302547519.pdf

|  1. DATE - TIME GROUP | 2. LOCATION  |
| --- | --- |
|  16 or 17 March 66 | Norwood, Mass  |
|  3. SOURCE | 10. CONCLUSION  |
|  Civilian | Other (UNRELIABLE REPORT) ☑ Report from young in appearance observed.  |
|  4. NUMBER OF OBJECTS | 11. BRIEF SUMMARY AND ANALYSIS  |
|  One | Object was a bright white light hovering 30 to 50 yards away from observer and then took off at a terrific rate of speed. Hovered at tree top level. Witnesses age is only 6 yrs. This report will be carried as unreliable due to the high amount of imagination of an observer of this age.  |
|  5. LENGTH OF OBSERVATION…

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 o…

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8. IF you saw the object at NIGHT, 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. What were the weather conditions at the time you saw the object?

CLOUDS (Circle One):
a. Clear sky
b. Hazy
c. Scattered clouds
d. Thick or heavy clouds

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

10. The object appeared: (Circle One):
a. Solid
b. Transparen…

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14. Did the object disappear while you were watching it? If so, how?
"It took off" went speed.

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. Sound: white - white - white
b. Color: Bright (no color)

18. We wish to know the angular size.…

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|  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? *Extremely fast.*  |   |
| --- | --- |
|  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? *30 to 50 yards*  |   |
|  22. 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 (type) e. At sea f. Other _________________________ | 23. Were you (Circle One) a. In the busi…

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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 compass where you last saw the object.

![img-1.jpeg](img-1.jpeg)

![img-2.jpeg](img-2.jpeg)

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…

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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:
Diana Dima - girl of 8.

32. Please give the following information about yourself:
NAME
Last Name First Name Middle Name
ADDRESS
Street Norwood, Mass. 02062
City Zone State
TELEPHONE NUMBER AGE 6 SEX M
Indicate any additional information about yourself, including any special experien…

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34. Date you completed this questionnaire:
Day 8 Month April Year 1966

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.