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16. TYPe 0~ OBSERVATION .

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'--------------------------~ ; 7. COU~SE I L . .;o;. ztatc;J.

1 8. PHOTOS

! ? . PHYSICAL EVI DENCE •

I D Yes :.LX No

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11. BRIEP SUMMARY AHO ANALYSIS •

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i- TO H ;J 6 l 0·329 (TOE) Pr.vlou ediUOftt of UU1 ,.,. .. , be u .. d. -

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SECTION D

22 . In the f ollc.wing sketch, imagine your eye at the point shewn . Pla.ce a.n 11A11 on the curved line to show ho'.J high the obj ect vias above the horizon t:hen you firs t saw it. Place a 11 B11 to show \-Jhere it \las vJhan \J:ten you l o.s t saw it. -

aver head

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Y"'ur eye

23. In the follCNing sketch place an "A" at the position the object Yas llhen you first saw it, and a 11B" at its position l-lhen you last saw it.

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Cverr.~ad •

Y·1ur eye

D~av a picture that will show the motion that the object made. an "A" at the beginning of its path and a "B" at the end o£ its

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Plaee path.

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traw a pictur e t .1a t t1ill s hot.J t~w s hape of tbs obja ct . Label a~d includa in y our s ket ch any det ails of t he ob j ect th3t y ou sa~ , and p lace an arrcw beside t he dr :;rwing t o s ho\J the dir e ct i on the object ,,,as moving .

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SECTION E

26. Has this the tim~3t you have seen an objeet like this?

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(C irele One) :--~ illY

26.1 IF you ans'Wered dO, then t·lhen, where, and under what e onditions did you see other ones? ___ £j_E.-=_.b.._tf~'f .... d'"'"4¥x'-'-"'.2..._._C_-..t_l_.._>' ..;,_-__ _

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l:iiddla Name

ADDRESS a llto . Zone St ate

TELEPHONE nUMBER

Hhat i 3 y our !Jr esant job? -Aea _ ...-;...;t._rr __ _ Se~ / ;t;.l..<

_., / -.... £t .--)k . ~~~ .. ~ --li L~3 ~School Atter.ded c: ...... ;.;~ /k-&~ ~ Pc . ~ 1

Ye.l::- of l~s t c.t'te r.d~ace at t }-l i s 3chool /2/_<? '1 ...

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29. \Io.s anyone el ae 'J i th you at the tir.1e you se'-l the obj ect?

(Circle One ): Yes

29.1 IF you ans~ered YES , did they s ee t he object too? •

(Circle 0.:1e ): Yes or lfo

29.2 Please li5t their names and addresses :

30. Please add here any further comments which you believa are important. Use additional sheets or the same size paper if necessary.

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PAGE Tri o Jl.IPDM 87 •

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5. OBS BY MISS CMA 3~6 FIFTH AtJE Cl1A PUYALLUP

-· · -Ct1A TiAS H CMA M CMA PUYALLUP FURNITURE CO CMA PUYALLUP

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• • NAMED OBS IS MCCHORD PI E~?LOYEE CMA HS REPORTED PRIOR SIGHTING

SAME AR~ CMA CONSIDERED FAIRLY RELIAaLE• OTHErt OBS RZLIABILITY UNKNOWN• •

6 . WEAT HER NE~~ST OBS Tl~E AVAIL IS • • I

1S~~ PST CAVU C~A WINDS J~a . . -• • • --DEGREES CMA 38 KNOTS AT 150~3 CMA 58 KNOTS AT 25~0~. OBS RPT

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IU.llASiftG OffiCERS SIGNATURI

REI'UCIS N"f FOR~ 1'11. I MAY • WHICH MAY IE l.Sf.O.

.UNCLASSIFIED •

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SEC'l'ION A . c " , ...

1, Hhen did you see the object:

1.1 Date: ... ~ J~lt 115"~ Day Year t·ion

1.2 Time of day : 9 2o A.H. Hrs. lUn.

or@ (Circle Cne)

1.) Time Zone: (Circ1a One) t

r8:~ Eastern d. Pacific ~ Central

e. Hountain

(C irele One) :

e. Other

a. Daylight Saving (§) Standard

/ 1.4 Ci-rcle one of the following to il!dicate how certain you are of yo1~ ans~er to the above question 1.2:

fa~ Certain '-o: Fairly certain

c. Hot very sure d. Just a guess

2 . ~There did you see the object?

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City or TO'Wn State

3. \Jhere were you located Hhen you sa\-1 the object:

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Country

(Circle One): a. b.

L~side a building In a car

d. In an airolane •

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@ Cut doors r. Other

3.1 Uere you:

(Circle One): a. ~

In the bus iness section of a citJ?

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In th~ residential section of a city? c. In o~~n count~;side? d. Flyin~ nea:- an ai:' fiald? e • Flyi..r ; 0 11'9r a ci ty? f. Flyi~~ over open country? g. Othe::-

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--------------------------------------------------------------------------------------------------· ;. Hhen clid you r eport to some official that you had seen the object'?

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fl. \-That Here you doing a t the tine you saw the object?

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' Hhat had you been doing for the 30 minutes before you saw object? Try to list the activity or acti viti9s 1 ar.d the n.pproximate amount of time spent on eac.'l-t •

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7. \-I ere you moving at any time 1o~hile you saw the object? (Circle One):

Yes or

IF you answered y-LS, then complete the following questions.

7.1 Hhat direction l·Jere you moving?

(Circle One) a a. tlorth e. South b. Northeast f. Soui;hwest c. East g. Hest d. Southeast h. northwest

7.2 How fast \Jere you movine? ---- niles per hour.

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7.3 Did you stop at acy tiu:e \·lhile you \·Ja:re looking o.t the object?

(Circls Cne ) : Yes or ITo -•

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8 . Hhat d irPction \Jere you f a cing vlhen you firs t s n.w the object?

(Circle Cne ): e. . b. c

c:g;

Nor ch t!or theast E.1s t Southeast

e . South r . s outh,.Jes t g . Hest h. l!ortht.les t

8 .1 \·!hat d irecti on llere you facing \lhen the object disappeared?

(Ci rcle One) : a . North a . So".lth b. I~:ortheas t f . S outhwest c . East g . Hes t

@ Southeast h . ITorth,.,est

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8 .2 Circle one of t he following to indicate hc'.J c~rtain you are of your o.nswer to tha above wo questions . (8 and 8 .1) .

r;) Cert~in ~ F~irly certain

c. Not very sure d. Just a guess

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9. Here you wearing eye glasses when you saw the object? (Circle One) :

Yes ar @ 10. Hew was the object seen?

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(Circle One): a. Through \olind.CW glass b. Through windshield c. Thr ougb binoculars d. Through telescope

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T11rough theodolite Through sun gl3sses Through open space Otter

11. Hhat do you remember about the weather conditions at the time you saw the object?

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G) Clear sky o. Hazy

{§) Dry b. Fog, Hut, or light rain

c . Scattered clouds c. lfcderate or heavy rain d . T:-:.Lck or ~ea vy clouds d . SnOtJ e. Dou 1 t rew.enber e. Dcn 1t renember

11 .2 1.1I:TI (:~1:-cle One) 11.4 T:NfE:9.ATUP.S (Circle Or.e)

& ... \oJ lld Cold . ·o a .

b. 51.; -'1 t ':1:--agze b . C::>ol - · n s .f . ... . - ·p . :1 ~ ~!Arm c. . . ~,

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d. !),:,n l~ r ., ~-be .. -:- . .;,.,._ - d . f1• )t e • r-,r.'t r ,., r.: en 't e r

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12. Estimate hO\I long you sa~ the object? _ Q . I S Hours 1-Iinutes Seconds

12.1 Ci rcle one of t he following to indicat e hew certain you are of ycur ans~er to Q~estion 12:

@ Certain e. ~!ot very sure b. Fairly sure d. J ust a guess

1.3. Did the object look: (Circle One f{_ Solid \ or Transparent?

14. Did the object at any time:

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14.1 Change direct ion? 14.2 Change speed? 14.3 Change size? 14.4 Change color? 14.5 Break up into parts or

explcde? 14·.6 Give oft smoke? 14.7 Change brightness? 14.8 Flicker, throb, ar

pulsate? 14.9 Remain motionless?

15. Did tba object giva off a light?

(Circle One f or each qt.:estion)

Yes d es)

Yes

Ye es

No Don't lalC\1 - Don 1 t knew Don't knO'J -Don 1 t know

Don 1t knC\1 Don 1t kn~ Don't k nC\1

~ Don't kncv ~ Don' t kn~

(Circle One): ~ No Don't know 0

15.1 IF you ansver'!d YES, l-lhat waa the color of tl'".e light?

16 , Tell in a few words tte following t hings about the object?

16,1 Sound

16.2 Color

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1?. 1F there \.Jas NcaE TiillY mJE object, then how many were there? Draw a pioture of heN they were arranged, and put an arrcw to show t he direction they were traveling •

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18 . Did tha object at any t ice:

18.1 Move behind scmething? (Circle One) Yes -(jlo) Don rt kno•..1

lF you ansuer ed YES 1 then tell ~1ha t it I:loved b~hind.

18.2 Nove in front of sonething? (Circle Or.e) Ye9 (]g) pon 't !~no.~

IF you answered YES, then tell what it moved in front of.

1S.3 Blend l-lith the background? (Circle One) Yes @ Don't know

19, vlhich of the following objects ia about the same actual size as the object you saw? (Clrele One):

C P Pea b. Baseball c. Basketball d. Bicycle "'heel e. Office desk

t. Automobile g. Sr..all airplane h, Laree airplane i. Dirigible j, Other

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19.1 Ci!"~le ~me of the following to iaiicate hew certain you are of your answer to Question 19.

c::a:' Certain b, Fairly certain

c. Not very sure d, Uncertain

20, Try to tell the follmJing things about t~e object:

20.1 Hew higll above the earth t1as it? !i~ far was lt f rom yuu~ /0v~ :cet or wile~

How fast was it goil1g? 5 ~zl:;t nttsv miles per hom-. , Ci rcle one of t~e follO\oling to indicate hew certain y ou a re of your ans,.,er to the above questionn :

c:f/ Certain b. Fairly certain

c. i 1ot very sure d. Just a guess

21 . Hew did t he object di~appear frcm view?

(Circle One): a. St;ddenly @ Gradually

c. Other ------d. Don't re~~nber

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