28982490.pdf

|  1. DATE | 2. LOCATION | 12. CONCLUSIONS  |
| --- | --- | --- |
|  17-18 March 59 | 9 M E of Centerville, Ohio | ☐ Was Balloon ☐ Probably Balloon ☐ Possibly Balloon  |
|  3. DATE-TIME GROUP Local GMT 18/21/28Z | 4. TYPE OF OBSERVATION ☐ Ground-Visual ☐ Air-Visual ☐ Ground-Radar ☐ Air-Intercept Radar | ☐ Was Aircraft ☐ Probably Aircraft ☐ Possibly Aircraft  |
|  5. PHOTOS ☐ Yes ☐ No | 6. SOURCE Civilian | ☐ Was Astronomical Mars ☐ Probably Astronomical ☐ Possibly Astronomical  |
|  7. LENGTH OF OBSERVATION 30 mins | 8. NUMBER OF OBJECTS one | 9. COURSE West  |
|  10. BRIEF SUMMARY OF SIGHTING…

U. S. AIR FORCE TECHNICAL INFORMATION SHEET

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, and will be regarded as confidential material. 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 contac…

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8. IF you saw the object at NIGHT, TWILIGHT, or DAWN, what did you notice concerning the STARS and MOON?

8.1 STARS (Circle One):
a. None
b. A few
c. Many
d. Don't remember

8.2 MOON (Circle One):
a. Bright moonlight
b. Dull moonlight
c. No moonlight — pitch dark
d. Don't remember

9. Was the object brighter than the background of the sky?
(Circle One):
a. Yes
b. No
c. Don't remember

10. IF it was BRIGHTER THAN the sky background, was the brightness like that of an automobile headlight?:
(Circle One) a. A mile or more away (a distant car)?
b. Several blocks away?
c. A block away?
d. S…

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16. Tell in a few words the following things about the object.
a. Sound _________________________
b. Color _______________________

17. 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.

18. The edges of the object were:
(Circle One):
a. Fuzzy or blurred
b. Like a bright star
c. Sharply outlined
d. Don't remember
e. Other ____________________…

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|  25. Where were you located when you saw the object? (Circle One): a. Inside a building b. In a car c. Outdoors d. In an airplane e. At sea f. Other _________________ | 26. Were you (Circle One) a. In the business section of a city? b. In the residential section of a city? c. In open countryside? d. Flying near an airfield? e. Flying over a city? f. Flying over open country? g. Other _________________  |
| --- | --- |
|  27. What were you doing at the time you saw the object, and how did you happen to notice it? ________________________________________________________________________…

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34. What were the weather conditions at the time you saw the object?

34.1 CLOUDS (Circle One)
a. Clear sky
b. Hazy
c. Scattered clouds
d. Thick or heavy clouds
e. Don't remember

34.2 WIND (Circle One)
a. No wind
b. Slight breeze
c. Strong wind
d. Don't remember

34.3 WEATHER (Circle One)
a. Dry
b. Fog, mist, or light rain
c. Moderate or heavy rain
d. Snow
e. Don't remember

34.4 TEMPERATURE (Circle One)
a. Cold
b. Cool
c. Warm
d. Hot
e. Don't remember

35. When did you report to some official that you had seen the object?
Day _________ Month _________ Year _________

36. Was anyone e…

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39. 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? ______________ m.p.h.

40. 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? ______________ feet.

41. Please give information about yourself:

NAME _____________ First Name _____________ Middle Name _____________
ADDRESS _____________ Street _____________ City _____________ Zone _____________ State _____________
TELEPHONE NUMBER _____________

What is yo…

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U.S. AIR FORCE TECHNICAL INFORMATION SHEET
(SUMMARY DATA)

In order that your information may be filed and coded as accurately as possible, please use the following space to write out a short description of the event that you observed. You may repeat information that you have already given in the questionnaire, and add any further comments, statements, or sketches that you believe are important. Try to present the details of the observation in the order in which they occurred. Additional pages of the same size paper may be attached if they are needed.

|  NAME | (Please Print) | (Do No…