AR 15-6 Investigation re: Death of a Detainee

DEPARTMENT OF THE ARMY
HEADQUARTERS 4TH INFANTRY DIVISION (MECHANIZED) OFFICE OF THE STAFF JUDGE ADVOCATE FORT HOOD, TX 76544-5000 .
REPLY TO
ATTENTION OF:

AFYB-JA-AL 06 September 2003
MEMORANDUM FOR COMMANDER, 4th Infantry Division (Mechanized), Fort Hood, Texas 76544
SUBJECT: AR 15-6 Investigation — Legal Review
1. In accordance with AR 15-6, para a h 2-3, I have reviewed the AR 15-6 investigation into the 16
August death of an,detainee,

detainee 411/M. I make the following determinations: 9
a.
The proceedings comply with the legal requirements.

b.
Errors in the proceedines, if any, do not have a material advers e effect on any individual' s
substantial rights.

c.
Sufficient evidence supports the findings.

d.
The recommendations are consistent with the findings.

2.
The investigation is legally sufficient.

3.
The point of contact is the undersigned, (DNVT) 5341111111

CPT, JA Administrative Law Attorney
6

DEPARTMENT OF THE ARMY
HEADQUARTERS, 3 RD BRIGADE COMBAT TEAM
4TH INFANTRY DIVISION (MECHANIZED)
Balad, Iraq

AFZC-FC-BSO 27-Aug-03
MEMORANDUM FOR CHIEF OF STAFF, 4 11-1 INFANTRY DIVISION
SUBJECT: 15-6 Investigation Findings and Recommendations of the deathlof detainee,
1.
The purpose of this memorandu« o determine the circumstances surrounding the
cause death of

2.
Findings:

(a)
(a) On the 07 Aug 03 A Co, 1/8 IN BN conducted a raid on a house, and detained a suspected arms dealer, ith 38 x AK-47s, 5 SKS, 1 x Tari isto1 5 x RPGs, 3 x Enfield rifles, x ragunov sniper rifle, and 2 x RPG sights.
nprocessed at the detainment facility on 09 August 2003.
(b) Millaralirserved in the Iraqi Army from 1978-1980 as an infantry
private.
41(0 -14

(c)
was 44 years of age.

(d)

-was held a POW for eight years during the Iran/Iraq War
in Iran.
\,, L,...y Oc-4

(e) was medically evaluated until 13 August 2003. The results of the screening found the detainee appeared to be nauseous, pale, weak, and unable to keep any food in his stomach_
0-or that the detainee
was taking any medication. Th-, "ege
- ) fk fluids and planned
,,.9, ' , allitt a i
to follow up the next day. Also noticed the fact he was being carried by his
brothers for role call.
(0(to. -1-1 i (b.r)(/)(c - 4
(f) 15 Aug 03 the detainee was again treated for dehydration and nausea. The medic gave him a liter of Gatorade, rehydration salts, and Mylanta. The medics stated that they would return the followin,4 or a follow on the detainee.
63:)4,
(g)
The detainment facility provides two MREs per day and water from a water buffalo is readily available for the detainees. The detainment facility also allows the detainees to wash off in a shower every two days. The detainment facility, which is a large open hanger, provides adequate airflow and shade for the detainees.

(h)
The detainment facility conducts hourly role call for all detainees.

(i)
Most of the detainment facility personnel are either CLS, CPR, and some are EMT certified, but there is not a medic permanently on site. The medics from 64 th MP BNconduct the medical screening of all the detainees.

(j)
The medic does not visit the detainment facility unless requested. The facility also does not have a nonstandard casevac vehicle on site. The medic from 64 th MP BN are located on Samara East Airfield within five minutes of the detainment facility.

(k)
The investigation shows that on the day of detainee death that all personnel

. kvolved reacted well and provided adequate medical assistance during the incident.
(1) The 3/29 FA BN PA and medics visit the detainment facility daily since the
. incident occurred.
3. Recommendations:
(a) That the medic needs to evaluate detainees no less than 24hrs after arrival at the
detainment facility.
(b)
Detainees need to be forced to hydrate while in the detainment facility and also the
personnel on shift at the detainment facility need to monitor the hydration.

(c)
Provide humanitarian assistance meals or food purchased on the local economy

which will meet their diet.
(d) A medic needs to be added to the detainment facility team.
4. POC is undersigned at 534-11111
CPT, SC Brigade AS6

63J5

DEPARTMENT OF THE ARMY
HEADQUARTERS TASK FORCE IRONHORSE
TIKRIT, IRAQ

REPLY TO
ATTENTION OF

AFYB-CG 18 August 2003
MEMORANDUM FOR: 111.111111011. H.HC 3BCT
SUBJECT: Appointment as a 15-6 Investigating Officer
1. You are hereby appointed an investigating officer pursuant to AR 15-6 and AR 210-7, paragraph 4-3, to conduct an informal investigation into the 16 August death of an Iraqi detainee, Specifically, you will determine the facts and circumstances
( surroundiing the cause oi death. Additionally, you are to identify any systemic problems that thecommand can address and correct, if necessary.
2. You will use informal procedures under AR 15-6, Chapter 4. You will make specific findings and recommendations on all relevant issues you identify in the course of your investigation.
If,
during your investigation, you suspect that persons you intend to interview may have violated any provision of the Uniform Code of Military Justice (UCMJ) or any other criminal law, you must advise them of their rights under the UCMJ, Article 31, or the Fifth Amendment, as appropriate. Rights warnings and waivers will be documented on DA Form 3881. All witness statements will be
sworn and recorded on DA Form 2823.
3. Before proceeding with the investi ation, contact
, 4ID DIVIA1N, OSJA, at
5341efor an initial legal briefing.
will serve as your primary legal advisor.
4. Your report, together with all evidence marked as exhibits, will be submitted to me in
memorandum format no later than ten days from the date you receive this memorandum. Submit
any requests for delay to me either orally or in writing. You will obtain a written legal review prior

to submitting the completed investigation.
FOR THE COMMANDER:
cOL, GS Chief of Staff
6356

TABLE OF CONTENTS
TAB A. Appointment Orders.
TAB B. DA Form 1574 (Report of Proceedings by Investigating Officer).
TAB C. DA Form 2823 (Sworn Statements) and Privacy Act Statement:
xhibit A: imminipSworn Statement and Privacy Act Statement.xhibit B: TSworn Statement and Privacy Act Statement.xhibit C: Sworn Statement and Privacy Act Statement. xhibit D: 11111111.111111.111111111 Sworn Statement and Privacy Act Statement.
\oV" Exhibit E: 111.111111111110 Sworn Statement and Privacy Act Statement. Exhibit F: 1111111111111111111110 Sworn Statement and Privacy Act Statement.
TAB E. Detainee Case file from the Detainment Facility.
TAB D. Chronology of Actions Taken During Course of Investigation.

G357

REPORT OF PROCEEDINGS BY INVESTIGATING OFFICER/BOARD OF OFFICERS
For use of this form, see AR 15-6; the proponent agency is OTJAG.
IF MORE SPACE IS REQUIRED IN FILLING OUT ANY PORTION OF THIS FORM, ATTACH ADDITIONAL SHEETS
SECTION I - APPOINTMENT
Chief of Staff, 4th Infantry Division

Appointed by
(Appointing authority)
On 18 August 2003
(Attach inclosure I: Letter of appointment or sununaty of oral appointment data.) (See para 3-15, AR 15-6.)
(Date)
SECTION II - SESSIONS
The (investigation) (board) commenced at Samara East Airfield, Iraq at

(O 9Ti z e)
(Place).
(Time)
on 19 August 2003

.(If a formal board met for more than one session, check here . : Indicate in an inclosure thl time each session began and
Pate)
ended, the place, persons present and absent, and explanation of absences, if any.)
The following persons (members, respondents, counsel) were
present: (After each nmsse, indicate capacity, e.g., President, Recorder, Member, Legal Advisor.)

The following persons (members, respondents, counsel) were absent: (Include brief explanation of each absence.) (See paras 5-2 and 5-8a, AR 15-6.)
The (investigating officer) (board) finished gathering/hearing evidence at 1730 on 21 August 2003
(Time) (Date)
and completed findings and recommendations at 0900 On 23 August 2003
(Time) (Date)
SECTION III - CHECKLIST FOR PROCEEDINGS
A. COMPLETE IN ALL CASES
1 Inclosures (para 3-15, AR 15-6)

Are the following inclosed and numbered consecutively with Roman numerals:
(Attached in order listed)
a.
The letter of appointment or a summary of oral appointment data?

b.
Copy of notice to respondent, if any? (See item 9, below)

c.
Other correspondence with respondent or counsel, if any?

d.
All other written communications to or from the appointing authority?

I IX
e. Privacy Act Statements (Certificate, if statement provided orally)?
f. XI I
Explanation by the investigating officer or board of any unusual delays, difficulties, irregularities, or other problems encountered (e.g., absence of material witnesses)?
g. Information as to sessions of a formal board not included on page 1 of this report?
I IX
h. Any other significant papers (other than evidence) relating to administrative aspects of the investigation or board?
X I I
FOOTNOTES: .11 Explain all negative answers on an attached sheet. Use of the N/A column constitutes a positive representation that the circumstances described in the question did no: occur in this investigation
or board.
DA FORM 1574, MAR 83
EDITION OF NOV 77 IS OBSOLETE. Page 1 of 4 pages. t USAPA V1.20
2 Exhibits (para 3-16, AR 15-6) YES I NOIll NA=
a. Are all items offered (whether or not received) or considered as evidence individually numbered or lettered as
exhibits and attached to this report?

X
b
Is an index of all exhibits offered to or considered by investigating officer or board attached before the first exhibit?
XI
c. Has the testimony/statement of each witness been recorded verbatim or been reduced to written form and attached as
an exhibit?
d. Are copies, descriptions, or depictions (if substituted for real or documentary evidence)
properly authenticated and isthe location of the original evidence indicated?
e. Are descriptions or diagrams included of locations visited by the investigating officer or board
(para 3-6b, AR 15-6)?
f IX
Is each written stipulation attached as an exhibit and is each oral stipulation either reduced to writing and made an
exhibit or recorded in a verbatim record?

g. If official notice of any matter was taken over the objection of a respondent or counsel, is a statement of the matter
of which official notice was taken attached as an exhibit (para 3-16d, AR 15-6)?

3 Was a quorum present when the board voted on findings and recommendations (pares 4-1 and 5-2b, AR 15-6)?
B. I x'
COMPLETE ONLY FOR FORMAL BOARD PROCEEDINGS (Chapter 5, AR 15 -6)
4 At the initial session, did the recorder read,

or determine that all participants had read, the letter of appointment
(para 5-3b, AR 15-6)?
5 Was a quorum present at every session of the board (para 5-2b, AR 15-6)?
6 Was each absence of any member properly excused para 5-2a, AR 15-6)?
7 Were members, witnesses, reporter, and interpreter sworn, if required (para 3-1, AR 15-6)?
8

If any members who voted on findings or recommendations were not present when the board received some evidence,
does the inclosure describe how they familiarized themselves with that evidence para 5-2d, AR 15-6)?
C. COMPLETE ONLY IF RESPONDENT WAS DESIGNATED (Section II, Chapter 5, AR 15-6)
9 Notice to respondents (para 5-5, AR 15-6):

a.
Is the method and date of delivery to the respondent indicated on each letter of notification?
b.
Was the date of delivery at least five working days prior to the first session of the board?
c. Does each letter of notification indicate —
(1)
the date, hour, and place of the first session of the board concerning that respondent?

(2)
the matter to be investigated, including specific allegations against the respondent, if any?

(3)
the respondent's rights with regard to counsel?

(4)
the name and address of each witness expected to be called by the recorder?

(5)
the respondent's rights to be present, present evidence, and call witnesses?

d.
Was the respondent provided a copy of all unclassified documents in the case file?

e.
If there were relevant classified materials, were the respondent and his counsel given access and an opportunity to examine them?
10 If any respondent was designated after the proceedings began

(or otherwise was absent during part of the proceedings):
a.
Was he properly notified (para 5-5, AR 15-6)?

b.
Was record of proceedings and evidence received in his absence made available for examination by him and his counsel

(pare 5-4c, AR 15 -6)?
11 Counsel para 5-6, AR 15 -6):
a. Was each respondent represented by counsel?
Name and business address of counsel:

(If counsel is a lawyer, check here L )
b.
Was respondent's counsel present at all open sessions of the board relating to that respondent?

c.
If military counsel was requested but not made available, is a copy (or, if oral, a summary) of the request and the
action taken on it included in the report (para 5-6b, AR 15-6)?

12 If the respondent challenged the legal advisor or any voting member for lack of impartiality ( para 5-Z AR 15-6):
a.
Was the challenge properly denied and by the appropriate officer?

b.
Did each member successfully challenged cease to participate in the proceedings?
13 Was the respondent given an opportunity to (para 5-8a, AR 15-6):

a.
Be present with his counsel at all open sessions of the board which deal with any matter which concerns that respondent?

b.
Examine and object to the introduction of real and documentary evidence, including written statements?

c.
Object to the testimony of witnesses and cross-examine witnesses other than his own?

d.
Call witnesses and otherwise introduce evidence?

e.
Testify as a witness?

Make or have his counsel make a final statement or argument (para 5-9, AR 15 -6)?
14 If requested, did the recorder assist the respondent in obtaining evidence in possession of the Government and in
arranging for the presence of witnesses (para 5-8b, AR 15-6)?

15
Are all of the respondent's requests and objections which were denied indicated in the report of proceedings or in an
inclosure or exhibit to it (para 5-11, AR 15 -6)?
FOOTNOTES: I/ Explain all negative answers on an attached sheet.
V Use of the N/A column constitutes a positive representation that the circmstances described in the question did not occur in this investigation
or board.
Page 2 of 4 pages, DA Form 1574, Mar 83
USAPA V1.20
Y
2 Exhibits (para 3-16, AR 15-6)
YES IN0 1/1 NA2
a. Are all items offered (whether or not received).or considered as evidence individually numbered or lettered as exhibits and attached to this report? X
. b. Is an index of all exhibits offered to or considered by investigating officer or board attached before the first exhibit?
X 1
c. Has the testimony/statement of each witness been recorded verbatim or been reduced to written form and attached asan exhibit? X 1 I
d. Are copies, descriptions, or depictions (if substituted for real or documentary evidence) properly authenticated and isthe location of the original evidence indicated? X 1 1
e. Are descriptions or diagrams included of locations visited by the investigating officer or board (para 3-6b, AR 15-6)?
1.I X /1.Is each written stipulation attached as an exhibit and is each oral stipulation either reduced to writing and made an exhibit or recorded in a verbatim record? X
g. If official notice of any matter was taken over the objection of a respondent or counsel, is a statement of the matter of which official notice was taken attached as an exhibit (para 3-16d, AR 15-6)? X
3 Was a quorum present when the board voted on findings and recommendations (paras 4-1 and 5-2b, AR 15-6)?
X
B. COMPLETE ONLY FOR FORMAL BOARD PROCEEDINGS (Chapter 5, AR 15-6) '''.:fir3f74;Lr, 4 At the initial session, did the recorder read, or determine that all participants had read, the letter of appointment (para 5-3b, AR 15-6)? ­5 Was a quorum present at every session of the board (para 5-2b, AR 15-6)?
6 Was each absence of any member properly excused (para 5-2a, AR 15-6)?
7 Were members, witnesses, reporter, and interpreter sworn, if required (para 3-1, AR 15-6)?
8 If any members who voted on findings or recommendations were not present when the board received some evidence,
does the inclosure describe how they familiarized themselves with that evidence (para 5-2d, AR 15-6)?
C. COMPLETE ONLY IF RESPONDENT WAS DESIGNATED (Section II, Chapter 5, AR 15 -6)
Notice to respondents (para 5-5, AR 15-6):

a.
Is the method and date of delivery to the respondent indicated on each letter of notification?

b.
Was the date of delivery at least five working days prior to the first session of the board?

c.
Does each letter of notification indicate —

(1)
the date, hour, and place of the first session of the board concerning that respondent?

(2)
the matter to be investigated, including specific allegations against the respondent, if any?

(3)
the respondent's rights with regard to counsel?

(4)
the name and address of each witness expected to be called by the recorder?

(5)
the respondent's rights to be present, present evidence, and call witnesses?

d.
Was the respondent provided a copy of all unclassified documents in the case file?

e.
If there were relevant classified materials, were the respondent and his counsel given access and an opportunity to examine them?
10 If any respondent was designated after the proceedings began (or otherwise was absent during part of the proceedings):

a.
Was he properly notified (para 5-5, AR 15-6)?

b.
Was record of proceedings and evidence received in his absence made available for examination by him and his counsel (para 5-4c, AR 15 -6)?
11 Counsel (para 5-6, AR 15-6):

a.
Was each respondent represented by counsel?
Name and business address of counsel:

(If counsel is a lawyer, check here . )
b.
Was respondent's counsel present at all open sessions of the board relating to that respondent?

c.
If military counsel was requested but not made available, is a copy (or, if oral, a summa y) of the request and the
action taken on it included in the report (para 5-6b, AR 15-6)?

12 If the respondent challenged the legal advisor or any voting member for lack of impartiality (para 5-7, AR 15-6):
a.
Was the challenge properly denied and by the appropriate officer?

b.
Did each member successfully challenged cease to participate in the proceedings?
13 Was the respondent given an opportunity to (para 5-8a, AR 15-6):

a.
Be present with his counsel at all open sessions of the board which deal with any matter which concerns that respondent?

b.
Examine and object to the introduction of real and documentary evidence, including written statements?

c.
Object to the testimony of witnesses and cross-examine witnesses other than his own?

d.
Call witnesses and otherwise introduce evidence?

e.
Testify as a witness?

f.
Make or have his counsel make a final statement or argument (para 5-9, AR 15-6)?

14 If requested, did the recorder assist the respondent in obtaining evidence in possession of the Government and in
arranging for the presence of witnesses (para 5-81r, AR 15-6)?

15 Are all of the respondent's requests and objections which were denied indicated in the report of proceedings or in an
inclosure or exhibit to it (para 5-11, AR 15-6)?

FOOTNOTES: 11 Explain all negative answers on an attached sheet. V Use of the N/A column constitutes a positive representation that the circumstances described in the question did not occur in this investigation
or board_
Page 2 of 4 pages, DA Form 1574, Mar 83 USAPA V1.20
TASK FORCE IRONHORSE
HEADQUARTERS, 3' d BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: 27/A 6-0 3
, understand that the results of this
investigation are releasable under the Privacy Act of 1974 and the Freedom of Information Act This means that individuals can, upon completing a proper infolination request, receive a copy of the foimal findings of this investigation
0-at
11(Name: VI (--l Rank: Unit: Z;--fi A 4P Co
6300

SECTION VI -AUTHENTICATION (para 3-17, AR 15-6)
THIS REPORT OF PROCEEDINGS IS COMPLETE AND ACCURATE.
(If any voting member or the recorder fails to sign here or in Section VII
below, indicate the reason in the space where his signature should appear.)
(Recorder)
(Member)
(Member) (Member)
SECTION VII - MINORITY REPORT
(para 3-13, AR 15 -6)
To the'extent indicated in Inclosure , the undersigned do(es) not concur in the findings and recommendations of the board.
In the inclosure, identi.
fy by number each finding and/or recommendation in which the dissenting nzember(s) do(es) not concur. State the
reasons for disagreement. Additional/substitute findings and/or recommendations may be included in the inclosure.)

(Member)
(Member)
SECTION VIII - ACTION BY APPOINTING,A4-T-HaRI,TY
(para 2-3, AR 15 -6)
The findings and recommendations of the ar
(investigating officer) (board) (approvedi_Wapproved) (approved with following exceptions/
substitutions). (If the appointing authority returns the proceedings to the inveetfu8 officer or board for further proceedings or corrective action, attach that correspondence (or a summary, if oral) as a numbered inclosure.)
R PCPIV-D RAYMOND T. ODIEP_NO
Major General, USA
09 SEP 2003
Commanding

63'31

Page 4 of 4 pages, DA Form 1574, Mar 83
i-: USAPA \/12,0
SECTION IV - FINDINGS (para 3-10, AR 15-6)
The (investigating officer) (board), having carefully considered the evidence, finds:
See attached Memorandum
SECTION V - RECOMMENDATIONS (para 3-11, AR 15-6) In view of the above findings, the (investigating officer) (board) recommends:
6362

Page 3 of 4 pages, DA Form. 1574, Mar 83
USAPA V1.20
SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS

PRIVACY ACT STATEMENT
AUTHORITY:

Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
(ESN).

PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:

Your social security number is used as an additional/alternate means of identification to facilitate filM and etrieval. Lo ..AA
DISCLOSURE:
Disclosure of your social security number is voluntary.
b (P 10 %D1 L r1. LOCATION 2. DATE (YYYYMMDD) 3. TIME 4. FILE NUMBER

Samarra East Air Field
2003/08/1
icffg

5. LAST NAME. FIRST NAME, MIDDLE NAME
6. SSN
7. GRADE STATUS h k)-4

blt.
8. ORGANIZATION OR ADDRESS
•

64th Iv CO, 720th MP BN, Samarra East Air Field
WANT TO MAKE THE FOLLOWING STATEMENT UNDER 04H:
My platoon has been assigned to duties at the EPW cage now for the past 4 days. EPW has been showing signs andsymptoms of dehydration and his body movements are weak. He al o has to be esc d carried h his two brothers everytime he needs to go use the latrine outside. Yesterday, 15 Au 03 u stopped by the cage toevaluate some other EPW's and I asked them to evalate . They el/al-dated hirci and said that he was dehydrated and
advised to give plenty of water for him to drink. Each EPW is given water at their request daily. He was fed at 1100 hrs
yesterday and could not kee, his food down, he was vomitting. When my squad was relieved from shift that day, I backbriefed

my platoon leader about the same EPW. This morning when my squad came onto shift, the EPW was -
condition. ame
came',y the cage at about 0945 hrs, and advised him of the,EPW a,-ain:_:, ea
329 FA BN: 1 ,:; a74,41
ronah of the cage area at 1015hrs.
advised .

condition. of
took his tag number and name, en e e . At approXittra
headcount, the tw during a hourly_
ors: aKI-that something was wrong with him again. We then c
am to. ave

scene. At 1222, _ . on
arrived and started evaluating him with the help of
crivina an IV to the u tried
4, b rt
-could not get one started. We had one of the other EPW's who spoke a' little bit of english to ask
what was wrong with him, but he could b ely speak or be understood He also started to reath heavi . Around 1300 wenotfied Guardian Main that said to have a PA sent immediately. At 1320
and .

start to erfo -
on e EPW, I notified Guardian Main to have Pacesetter expidite. Approkithately 1330
nd

64th medics, also arrived and took over CPR. At 1333 an ambulance from Pacesetter finallytransporte
to BN Aid station.///End of Statement/alle
10. EXHIBIT
11. INIMISON MAKING STATEMENT
PAGE 1 OF PAGES

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF
TAKEN AT

DATED THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
63"3
DA FORM 2823, DEC 1998
DA FORM 2823, JUL 72, IS OBSOLETE
i,USAPA V1.00

STATEMENT OF
TAKEN AT
DATED

9. STATEMENT (Continued) AFFIDAVIT
b k -14 \ ko1c---4
HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
WHICH BEGINS ON'PAGE 1 A NOS ON PAGE
2

. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COER
UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
'¦(1 .9 .-Q Pvt1C-"°'
(Signature of Person Making Statement)

WITNESSES:
Subscribed and sworn to before me, a person authorized by law to administer oaths, this 16th day of August , 2003 at Samarra East :Air Field
ORGANIZATION OR ADDRESS
Signature of Pirionkliti Is &Mg Oath)
ART 136 (b) (4) UCMJ

ORGANIZATION OR ADDRESS
(Authority To Administer Oaths)

INITIALS OF PERSON MAKING STATEMENT
001 \c4-‘',
PAGE

o-l c,"A
OF PAGES

PAGE 3, DA FORM 2823, DEC 1998
63 G 4APA V1.00

DOD 002749

-
4y

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT
AUTHORITY:

Title 10 USC Section 301; Title 5 USC Section 2951; ED. 9397 dated November 22, 1943
[SS/V).

PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:

Your social security number is used as an additionallalternate means of identification to facilitate filing and retrieval.
DISCLOSURE:

Disclosure of your social security number is voluntary.
Vo..._-4 1:)1 C---"

1. LOCATION .
2. DATE (MYMMODI Mil
3. TIME 4. FILE NUMBER

Samarra East Airfield, Iraq 2003/08/1, -----175.-Irsr
5. LAST NAME, FIRST NAME li . I A
6. SSN
‘0 10 —0 , 7. GRADE/STATUS _
v

8. it---2it ATION OR ADDRESS
64th Military Police Company, Samarra East Airfield, Iraq
\01(/
WANT TO MAKE THE FOLLOWING STATEMENT UNDER 04:
I receive a report from illEMIliat approximately 1305 that the EPW Cage was requestina a medic but did not knowthe cause. I called the EPW Cage for futher information on the reason for call and was informed that there was a detaineg___'complaining of feeling weak, and not having been to the bathroom to urinate or defecate for the last 24 hours. Informed...
1111111111111111to attend the call at approximately 1308. At approximately,
1330, overheard a request for Pacesetter Medic to attend thedetainee at the camp because he had "Stop Breathing".
At first break in comunication, verified with EPW Cage, status as towhat was happenm at the cage and was told the
was atte _ ina Ca_rdioPulmonar Resustation (CPR) on the
Detainee. Me and then went to the Cage, upon w al, m
arriv
was attempting CPR.

Verified that the patient hadno pulse or was breating. Introduced a .T.- u °e Int -.
engie s airway .secur airway and hold
-

tongue m place. Relieved 1111•111111/1.performing Chest compression while , fieved from
performing rescue breathing. After performing CPR for approximately 5 minutes, directed to prepare our M998 totransport patient to Aid Station. At that time, the ambulance
from the aid station arrived. We continued CPR while theambulance was readied to tran atient. Patient was transported to Aid Station from EPW Cage at approximately 1345 under
supervision of End of Statement
. _ .
, .._

. --1 i i 1
10. EXHIBIT 11. INITIALS OF PERSON MAKING STATEMENT PAGE 1 OF 2_ PAGES
f
VJ^a -64

ADDITIONAL PAGES MUST CONTAIN THE HEADING 'STATEMENT OF
TAKEN AT DATED THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
63

DA FORM 2823, DEC 1998
DA FORM 2923, JUL 72, IS OBSOLETE
USAPA V1.00

STATEMENT OF
TAKEN AT
DATED

9. STATEMENT (Continued)
AFFIDAVIT
, HAVE READ DR HAVE HAD READ TO ME THIS STATEMENTWHICH B II • . I FULLY UNDERSTAND THE CONTENTS OF THE­
ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT,AND-WITHOUTCOERCIM UNLAWFULINFLUENCE
;'-OR. UNLAWFUL INDUCEMENT.
• Noic -`4
(Signa are of Person Ma mg a emen

WITNESSES:
Subscribed and sworn to before me, a person authorized by law to •

administer oaths, this
C day of !7c-( o{ kft , 2003 at -C.A. Ai .4 r•r-4' V..1- 3 f 4,;-;)c (e0',
ORGANIZATION OR ADDRESS
yped Name of PerSon dinkistering Oith)
(oC6) 4:e

ORGANIZATION OR ADDRESS
[Authority To Administer Oaths)

INITIALS OF P TATEMENT
\JA.U.Lk PAGE 2 OF Z. PAGES
PAGE 3, DA FOR 2823, DEC 1998
oe3ot3r)
TASK FORCE IRONHORSE
HEADQUARTERS, 3' d BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: \oly-"4 A Vic/
, understand that the results of this investiga on are releasable under the Privacy Act of 1974 and the Freedom of Tnfoiniation Act. This means that individuals can, upon completing a proper infoiniation
request, receive a copy of the formal findings of this investigation
Name:
Rank:
Unit: 4,4/ ftp
6367

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT
AUTHORITY:

Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943 (ESN).
PRINCIPAL PURPOSE:

To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:

Your social security number is used as an additionallalternate means of identification to facilitate filing and retrieval.
DISCLOSURE:

Disclosure of your social security number is voluntary.
lor,4 41 \el Lt(
L LOCATION

I 2. DATE (ITYYMMDD) fps
3. TIME FM-
4. FILE NUMBER

Samarra East Air Field, Iraq 2003/08/16 17 hrs
5. LAST NAME, FIRST NAME MIDDLE NAME 1\
16. SSN
7. GRADEISTATUS

1111.11111111,

8. ORGANIZATION OR ADDRESS
64th Military Police Company, Samarra East Air Field, Iraq
9.
‘p lia

1)16'1A
111111.P

r WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
instructed me to go down to the epw camp to check one of the epw's out who was complaining of feeling sick. Iheaded down there at around 1325 hrs. I set up the litter with litter stands to better treat the individual. I recognized this patientfrom yesterday when I evaluated him for nausea. Yesterday I gave him my personal cold one liter gatorade and instructed him to
° drink it and I also gave him rehydration salts and some mylanta. I advised him he needed to eat some food and also to drink therehydration salts and if he wasn't better by tomorrow I would come see him again. The patient had no temperature and appearedweak as if he hadn't been eating. 4Almost every epw looks sick there too. The rehydration salts appeared to work for the others
or if not we'd give them I.V. So today his two friends which one was his brother two man carried him upon the litter. Just from looking at him he appeared weak and sick. I immediately tried to initiate an IV to get some fluids in him. I was unable to do so.I tried taking his blood pressure and pulse and couldn't feel a pulse neither on the carotid or the radial. The patient was cold to
touch and had poor circulation because he had no capilary refill. The patient was conscious and responding well.
The patient was breathing and talking to us. But his speech was a little slurred but I was trying to get his pertinent past history ofmedical history and background. His brother said he hadn't ate- anything in eight days. Whenever he tried to eat or drink anything he would vomit it all out. The epw who was helping with the translating told me that the patient had never been to a
hospitaf before for anything and has been perfectly healthy up to this point. I specifically asked for any heart or lung conditionsand they told me no.
, told me they tried to give him some Milk yesterday but he threw that up too. At no point did
the patient complain of chest pain. When I asked him he said he 6n1r140pain in his stomach. After checking his pupils for
constriction whic
, did t constrict when I shined the light in his eyes; I decided that I need the Physician's Assistant atPacesetter TOC, to come evaluate this patient. At my skill level there was 'nothing more I could do for him. I
recognized the signs and called for the P.A. After 20 minutes of waiting *called back and spoke with Pacesetter P.A. and toldthem I could not feel a pulse, I couldn't get a blood pressure reading and I couldn't get an I.V. started. They instructed me tobring this patient to them instead ofthem corning down to the epw cage. As soon I got b e anent I tried taking his
temperature. When the thermometer was in his mouth I noticed the patient stopped bi And myself startedCPR on the patient. We performed CPR for approximately ten to fikeen minutes and
at the
scene and took over CPR. Then three to five minutes later the Pacesetter
-ambulance

Pacesetter-ambulance arrived
, arrived_ with his

so iers totally unprepared for a respiratory or earth -it euproblem. We rinedCPR and after two more minutes we packaged the
patient up and transported him to the Pacesetter Aid Station. There he was put on a monitor. They shocked him with the paddlesand intubated him. No one at the Aid Station was able to initiate an I.V. either. The.P.A. was doing everything he could then. They were unable to revive the patient. When called for the P.A. the first time it was becauseI knew this was a serious issue
and out of my scope of practice. I was dissafo r inted when they had told me that I had to bring the patient to them because thepatient was in need of advanced care and I li sad‘ don
-FeverYthing I could before I called them. After they knew the patient wasn'tcoming back to life the P.A. was asking anyoneiiiinever had experience shocking, performing cpr or bagging a human patient
to step up and practice.////End of Statement.////
10. EXHIBIT
11. INITIALSALURSON MAKING STATEMENT
(iP "' (eZ1 G "i PAGE 1 OF 2. PAGES

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF
TAKEN AT
DATED

THE BOTTOM Of EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
63d

DA FORM 2823, DEC 1998
DA FORM 2823, JUL 72, IS OBSOLETE
USAMV1.00

STATEMENT OF
TAKEN AT
DATED

9. STATEMENT /Continued)
AFFIDAVIT
I,

, HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
WHICH BEGINS ONI5AGE AVIENOS ON PAGE
. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE
BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS
STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.

\ -‘4 \ey..-4!
Signature of Person Making Statement)

WITNESSES:
Subscribed and sworn to before me, a person authorized by law to administer oaths, this / 6 day of fiLt]t..(7tt— , 200 at CAS -I-Ar—uar`f•A triqt -A slca TT—
; ,1/47

ORGANIZATION OR ADDRESS
fP
Signa ur o erson ministering of
tame o IS011 iministering
c-KC X3 C -G)

ORGANIZATION OR ADDRESS
(Authority Fa Administer Oaths)

INITIALS OF PERSON MAKING STATEMENT PAGE 2 OF 2— PAGES
PAGE 3, DA FORM 2823, DEC 1998
USAPA ‘,1603 0 0
DOD 002754

TASK FORCE MONHORSE
HEADQUARTERS, 3 16 BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: ;2z./ / D 3

V¦.P":‘'q
C.-34

, understand that the results.of this investigation are releasable under the Privacy Act of 1974 and the Freedom of Infolination Act. This means that individuals can, upon completing a proper information
request, receive a copy of the formal findings of this investigation
L "
Signature

Name:
Rank:
Unit: 6 ‘77-/-,/ i/L& 6 0

63+0

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSDPS
PRIVACY ACT STATEMENT
AUTHORITY:
Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
IMO.

PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:

Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.
DISCLOSURE:
Disclosure of your social security number is voluntary.
\ —

1. LOCATION \ -U. —A*
2. DATE irryymmawalle .TIME
Samarra East Airfield, Iraq dial 4. FILE NUMBER
2003/08/ 1200h's

5. LAST NAME, FIRST N ME, MIDDLE NAME
6. SSN
NA9 -14
cob—L 7. GRADEIST US
kOlo
(3,-)

B. ORGANIZ ION OR ADDRESS )01c.-
64th Military Police Company Samarra East Airfield, Iraq
9.
\cAP-'4 \en C-4 , WANT TO MAKE THE FOLLOWING STATEMENT UNDER 011-1:
On 15 August 2003, and I went to the EPW Cage -to treat patients compla
being unable to have a , stomach
owe col cramps, and
movement for a few days. A certain detainee was gi ven personal
some Maalox to help his stomach. This detainee is the same one who passed on 16 AuguSt d gatorade and
at 406. On 15 August 2003 is
e.first ti e I had seen the detainee sick and dehydrated We did not get any complaints from him before. On 16 August 2003 and I came to the EPW Cage at a little passed 1300 after listening to the radio that ere as a etamee that was not
I breb. ing and one r fello .
.

assistance. We came up on the scene and saw-'
compresSions and AchniniStering chest
administering the breaths. We asked questions about the situatio
. . . -an
with the chest compreSSibils' and I took e 'th enr took over
rinR
and the patient was loaded onto the ambulance and taken to the Aidstation where he received further treatment. All the medicsbreaths. About ten minutes later the am tafits_owed up

assisted the PA as they could until the detainee was pronounced dead at 1406. MM.
_ _--\01.9-LA
7--

10. EXHIBIT
1L INITIALS OF PERSON MAKING STATEMENT
I PAGE 1 OF
cn (4-c VA —1

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT Of
TAKEN ,47-
DATED

THE BOTTOM OF EACH ADDITIONAL PAGE MUST
.

BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
DA FORM 2823, DEC 1998
DA FORM 2823, JUL 72, IS OBSOLETE
yunlam

STATEMENT OF
t

TAKEN AT DATED WV? 0%),1
9. STATEMENT (Continued)
AFFIDAVIT eu•-4 , HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
\OP .—Lk \

WHICH BEGINS ON PAGE 1, AND NOS ON
. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE
BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS

.

STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, ANI WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
arson Making Statement

WITNESSES:
Subscribed and sworn to before me, a person authorized by law to administer oaths, this 17 day of August
at Sarnarra East Airfield, Ir
.

ORGANIZATION OR ADDRESS
(Signature of Person Admix:Vannu Oath)
, •
yge amen ng g
Article 136b (4) UCMJ

ORGANIZATION OR ADDRESS
(Authority To Administer Oaths)

INI (ALS OF PERSI AKING STATEMENT
PAGE —PAGES
3 --
I

PAGE 3, DA FORM 2823, DEC 1998
USAPA VI6 3
DOD 002757

TASK FORCE ER ONHORSE
HEADQUARTERS, 3rd BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: ,P LI A1-45' S DO 3
\::11 understand that the results of this
in

a ion are releasable under the Privacy Act of 1974 and the Freedom of Information Act. This means that individuals can, upon completing a proper information request, receive a copy of the formal fundings of this investigation

63(3

L

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS

PRIVACY ACT STATEMENT
AUTHORITY:

Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
(SSN).

PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately ROUTINE USES:
Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.DISCLOSURE:
Disclosure of your social security number is voluntary.
1. LOCATION
7 12. DATE (YYYYMMDD)
3. TIME

4. FILE NUMBER vy•--- r , /96-1
,SCe5 —1 / T NAME, MIDDLE NAME RADE/STA,TUS
V9-'4 t
C,
DDRESS

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9.
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I, ,01(..."-k , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
ijt'S /.,

0 tr\- c2.-/62 /4;1 e/C` 0 3 / .-
1-./----c,... 4 'Z'

o_il cat„„ e --,Cr rein •..-,_ "._----,,12/ '' / - 'a c---,,,_ A ,...-. / sl -
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10. EXHIBIT
I 11. INITIALS
KING STATEMENT
• 6 .1,41.. be...,q I PAGE 1 OF `,--i PAGES

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT
TAKE • AT
DATED

THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER .
MUST BE BE INDICATED.
DA FORM 2823, DEC 1998
DA FORM 2823, JUL 72, IS OBSOLETE

6274°°
USE THIS PAGE IF NEEDED. IF THIS PAGE IS NOT NEEDED, PLEASE PROCEED TO FINAL PAGE OF THIS FORM.
STATEMENT OF TAKEN AT DATED
9. STATEMENT (Continued)
lS //\e. crA
O 1 c"-(2.9c­47
/
)7,47 p? -1A-c--E.? 4., ( Z­7.ec
C.) 51- ;Ley `7-­-1 e ;7- 1,05/ • -
1)
E FT5 fi JF r IJJl G !
e
/Vo

INITIALS OF
N MAKING STA EMENT
^

LI PAGE OF L/ PAGES
C7-¦
PAGE 2, DA FORM 2823, DEC 7998
DOD 002760

STATEMENT OF
TAKEN AT
DATED
9. STATEMENT (Continued)
AFFIDAVIT
101 C" HAV READ OR HAVE HAD READ TO ME THIS STATEMENTWHICH NS-ON PAGE 1, AND ENDS AGE.
. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE
BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE
CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE QF BENEFIT OR REWARD, WITHOUT
THREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL IND

,4 -(4
gnature of Person Making Statement)
WITNESSES:
Subscribed and sworn to before me, a person authorized by law to
administer oaths, this day of
at
ORGANIZATION OR ADDRESS
(Signature of Person Administering Oath)
(Typed Name of Person Administering Oath)
ORGANIZATION OR ADDRESS
(Authority To Administer Oaths)
INITIALS OF PERSON MAKING STATEMENT
PAGE OF PAGES
I
PAGE 3, DA FORM 2823, DEC 1998
USAPA V1.00
63' 1

"
TASK FORCE IRONHORSE
HEADQUARTERS, 3' d BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: g.087 6,3
understand investigation are releasable under the Privacy Act of 1974 and the Freedom of Information Act. This means that individuals can, upon completing a proper information request, receive a copy of the formal findings of this investigation
\WI('un erstand that the results of this
Signature
Name: Rank: Unit: t-rt-4-1
6 3
0
/

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT

AUTHORITY:
Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
/SSW
PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately
ROUTINE USES:
Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.
DISCLOSURE:
Disclosure of your social security number is voluntary.
1. LOCATION
2. DATE (YYYYMMDD) 3. TIME
4. FILE NUMBER
gZ79 /545 /-=74
;7-003 ,9g VO
AST AM NAME ,1 6. SSN
7. GRADE/STATUS
‘0(.9 C,' t ‘
- • • vr ••11'
I,
, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
Qpi-g:1;fis;* /2-7:
X7e791/ 6' 0/ V14­
%
FI V) Of.,e OWE 7/7eatliee--/ °mkt& vie ike to 30 , 1111111.f-tie 0.97,A.7)0o-ze 7-Ay 66,-4 19
-

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it(11-0 OPOIAied
) DA-6 ; 1n -Cy ti 6C.9 PCIf C'Ci 0 t t e51—.. , ‘,4%6 ,,,,o-k,iffra, 2,6/ 7,76-6-4-0 / /104/M9177" )1/1(16-lis 4 ciern(e eo,/,----/ UG Aa- S 07,-p S ,5-:;-?,----- /44: Z.;;!"J6_5' -0-Y" -57 r i /7 i irl fair¦CJ Liice 0 (,),,loW 6, -i-o r-- e v ; -1-6, I ,--_6 rkiv7 7z,
zy// 7/7 /1,7e c' .4--7//i ar 7 //I 'g 0/7di.,/,.74.../ -7-67, 41A /13
lo(.0 to -1 C."4
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT
TAKEN AT DATED
THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
DA FORM 2823, DEC 1998
DA FORM 2823, JUL 72, IS OBSOLETE
6u
DOD 002764

USE THIS PAGE IF NEEDED. IF THIS PAGE IS NOT NEEDED, PLEASE PROCEED TO FINAL PAGE OF THIS FORM.
STATEMENT OF
TAKEN AT 36 el /3-4-5
DATED -603
9. STATEMENT (Continued)

\lkho
\a6 -34

I ITI4 •-57
ERSON MAKIN STATEMENT
•••14

PAGE ) OF PAGES

PAGE 2, DA F01411/1 2823, DEC 7998
US

DOD 002765

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT AUTHORITY:
Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
(SSN).

PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately ROUTINE USES:
Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval. DISCLOSURE:
Disclosure of your social security number is voluntary.
1. LOCATION
2. DATE (YYYYMMDD) 3. TIME 4.
FILE NUMBER

3/A9 /5 P.603 05 /6
5. LAST NAME, FIRST NAME, IDDLE NAME
6. SS
7. GRAD TATUS
TION OR ADDRESS
, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

10. EXHIBIT
11. INI
ERSON MAKING STATEMENT

PAGE 1 OF -5 PAGES
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT
TAKEN AT DATED

THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
DA FORM 2823, DEC 1998 DA FORM 2823, JUL 72, IS OBSOLETE
P V1.00
DOD 002766

STATEMENT OF
TAKEN AT
DATED 1(.2
0

9. STATEMENT (Continued)
AFFIDAVIT
, HAVE READ OR HAVE HAD READ TO ME THIS STATEMENTWHICH B ,7S ON PAGE 1, AND ENDS ON PAGE

. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
\t)6 nett
Signature of Person Making Statement)

WITNESSES:
Subscribed and sworn to before me, a person authorized by law to administer oaths, this day of at

ORGANIZATION OR ADDRESS
(Signature of Person Administering Oath)
(Typed Name of Person Administering Oath)

ORGANIZATION OR ADDRESS
(Authority To Administer Oaths)

INITIALS OF PERSON MAKING STATEMENT
PAGE OF PAGES

PAGE 3, DA FORM 2823, DEC 7998
TASK FORCE IRONHORSE
HEADQUARTERS, 3' d BRIGADE COMBAT TEAM
BALAD, IRAQ

DATE: ‘,3
\do 'A LA I,
'"1(--thderstand that the results of this inves iga on are releasable under the Privacy Act of 1974 and the Freedom of Information Act. This means that individuals can, upon completing a proper infoimation request, receive a copy of the formal findings of this investigation
6383

Chronology of Actions Taken During Course of Investigation
18 Aug 03: 1.111.1.otified of the appointment of 15-6 investigating officer.
19 Aug 03: I notified 3/29 FA that I would be traveling to SEAF to conduct investigation on the 20 Aug 03 and coordinated for escort support, from 3 BCT.
20 Aug 03: I start the investigation at SEAF. I received the case file of the detainee and the sworn statements from all the individuals involved in the incident. I reviewed all the information given to me then I visited the detainment facilit i to receive an overview of the detainment facility operation and to speak with the about the incident.
0384

SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT
AUTHORITY:

Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
ISSN'.

PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:

Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.
DISCLOSURE:

Disclosure of your social security number is voluntary.
1. LOCATION
2. DATE IrYYYMMDDI
3. TIME
4. FILE NUMBER

3 BCT DETENTION CENTER, SEAF, IRAQ N/A
5. LAST NAME, FIRST NAME
6. SSN

. 7. GRADE/STATUS
8. 0 GANIZATION OR ADDRESS
HHB, 3-29 FA, UNIT 92616, APO AE 09323-2616 (SAMARRA EAST AIR FIELD, IRAQ)
9. IIIINIIIIIIIMIIIII r -1c--z­
, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OAT

ALL WEAPONS AND MILITARY EQUIPMENT SEIZED IN CONJUNCTION WITH THE DETENTION OF THIS INDIVIDUAL HAVE BEEN TURNED-IN TO THE APPREHENDING UNIT'S HEADQUARTERS AND WILL BE TURNED IN TO 3BCT FOR THE PURPOSE OF RE-ARMING LEGITIMATE IRAQI POLICE AND MILITARY FORCES.
91/

10. EXHIBIT
11. INITIA
MAKING STATEMENT

N/A
PAGE 1 OF 1 PAGES

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF
TAKEN AT DATED

THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
63851
DA FORM 2823, DEC 1998 DA FORM 2823, JUL 72, IS OBSOLETE
USAPF V1.00
STATEMENT OF TAKEN AT SEAF DATED 2003/08/05
9. STATEMENT (Continued)
YAW —
I,
B AGE ; 1 a4 FULLY

. F LLY BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF
WITNESSES:
ORGANIZATION OR ADDRESS
3 BCT DETENTION CENTER SAMARRA EAST AIR FIELD, IRAQ
ORGANIZATION OR ADDRESS INITIALS OF PERSON MAKING SPC CEMENT AFFIDAVIT
7.
, HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT ilNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
(Signature of Pelson Making Statement) 'I--
Subscribed and sworn to before.me, a person authorized by law to " administer oaths, this 5TH day of AUGUST at SAMARRA EAST AIR FIELD, IRAQ , 2003

N/A
(Signature of Person Administering Oath)
N/A
(Typed Name of Person Administering Oath)
N/A
(Authority To Administer Oaths)
PAGE 1 OF 1 PAG

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DOD 002771