AR 15-6 Investigation: Report of Proceedings by Investigating Officer/ Board of Officers

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
Commanding General, 4th Infantry Division
Appointed by
(Appointing authority)

on 12 Sep 03 (Attach inclosure 1: Letter of appointment or summary of oral appointment data.) (See para 3-15, AR 15-6.) (Date)
SECTION II - SESSIONS
The (investigation) (board) commenced at Forward Operating Base Raider, Tikrit, Iraq at 1830 hrs (Place) (Time)
on 12 Sep 03 (If a formal board met for more than one session, check here E.]. Indicate in an inclosure the time each session began and
(Date)
ended, the place, persons present and absent, and explanation of absences, if any.) The following persons (members, respondents, counsel) were present: (After each name, 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.)
2030 hrs 13 Sep 03
The (investigating officer) (board) finished gathering/hearing evidence at on
(Time) (Date)

1900 14 Sep 03.
and completed findings and recommendations at on
(Time) (Date)
SECTION III - CHECKLIST FOR PROCEEDINGS
A. COMPLETE IN ALL CASES YES NO 11 N)6 =1
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
X I
b. Copy of notice to respondent, if any? (See item 9, below)
1 X
c. Other correspondence with respondent or counsel, if any?
X
d. All other written communications to or from the appointing authority?
I I X P Privacy Act Statements (Certificate, if statement provided orally)?
X I I 1,1anation by the investigating officer or board of any unusual delays, difficulties, irregularities, or other problems X
.,countered (e.g., absence of material witnesses)?
g. Information as to sessions of a formal board not included on page 1 of this report?
I I X Iz. Any other significant papers (other than evidence) relating to administrative aspects of the investigation or board?
X I I
FOOTNOTES: 1.1 Explain all negative answers on an attached sheet. V Use of the N/A column constitutes a positive representation that the circtunstances described in the question did not occur in this investigcua
_ 20 4 q 4
or board.
DA FORM 1574, MAR 83 EDITION OF NOV 77 IS OBSOLETE. Pagel of 4 pages USAPA V1.20
DOD-043574