CIA Copy: Coalition Provisional Authority Forces Apprehension Form

C05950960
(6PPROVED FOR RELEASE DATE: 06-Sep-2013 I
0 COALITION PROVISIONAL AUTHORITY FORCES APPREHENSION FORM
YELLOW FIELDS MUST BE FILLED IN, IF APPLICABLE, UPON APPREHENSION 0
i Oolfense against Civillan(s) [check one) If "Other" then describe: ______________________
c:JArson (I.P.C. 342) r::JBurglary or Housebreaking (J.P. C. 428)
c:JSollcltation of Fornication/Prostitution (J.P.C. 399) r::::Jextortion/Communicatlng Threats (I.P.C. 430)
c::JRape/lndecent/Sexual Assaults/Acts (I.P.C. 393-98, 402) c:JThefl (I.P.C. 439)
c:JMurder (I.P.C. 405) CJ'Destruction of Property (LP.C. 477)
c::J.Aggravated Assault/Assault With Intent To KVI (I.P.C. 410) c:JObslructing a Publ!e Highw ay/Piace (tP.C. 487)
c:::JMaiming (lP.C. 412) CJDischarging Fi_rearml Explosive In City/Tow niV~Iage (I.P.C. 495)
c:JSimple Assaun (LP.C. 415) CJRIOt or Breach of Peace (I.P.C. 495(3))
c:JKidnapping (I.P. Dolfense against Coalition Forces [check one) If "Other" then describe: _____________________
c:JViolatlon of Curfew c:Jrrespass on-Military lnslaH~tion or Facirrty
c::JUiegaJ Possession of Weapon c::JPhotographing/Sur.velliing MlUtary lns~allation or Facilily
CJAssault/Attack on coalition Forces c:JObstrueting Performance of Military Mission
c:Jrheft of Coalition Force Property c:JOther
Apprehending Unit: I Location Grid:
Date of Incident: (0/M/Y) ·rime of Incident:
his I Date of Report: (0/M/Y) ITime of Repor.t:
I I to I I hrs to I I hrs
Detainee # ---.:...----------~-------~-- Key Co~nected Person: . Dvictim Dwitness
Last Name: Last Name:
First Name: Given Name: First Name.: Given Name:
Hair Color: Scars/Tattoos/Deformities: Hair Color: S c ars/Tattoos/Oeform ities:
Eye-Color: Weight: lb !Height: in Eye-Color: Weight: lb JHeight: In
Address: Address:
Place of Birth: Place of Birth:
Ethn/Tribe/ Sex: Phone#: Ethn/Tribe/ Sex: Phone#:
Sect: DM DOB DIMlY: 0Moblle Sect:
OM DOB D/M/Y: DMobile
OF 0Regular OF 0Regular
0Passport Ocr. license Oolher (specify) 0Passport Oor. lic_~nse L Other (specify)
Document#: . Document#: I Total Number of Persons Involved -- (hst names/tdenltfytng mfo on reverse under .A ddttlonal Helpful Information ' ) I
Ovehicle Information Vehicle Number _____ of __ Vehlcle(s) Owner:
Make: Color: IV IN:
Model: Type: !Plate No.: !Number of-People in Vehicle:
Year: Names of People in Vehicle:
Contraband/Weapons in Vehicle:
0Property/Contiaband Ow.eapon I Photo Taken of Suspect with W eap.on/Contraband: Yes/ No
Type: !Model: Color/Caliber:
Serial No.: louanlity: !Make: Receipt Provided to Owner: Yes/ No
Other Details: IW h"ereFound: Owner:
Name of Assisting Interpreter: Email. Phone, or Contact Info:
Detaining Soldier's Name Supervising Officer's
-{Print\: Name IPrintl:
last, First M I last, First Ml
Signature: Signature:
f Email: Email:
Unit Phone: Dale: I I Unit Phone: Date: I I
C0,5950960
!APPROVED FOR RELEASE DATE: 06-Sep-2013 I
COALITION PROVISIONAL AUTHORITY FORCES APPREHENSION FORM
Who was with this person?
What other information did you get from this person?------------~-----
Additional Helpful Information: ------------------------