Sworn statement of a Medic testifies that treated a Captain's hand injury that appears to have been caused by punching someone or something. This document relates to an AR 15-6 investigations in to alleged detainee abuse at Ramadi Palace, Iraq – July 11-12, 2003. This document is part of an investigation in to an incident related to ACLU RDI 1136 through 1171.
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 ISM.
PRINCIPAL PURPOSE: To provide commanders and fawenfercement officials with means by which information may be accurately identified.
ROUTINE 1.1SES: Your social security number is used as an additionalfalternate means of identification to facilitate filing and retrieval.
DIStLOSORE: Disclosure of your social security number is voluntary.
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10. EXHIBIT '
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF TAKEN AT IDATED THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE !MUMS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED. LISAPP I/1.co
DA FORM 2823, DEC 1998 DA FORM 2823, JUL 72, IS OBSOLETE
CO3257
DOD 006886
STATEMENT OF AKEN AT -DATED /V) ,
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9. STATEMENT (Continued)
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AFFIDAVIT
I HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
WHICH BEGI S ON PAGE 1, AND ENDS ON PAGE , 7 . 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 P I i AIRING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT .
MENT.
PUNISHMENT
Subscribed'and sworn to before me, a person authorized by law to
WITNESSES:
administer oaths, this 1 q day of j
ORGANIZATION DR ADDRESS area erson:AilaWit(stering Oath)
(Typed Nark, if Persorf Adiaiiiiitedny Oath) R ANIZATION OR ADDRESS (Authority To Administer Oaths) INITIALS OF PERSON MAKING STATEMENT OF 7 PAGES
IISAPA 01.00
PAGE 3, DA FORM 1823, DEC 1998
C 03258
DOD 006887