23857122-1403-531545-0014

RESTRICTED U. Ss. 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 personal information so that, if it is deemed necessary, we may contact you for further details. 21 eis Hour Minutes . When did you see the object? 2. Time of day: 26: January 1953 Day Month Year (Circle One): A.M. P.M. . Time zone: (Circle One): a. Eastern (Circle One): a. Daylight Saving b. Central Cb) Standard C) Mountain d. Pacific e. Other . Where were you when you saw the object? Continental Divide Continental Divide New Mexico Nearest Postal Address City or Town State or Country Additional remarks: bg . Estimate how long you saw the object. Hours Minutes Seconds 5.1 Circle one of the following to indicate how certain you are of your answer to Question 5. a. Certain c. Not very sure G) Fairly certain d. Justa guess . What was the condition of the sky? (Circle One): a. Bright daylight d. Just a trace of daylight b. Dull daylight (.) No trace of daylight c. Bright twilight f, Don’t remember IF you saw the object during DAYLIGHT, TWILIGHT, or DAWN, where was the SUN located as you looked at - the object? (Circle One): a. In front of you d. To your left b. In back of you e. Overhead c. To your right f. Don’t remember RESTRICTED SECURITY INFORMATION + iat 6 = Declassification Authority: NND 57565