Sworn statement of a soldier who witnessed a Captain hit detainees on two occasions... 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
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Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
To provide commanders and law enforcement officials with means by which information may be accurately identified.
AUTHORITY:
PRINCIPAL PURPOSE
-Your social security number is used as an additionallalternate means of identification to facilitate filing and retrieval.
ROUTINE USES:
DISCLOSURE: Disclosure of your social security number is voluntary.
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10. EXHIBIT ' 11. INITIALS OF PE ATEMENT \ PAGE 1 OF OK PAGES
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AKEN AT DATED ,-: 1 i CI f0 7/ - jADDITIONAL PAGES MUST CONTAIN THE HEAVING "STATEMEN F THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
_ USAPA 111.00
DA FORM 2823, JUL 72, IS OBSOLETE
DA FORM 2823, DEC 1998
C 08235
DOD 006867
.1
STATEMENT OF TAKEN AT i" di' 1) I.' .! DATED 1` / acv 1
9. STATEMENT (Continue
AFFIDAVIT
,HAVE READ OR HAVE HAD;READ TO ME THIS STATEMENT WHICH BEGINS' 0 PAGE I, AND'ENDS'ONTADe . I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THEHDTTOMIlf EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS
STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD', WITHOUT THREAT OF fUNISHMENTir'AND*ITHOOttOEOCION4IRXWil.H10LUEHOL.DRUNLAWFUL INDUCEMENT.
Subscribed and sworn to before me, a person authorized by law to
WITNESSES:
administer oaths, this t 1 day of
at
WO Admrnisterng Vaibl
aluieof
TrY110100.Of gaol? mos ermg
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ZAftbff OFI ADDRESS (Authority To AdmingtOr Oaths/
INITIALS OF PERSON MAKING STATEMENT PAGE PAGES
USAPA V1.00
PAGE 3, DA. FORM 2823, DEC 1998
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