Sworn statement of a soldier who witnessed an incident where an Army Captain abused a detainee. The Soldier states he saw the Captain threatening detainees with a gun and treating them in a disrespectful way. 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 19045; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT
AUTHORITY: Title lfl USC Section 301; Title 5 USC Section 2951; E.G. 9397 dated November 22, 1943 NM.
PRINCIPAL PURPOSE To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES: DISCLOSURE: 1. LOCATION Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval. Disclosure of your social security number is voluntary. l 2. DATE 0111MMODI 3. TIME 4. FILE NUMBER • '&L4 ji /0
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10. EXHIBIT iliIllpPERSE7,g)STAT3MENT 1 --PAGE t OFlPAGES
7,7Ti l [
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF TAKEIV 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.
_
USAPA 01.00
DA FORM 2823, DEC 1998 DA FORM 2823. JUL 72, IS OBSOLETE
C 0 3 2 6 3
DOD 006892
STATEMENT OF TAKEN AT DATED
9. STATEMENT (Continue
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AFFIDAVIT
, HAVE READ OR HAVE HAD READ TOME THIS STATEMENT
WHICH BEGINS ON P D ENDS ©N 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 QF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS
STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD -, WITHOUT THREAT OF PUNISHMENT, ANI1WITOOUT CO .OR UNLAWFUL INDUCEMENT.
Subscribed and sworn to before me, a person authorized by law toWITNESSES:
d,
administer oaths, this OkID day of /1 at
so ra fu-z. z
rson Administering Oath)
(Typed Nime if Period Administering Oath)
ATION OR ADDRESS /Authority To Administer Oaths)
INITIALS OF PERSON MAKING STATEMENT
PAGE OF PAGES
USAPA V IMO
PAGE 3, DA FORM 2823, DEC 1908
008264
DOD 006893