28953910.pdf

|  1. DATE - TIME GROUP | 2. LOCATION  |
| --- | --- |
|  19 March 53 19/2330Z | Crystal Lake, Ohio  |
|  3. SOURCE | 10. CONCLUSION  |
|  Civilian | AIRCRAFT  |
|  ~~NUMBER OF OBJECTS~~ Two | Objects could have been aircraft at high altitude.  |
|  5. LENGTH OF OBSERVATION | 11. BRIEF SUMMARY AND ANALYSIS  |
|  Not Reported | Two saucer shaped objects traveled at a slow rate of speed at high altitude.  |
|  6. TYPE OF OBSERVATION | Ground-Visual  |
|  7. COURSE | SW  |
|  8. PHOTOS | ☐ Yes ☑ No  |
|  9. PHYSICAL EVIDENCE | ☐ Yes ☑ No  |

FORM<br/>FTD SEP 63 0-329 (TDE) Previous editions of th…

( ATT + E
From - 100's report
(4 Mar 53
Form 21
19/1870
CA451a1
CA10

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 …

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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 None
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

19. IF there was MORE THAN ONE object, then how many were there?…

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20. 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.

21. IF POSSIBLE, try to guess or estimate what the real size of the object was in its longest dimension.
_____________ feet.

22. How large did the object or objects appear as compared with one of the following objects held in the hand and at about arm's length?

(Circle One):
a. Head of a pin
b. Pea
c. Dime
d. Nickel
e. Quarter
f. Half dollar
g. Silver dollar
h. Baseball
i. Grapefrui…

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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? Son called from out of doors to come and see objects  |   |
|  28. IF yo…

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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?
19 March 1953
Day Month Year

Was anyone else with you at the …

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39. Do you think you can estimate the speed of the object?
(Circle One) Yes No Slow rate of speed
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 35000 ft alt. Lake. Sighted object from Crystal Object was over Medway area traveling towards Dayton.
IF you answered YES, then how far away would you say it was? ______________ feet.

41. Please give the following information about yourself:

|  NAME | Last Name | First Name | Middle Name  |
| --- | --- | --- | --- |
| …