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CIA RDP81R00560R000100010003 8
Page 22
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U.S. AIR FORCE TECHNICAL INFORMATION 1. IF you saw the object et NIGHT, what did you notice concecning the STARS ond MOON?
28.1 STARS (Circle One) 182 MOON (Circle One):
This questionnaire has been prepared 40 that you can give the US. Air Force as much None 5 | @. Bright maoalight
Information os posible concerning the unidentified aerial phenomenon that you hove observed. Alow i. Dull moonlight
Pleote try 10 answer os many questions at you poibly con. The information that you give will Mony €. Nemoonlight~ pitch dark
bbe used for research purposes. Your name will not be used in connection with any statements, Dont remember 4. Dont remember
conclusions, or publicetions without your permision. We request this personal information so
thot ts deemed necestary, we may contact you fr further details.
What were the weather conditions atthe time you sow the object?
{CLOUDS (Czele One WEATHER (Circle One
1. When did you see the object? 2, Time of day: —__ © Clear sky = By
b. Hory Foga mis or ight rain
Scattered clouds ‘Moderate or heavy rain
6.
(Circle One) L . d. Thick orheary ous 4. Snow
‘Don't remember
‘The objec eppeareds (Cirle Oneh
(Circle One) 0. Eastern (Ciele One): @. Daylight Saving om
Cental ®, Stondord Soli
Time Zone
Mountain . Tronporent
is
Posie Vopor
8 Other
1s appeared o light, wos it brighter thon the brightest stars (Cirle One):
‘Where were you when you sow the objec? peices dental
1. Dimmer 4. Don'tknow
Neeren Pol Adon ChyerTown Sie or Comal 11.) Compartathtnn sn ett oi
How long wos object in ight? (Totol Duration) = —__
2. Certain «Not very sure The edges ofthe object wore:
i" . (Circle One): ©. Fuzzy or blucred
5.1 How war time insight determined? Like a bright sor
«. Shorply ouined
5.2 Was object insight continvoutly? 5 Sarpy caine
" Did the object: (Circle One for each question)
otakt on ‘Appear to stondstlot any ine? Ne Déetinow
b. Cloudy b. Cloudy ‘Suddenly speed up ond rvsh away at any time? No Don't know
Aeeak up into por or explode? Ne © Deetinw
Give off smoke? : 6 Ne: Dixthnes
IF you sow he cect during DAYLIGHT, where wos th SUN located a you looked a the objet? Chong bighinnt tat ¥ 4 pentleey
No. «Dent know
(Cicle Onek: 9. In trot of you 4, Toyourlet Change shape? : Nee
° 8 Inbodk of you ©. Ovethod Flesh ficker? WN onto
©. Toyourright Don't remember Disoppecr and rebopear? Ne Dénitkow
rom
FID Getee 164 Thisform supersedes FID 16, ju 6, which iobesete
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