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U.S. AIR FORCE TECHNICAL INFORMATION !
| This questionnaire has been prepared so that you can give the U.S. Air Force as much
os 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 it it is deemec
necessary, we may contact you for further-details,
3. Time Zone: | Ey {
{Circle One): a. Ecstermn (Circle One): a. Daylight Sadia gi
b. Central 3 b. Standard
' ¢. Mountain :
d. Pacific
i e. Other
i I *
| State or County
5. How long was object in sight? (Total Duration) Spine errmsg Chad NRL Ses RL Re Re Rem i |
: Hours... . Minutes S
il ET TN =
2. Certain A ae
5. ; Fairly certain
d. Just a guess
in sight determined? _\JNLC}
5. 1 H Q'N WCS 7 mn =
5.2 Was cbiect 'n sight continuously?
== ———— —_— —
i
6. What was the cancition of the sky?
a. Bright
b. Cloudy
7. |F you saw the object during DAYLIGHT, where was the SUN located as you looked ar the object?
(Circle One): a. In front of you d. To your left
b. In back of you e. Qvarheod
c. [o your rignt f. Don't remember | | §
To PORN —
FTD oct s2 164 This form supersedes FTD 164, Jul 61, which ia obsclete
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i din bi] a Bn 0 th mpi i fa ad fi 0 8 he re TE