with a light honging about
tanfuetbellowit ton fuet bullow it

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
A
90° 75°
60°3 N
45°
NW NE
30°
w E E
4 0
15° SW SE SE
S
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 show any changes in direction during the course.
B
A
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.

e UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
No
31. Was anyone eise with you at the time you saw the object? (Circle One) Yes
31.1 IF you answered YES, did they see the object too? (Circle One)
31.2 Please list their names and addresses:
32. Please give the following information about yourself:
NAME
Last Name Last Name First Name First Name
MiddrName Middiy Name
ADDRESS Dataeson
Streef City N.5.
Zone State
TELEPHONE NUMBER AGEZO SEX M
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 object? 33. When and to whom dia you report that you had seen the object?
Day Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: Day Masch 67 Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting.
I balieve this was a balloon
With a light ranging from it. The With a light ranging from
light seamed to swing Showing that light seamad to swing Showing that
14 was s vound at the bottom. 14 was  vound af the bottom.
W

OFFICIALU.S.AIR
Page 1
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 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 details. that if it is deemed necessary, we may contact you for further details.
1. When did you see the object? 2. Time of day: 6 6 45
Hours Minutes
2 manch_1961 March 1967 (Circle One): A.M. or A.M. or P.M. P.M.
Day Month Month Year
3. Time Zone:
(Circle One):) Eastern (Circle One): a., Daylight Saving
b. Central Standard
c. Mountain
d. Pocific
e. Other.
4. Where were you when you saw the phis
mone
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 0 2 0
Hours Minutes Seconds
a. Certain .Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? eslimaled
5.2 Was object in sight continuously? Yes___ No
6. What was the condition of the sky? 6. What was the condition of the sky?
DAY NIGHT
a. Bright Bright
b. Cloudy 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 (Circle One): a. In frant of you d. To your left
b. In back of you b. In back of you e. Overhead
c. To your right f. Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164, jul 61, which is obsolete.
)

FORCE UFO FORM
Page 2
3. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circle One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
5y Afew b. Dull moonlight
c. Many C.) No moonlight-pitch dark
d. Don'tremember d. Don't remember
9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): WEATHER (Circle One): WEATHER(Circle One):
a. Clear sky a. Clear sky a Dry a Dry
b. Hezy b. Hezy b. Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Thick or heavy clouds d. Snow d. Snow
e. Don'tremember
10 The obiect appeared: (Circle One): 10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
c. Vopor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter c. About the same
5. Dimmer d. Don't know
11.1 Compare brightness to some common object:
alont tuvice ay liright an the brcorhtiat
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
b. Like a bright star
. Sharply outlined
d. Don't remember
13. Did the object: 13. Did the object: (Circle One for each question)
a. Appear to stand still at any time? Yes Yes No No Don't know
b. Suddenly speed up and rush away at any time? Yes No 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 No No Don't know
f. Change shape? Yes No Don't know
Flash or flicker? Yes Yes <No Don't know
Disappear and reappear? Yes No Don't know

44
Official U.S. Air Force
Page 3
14. Did the object disppar hile youwe chin ifs, hw?
iwent behnind the tiorryon or got lielow
treetop level
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): YesNo 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? 16. Did the object move in front of something at any time, particularly a cloud?
(Circle One): (Circle One): YesNo Yes No Don't know. Don't know. IF you answered YES, then tell what
in front of: in front of:
17. Tell in a few words the following things about the object:
c. Sound.
5. Color nellow
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?
alanthelf
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 especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving.
etwas jlita aypedred cppecied-
elab of light elb of light afpeaed.
y
distgpa
7
-appear

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
iF you answered 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 Yes No
22. Where were you located when you saw the object? 22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One): (Circle One):
a. Inside a building a. In the business section of a city?
b. In a car b. In the residential section of a city?
Outdoors C Outdoors In open countryside? In pen countryside?
d. In an airplane (type) d. Near an airfield? of  small
e. At sea e. Flying over a city? toun
f. Other_ f. Flying over open country?
g. Other
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.
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 Yes NO
b. Sun glasses Yes No f. Telescope Yes No
c. Windshield c.Windshield Yes Yes No No g. Theodolite Yes
d. Window glass Yes No
No h. Other 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 ob- 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 ob-
jects which, when placed up in the sky, would give the some appearance as the object which you saw. jects which, when placed/up in the sky, would give the some appearance as the object which you saw.
dt agspeared to he like an airplant At agepeared it he like an airplane
lifht light
exept it pept agpearnin and exept it pept agpearniy anl
disapeerng ard it moned i a course disageeern and it moned in a course
iysassible mmvoaulile
for am airplane

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NE
30°
W
15° SW SE
B 0
00 S
2S. 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 2S. Draw o 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. the end of the path, and show any changes in direction during the course. A
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.
55 5 2

UFO form continued
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
31.1iF you answered YES, did they see the object too? (Circle One) No
31.2 Please list their names and addresses:
32. Please give the following information about yourself: 32. Please give the following information about yourself:
NAME NAME
Last Name First Name Middle Name
ADDRESS ADDRESS nayne nanne Penna Perna
Street City Zone State
19087 19087
ASE 14 SEX22 111 7
TELEPHONE NUMB Bip Code
Indicate any additional information about yourself, including any special experience, which might be pertinent.
It may seem to he a remendons
hit it was mathrng more tham a
coinciduce and itis mota foke
33. Whan and to whom did you report tha you ngd sen the object? - tt rny preren
2 ghaurch 1967 6
Dov Day Month Month Year

Frirfield, ConNN
OFFICIAL U.S.AIR
Page 1
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 nof 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 details.
1. When did you see the object? 2. Time of day:/020
Hours Minutes
UE5MAKCH1967 VESMARCH 1967 (Circle One): A.M. or P.M.
Day Month Year
X
3. Time Zone:
(Circle One):a) Eastern (Circle One): a) Eastern (Circle One): a. Daylight Saving (Circle One): a. Daylight Saving
b. Central b. Standard
c. Mountain
d. Pacific d. Pacific
e. Other e. Other
4. Where were you when you saw the object? 4. Where were you when you saw the object?
TiVAS iN MY CAn GOIN G TO WORK ON //-7 S/HIKT TIVAS iN MY CAn GOIN G TC WORK ON//-7 S/HKT
Nearest Postal Address City or Town State ar County
5. How long was object in sight? (Totel Duration) 4
Hours Minutes Seconds
Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuously? resL No
6. What was the condition of the sky?
DAY NIGHT X
.Bright a. Bright/
b. Cloudy
7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object?
(Circie One): a. In front of you d. To your left
b. In back of you e. Overhead
c. To your right f. Don'tremember
FORM
FTD OCT 62 164 This form supersedes FTD 164. ju1 61, which is obsolete.

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: 2 march 1967
Day Month Year
35. Information which you feel pertinent and which is not adequately covered in the specific points of the
questiornaire or a narrative explanation of your sighting.

OFFICIAL U.S.AIR
Page 1
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 possibie 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 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 details.
1. When did you see the object? 2. Time of day: 750 97 50
Hours Minutes
3 Manch 1967 Manch 1967 (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
d. Pacific
e. Other
4. Where were you when you saw the object?
Sanfraniiuco Calil
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Toral Duration) 5
Hours Minutes Seconds
a. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined? looabad at aloch ninute or
ofeer
5.2Was object in sight continuously? Yes No___ olyia pod
6. What was the conditian of the sky? 6. What was the conditian of the sky?
DAY NIGHT
a. Bright a. Bright
b. Cloudy
7. IF you sow the object during DAYLIGHT, where was the SUN located as you looked at the object? 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 (Circle One): a. In front of you d. To your left
b. In back of you e. Overhead e. Overhead
c. To your right c. To your right f. Don't remember f. Don'tremember
FTD OCT 62 164 This torm supersedes FTD 164. jul 61, which is obsolete. FORM

FORCE UFO FORM
Page 2
8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.) STARS (Circle One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
b.(Atew) b. Dull moonlight
c. Many c. No moonlight-pitch dark
d. Don't remember d. Don'tremember
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): CLOUDS (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry a. Dry
b. Hazy b. Fog, mist, or light rain
c. Scattered clouds c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Snow
e. Don'tremember e. Don'tremember
10. The object appeared: (Circle One):
a. Solid d. As a light
b. Transparent e. Don'tremember
c. Vapor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
c Brighter c. About the same
b. Dimmer d. Don't know
11.1 Compare brightness to some common object:
Weldeis dlash.
12. The edges of the object were:
(Circle One): a Fuzzy or blurred e. Other
b. Like a brightstar
c. Sharply outlined
d. Don'tremember
13. Did the object 13. Did the object (Circle One for each question) (Circle One for each question)
a. Appear to stand still at any time? Yes No Don't know
b. Suddenly peedup and rush away at any time? b. Sudcenly peed up and rush away at any time? Yes No Don't know
c. Break up into parts or explode? c. Break up into parts or explode? Yes No Don't know Don't know
d. Give off smoke? Yes Yes No Don't know Don't know
e. Change brightness? Yes No Don't know Don't know
f. Change shape? Yes Yes No No Don't know Don't know
g. Flash or flicker? Yes No Don't know
h. Disappeai and reappear? h. Disappegi and reappear? Yes No Don't know

4
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how? Went out of sight.
15. Did the object move behind something at any time, particularly a cloud?
(Circle One): YesNo 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:
17. Tell in a few words the following things about the object: 17. Tell in a few words the following things about the object:
. sound ahistle.
o cobor Head lcvel a" lriaht lilne tale ehilis
bluectaoerd fale
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?
3 of the head af it.
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 especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving.
—2
10

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Circle One) Yes No
IF you ans wered 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 vou located when you saw the object? 23. Were you (Circle One)
(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 c. In open countryside? c. In open countryside?
c: Outdoors d. Near an airfield?
d. In an airplane (type) e. Flying over a city? e. Flying over a city?
e. Atsea f. Flying over open country?
f. Other. f. Other... g. Othèr
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. Nortneast 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?
o. Eyeglasses e. Binoculars Yes No
b. Sun glasses Yes f. Telescope No
c. Windshield Yes No g. Theodolite
d. Window glass Yes No h. Other
26. In order mat you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob- 26. In order mat you can give as clear a picture as possible of what you saw, describe in your own words a common object or ob-
jects which, when placed up in the sky, would give the same appearance as the object which you saw. jects which, when placed up in the sky, would give the same appearance as the object which you saw.

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NW NE
30° 30°
w E
15° SW SW SE SE
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 show any changes in direction during the course.
B.
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.
5

UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyone alse with you at the time you saw the object? (Circle One) Yes No
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Please list their names and addresses:
32. Please give the following information about yourself: 32. Please give the following information about yourself:
NAME
Middle Name
ADDRESS inFrancisco CaLiF
Streef City Zone State
TELEPHONE NUMB GE36 SEX F
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 object?
Day Day Month Month Year Year

Official U.S. Air Force
Page 7
34. Date you completed this questionnaire: Mar 3 1467
Day Month Year
35. information which you feel pertinent and which is not adequately covered in the specific points of the
auestionnaire or a narrative explanation of your sighting.
W

OFFICIAL U.S. AIR
Page 1
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 guestions as you possibly can. The information that you give will
be used for research purposes. Your name will nof 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 details.
1. When did you see the object? 2. Time of day:/ 20-25
Hours Minutes
nd
3 March 1967 (Circle One): A.M. or P.M. A.M. or P.M.
Doy Month Year Year
3. Time Zone:
(Circle One): a. Eastern (Circle One): a. Daylight Saving
b. Centr b. Standard
c. Mountain
d. Pacific
e. Other
4. Where were you when you saw the cbject?
Live (1. (Fulton)
Nearest Postal Address City or Town State or County
5. How long was object in sight? (Total Duration) 10-15
Hours Minutes Seconds
Certain c. Not very sure
b. fairly certain d. Just a guess
5.1 How was time in sight determined? to prrrom oT.U:
5.2 Was abiect in sight continuously? Yes
6. Whar was me condition of the sky? 6. Whar was me candition of the sky?
DAY NIGHT
a. Bright
b. Cloudy b. Cloudy <b.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 b. In back of you e. Overhead
ç. To your right f. Don'tremember
FTDOCT 62 164 This form supersedes FTD 164. jul 61, which is obsolete. FORM

FORCE UFO FORM
Page 2
8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circie One): 8.2 MOON (Circle One):
a. Nane a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight-pitch dark c. No moonlight-pitch_dark
d. Don't remember
9. What were the weather conditions at the time you saw the object?
CLOUDS (Circle One): CLOUDS (Cirsle One): WEATHER (Circle One):
a. Clearsky a. Dry ns precip but
b. Hazy b. Fog, mist, or light rain e
c. Scattered clouds c. Scattered clouds c. Moderate or heavy rain
d.y Thick or heavy clouds d. Snow
e. Don't renember
10. The object appeared: (Circle One):
(aSolid d. As a light
b. Transparent e. Don'tremember
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 brightmess to some common object:
12. The edges of the object weren
(Circle One): a.Fuzzy or blurred (Circle One): a. Fuzzy or blurred e. Other Biing alondy with e. Other Breng aleudy uith
b. Like a bright star weteelorsunllt snen
c. Sharply outlined c. Sharply outlined hard t hesutieldinate hard te rhtesut celtinate
d. Don't remember d. Don't remember Linnacge Linnaege
13. Did the object: (Circle One for each question) (Circle One for each question)
a. Appear to stand still at any time? Yes No No Don't know Don't know
b. Suddenly speed up and rush away at any time? Yes Yes No Don't know
c. Break up into parts or explode? Yes Yes (NO Don't know
d. Give off smoke? d.Give off smoke? Yes Yes N (NO Don't know Don't know
e.Change brightness? Yes No Don't know
f. Change shape? Yes NO Don't know
g. Flash or flicker? Yes N Don't know
h. Disappear and reappear? Yes No Don't know

FORCE UFO FORM
Page 2
8. IF you sow the object at NIGHT, what did you notice concerning 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 No moonlight-pitch dark
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
c. Scattered clouds c. Moderate or heavy rain
d. Thick or heavy clouds d. Thick or heavy clouds . Snow . Snow
e. Don'tremember e. Don'tremember
10. The object appeared: (Circle One):
c. Solid a. Solid d. As a light
b. Transparent e. Don'tremember
Vapor
11. if it appeared as a light, was it brighter than the brightest stars? (Circle One):
Brighter c. About the same
b. Dimmer d. Don'tknow
11.1 Compare brightness to some common object:
LiKE A.CHKISTGASSTKEEALLLIGAT UP
12. The edges of the object were:
(Circle One): a. Fuzzy or blurred e. Other
Like a bright star
Sharply outlined
d. Don'tremember
13. Did the oblect: (Circle One for each question)
a. Appear to stand still at any time? Yes No Don't know
b. Suddeniy 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 No Don't know
f. Change shape? Yes No Don't know
g. Flash or flicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know

4
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how? Clesappredints
the dectanre
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 NoDon't know. YesNoDon't know. IF you answered YES, then tell what IF you answered YES, then tell what
in front of:
17. Tell in a few words the following things about the object:
.Soundhea LemVebriten ar bulaatiins
raetlitinguid vle
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?  eh ry,
cmau pritiose
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 especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving.
□0000

UFO form continued
Page 4
20. Do you think you can estimate the speed of the object?
(Cirale One) Yes
IF you answered 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
you  YEs, thn ho for way woul yousay wa IF you answered YES, then how far away would you say it was? lrat treutap leed
theTistten thetistte
22. Where were you located when you saw the object? 23. Were you (Circle One)
(Circle One): (Circle One):
a. In the business section of a city?
a. Inside a building
b. In a cor c. In open countryside? c. In open countryside?
c. Outdoors c. Outdoars d. Near an airfield? d. Near an airfield?
d. In an airplane (type) d. In an airpiane (type) e. Flying over a city?
e. At sea e. At sea f. Flying over open country? f. Flying over open country?
1. Omerdanedalls steted g. Other_
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.
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 No e. Binoculars Yes
b. Sun glasses No f. Telescope Yes
c. Windshield Yes No g. Theodolite
d. Window glass Yes No h. Other.
autoetuch
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 ob-
jects which, when piaced up in the sky, would givethe same appearance as the object which you saw.

Official U.S. Air Force
Page 5
27. In the following sketch, imagine that you are at the point shown. Place an "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 compass when you first saw it. Place a "B" on the com-
pass when you last saw the object.
90° 75°
60° N
45°
NW NE
30°
w w E
15° 15° SW SE
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 23. Draw a picture that will show the motion that the object or objects made. Place on "A" at the beginning of the path, a "B" at
the end of the path, and show any changes in direction during the course.
NHOVERED
A E
5
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.
55
1

: UFO form continued
Page 6
30. Have you ever seen this, or a similar object before. If so give date or dates and location.
31. Was anyone eise with you at the time you saw the object? (Circle One) Yes No
31.1 IF you answered YES, did they see the object too? (Circle One) Yes No
31.2 Plaase list their names and
32. Please give the following information about yourself:
NAME NAME
LastName First Name
Middle Name Middle Nome
ADDRESS LewisTown ILL
Street City Zone
State
TELEPHONE NO AGE35 SEX F
Indicate any additional information about yourself, including any special experience, which might be pertinent.
33.When and to whom d you re th you h se the be? T.V. Crmil - 19- Peonia
THues9Mreek1967 THues9 MAeK1962
Day Month Year

Official U.S. Air Force
Page 7
34. Date you completed this questiannaire: mait M止R 67 Year
Day Month
35. information which you feel pertinent and which is not adequately covered in the specific points of the
questionnaire or a narrative explanation of your sighting. Ae Ixair fts 6 enarmous evinlsws
Rs thes abgert moved rot to fast to the lase Rs this abgeist moved rat te fast to the eact
The luindemr laua lihe a Gavening The lurndams laea lihe a Ganening
iver Clraeng aver thin. fntil anly iver Clreing aver thin. ntil anly
oe leghit -on the Senth, wrs left one legt - on the Seuth, wrs left
Henaie Henaie d an teaet sed a thuaet
Apud. The eurtak it until it
dissappemed ise The desterse.

UFO form continued
Page 8
THE SIZE OF THE UFO WAS VERY IMPRESSIVE, THE LIGHTED WINDOWS
WERE SYMMETRICAL. THEY APPEARED TO BE SQUARE. I WOULD ESTIMATE
THE HEIGHT OF THE WINDOWS TO BE APPROXIMATELY HO FT IF THIS
ESTIMATION 1S CORRECT, THE UFO WOULD BE FROM 1GO TO 24OFT LONG.
IT 1S VERY DIFFICULT TO COMPARE THE INSENSITY OF THE LIGHT WITH
A KNOWN LIGHT SOURLE.
THE SOUND IS ALSO DIFFICULT TO EXPLHIN. IT HADA VERY LOW THE SOUND IS ALSO DIFFICULT TO EXPLHIN. IT HADA VERY LOW
PITCH. IT MIGHT BE DESCRIBEP AS A PULSATING OR VIBRATING
HUM OR WHI2 ZING NOISE. THIS SOUND WAS ALSO HEARD BY HUM OR WHI2 ZING NOISE. THIS SOUND WAS ALSO HEARD BY
TWO OF OUR NEIGHBORS.
WE DECIDED NOT TO SAY ANYTHING ABOUT TMIS SIGHTING TO WE DECIDED NOT TO SAY ANYTHING ABOUT TMIS SIGHTING TO
ANYONE. IT WASN'T UNTIL SIX DAYS LATER WHEN SEVERAL
REFORTS APPEARED ON T.V. ABOUT OTHER U.FO. SIGHTINGS IN THE
ARKA THAT WE CALLRD A LOCAL T.V. STATION AND REPORIED OUR
SIGH7INS
W

OFFICIALU.S.AIR
Page 1
U.S. AIR FORCE TECHNICAL INFORMATION
This questionnaire has been prepared so that you can give the U.S. Air Force as much This questionnaire has been prepared so thar 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 nof be used in connection with any statements,
conclusions, or publications without your permission. We request this personal information so conclusions, or publicationswithout 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: 9:45 9:45
Hours Minutes
1thhr Lth Bewrch1
(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
d. Pacific
e. Other
4. Where were you when you saw the object?
Hazlet
vecrest Postal Address City or Town State or County
5. How long was object in sight? (Totai Duration) 30
Hours Minutes Seconds
á. Certain c. Not very sure
b. Fairly certain d. Just a guess
5.1 How was time in sight determined?
5.2 Was object in sight continuausly? Yes Yes. No__ No
6. What was the condition of the sky?
DAY NIGHT
a. Bright
b. Cloudy b.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. Overhead
c. To your right f. Don'tremember
FORM
FTDOCT62 164 This form supersedes FTD 164. jul 61, which is obsolete.

FORCE UFO FORM
Page 2
8. IF you saw the abiect at NIGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circie One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight-pitch dar
d. Don'tremember d. Don'tremember
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 rain
J. Thick ar heavy clouds d. Snow d. Snow
e. Don'tremember e. Don'tremember
10. The object appeared: (Circle One): 10. The object appeared: (Circle One):
oSolld d. As a light
b. Transparent e. Don'tremember
c. Vepor
11. If it appeared as a light, was it brighter than the brightest stars? (Circle One):
o.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): o. Fuzzy or blurred e. Other
b. Like a brightstar
a. Sharply outlined
d. Don't remember
13. Did the object: 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 explode? Yes No Don't know
d. Give off smoke? Yes No Don't know Don't know
e. Change brighiness? (Yes Yes No Don't know
f. Change shape? Yes No Don't know Don't know
g. Flash or fiicker? g. Flash or filicker? Yes No Don't know
h. Disappear and reappear? Yes No Don't know

FORCE UFO FORM
Page 2
8. IF you saw the cbiect at NiGHT, what did you notice concerning the STARS and MOON?
8.1 STARS (Circie One): 8.2 MOON(Circle One):
a. None a. Bright moonlight
b. A few b. Dull moonlight
c. Many c. No moonlight-pitch dar
d. Don'tremember d. Don't remember
9. What were the weather conditions at the time you saw the object?
CLOUDS(Circle One): CLOUDS (Circle One): WEATHER (Circle One): WEATHER (Circle One):
a. Clear sky a. Dry
b. Hazy b. Fog, mist, or light rain b. Fog, mist, or light rain
c. Scattered clouds c. Moderate or heavy rain
J. Thick ar heavy clouds d. Snow d. Snow
e. Don'tremember e. Don't remember
10. The object appeared: (Circle One):
Solid d. As a light
b. Transparent e. Don'tremember
c. Vepor
11. If it oppeared as a light, was it brighter than the brightest stars? (Circle One):
o.(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): o. Fuzzy or blurred e. Other.
b. Like a brightstar
c. Sharply outlined
d. Don't remember
13. Did the object: 13. Did the object: (Circle One for each question) (Circle One for each question)
a. Appear to stand still at any time? a. Appear to stand still at any time? Yes No No Don't know
b. Suddenly speed up and rush away at any time? 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 Don't know
d. Give off smake? Yes No Don't know
e. Change brightness? e. Change brighiness? (Yes No Don't know
f. Change shape? Yes No Don't know
g. Flash or fiicker? g. Flash or fiicker? Yes Yes No No Don't know
h. Disappear and reappear? Yes No No Don't know

44
Official U.S. Air Force
Page 3
14. Did the object disappear while you were watching it? If so, how?
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:
17. Tell in a few words the following things about the object:
a. SOundYOU COULD HEAR IT ONLEY A LITTLE SOUND a. SOUndYOU COULD HEAR IT ONLEY A LITTLE SOUND
b. Color D b. ColorRD
13. 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 especially exhaust trails or vapor trails. Place an arrow beside the drawing
to show the direction the object was moving. THEDOSA RE RE
RE #上
9 5
K
不不
WHITE
TRAILSORUAPAR