CID Report: 0164-04-CID259-80220

<p>Investigation into report by the senior Counterintelligence Technician, 1st Brigade Combat Team, enclosing sworn statements of two detainees concerning abuse by members of the 2nd Squadron, 5th Cavalry. The detainees' sworn statements are not included in the released portion of the file; nor is any other information detailing the allegations. Based on the questions asked to the members of the 2nd Squadron in the investigation, the detainees alleged that they were struck, thrown on the ground, and had a pistol pointed at them during their detention. Major [REDACTED] from the 2-5th had previously conducted a 15-6 Investigation (also not released) and concluded that no evidence existed to support the allegations; however, the Counterintelligence Technician who reported the abuse to CID also reported that his soldiers believed the Major was &quot;just going through the motion[s]&quot; and &quot;seemed disinterested in what [the soldiers] had to provide.&quot; Nevertheless, the CID investigation appears to have largely relied on that 15-6 investigation, and concluded that the allegations were unfounded.</p>

Doc_type: 
Investigative File
Doc_date: 
Tuesday, August 3, 2004
Doc_rel_date: 
Wednesday, December 29, 2004
Doc_text: 

DEPARTMENT OF THE ARMY UNITED STATES ARMY CRIMINAL INVESTIGATION COMMAND 3Ri MILITARY POLICE GROUP (CID) 7e MILITARY POLICE DETACHMENT (CID) (FWD) BAGHDAD, IZ APO AE 09342 CIMPR-FR 3 Aug 04 MEMORANDUM FOR SEE DISTRIBUTION SUBJECT: CID REPORT OF INVESTIGATION — FINAL (C)/SSI —0164-04-C1D259-80220— /5C1A/5C2/5Y2EI6X-1 S-46 m3 DATES/TIMES/LOCATIONS OF OCCURRENCES: 1. 2 JUN 2004/0515 — 2 JUN 2004/0618 HRS; UNKNOWN HOLDING AREA, BAGHDAD, 1Z DATE/TIME REPORTED: 14 Jun 2004, 1745 HRS 104C —1 11111111•111 SA.MIIMEMINNIIIM111110; SA GINNIIIMIIIIINIMMIP SA INVESTIGATED BY: SA qC 1" i°4;. 1111.1.111.11111171.1"1"li-rD14 111=1¦11111111111144C-I 106-1 1 ba- 106 SUBJECT: 1. (UNKNOWN); (NFI); [AGGRAVATED ASSAULT (UNFOUNDED)] [SIMPLE ASSAULT (UNFOUNDED)] [CRUELTY AND MALTREATMENT (UNFOUNDED)] [CONSPIRACY (UNFOUNDED)] 2. (UNKNOWN); (NFl); [AGGRAVATED ASSAULT (UNFOUNDED)] [SIMPLE ASSAULT (UNFOUNDED)] [CRUELTY AND MALTREATMENT (UNFOUNDED)] [CONSPIRACY (UNFOUNDED)] 3. (UNKNOWN); (NFl); [AGGRAVATED ASSAULT (UNFOUNDED)] [SIMPLE ASSAULT (UNFOUNDED)] [CRUELTY AND MALTREATMENT (UNFOUNDED)] [CONSPIRACY (UNFOUNDED)] be-N-ki.9- IZ; IZ; (NFI); [FALSE OFFICIAL STATEMENT] Ob-5- 5. [FALSE OFFICIAL STATEMENT]. 6-4c -4 5. VICTIM: 1 . iz; IZ; (NFI); [AGGRAVATED ASSAULT (UNFOUNDED)] [SIMPLE ASSAULT (UNFOUNDED)] [CRUELTY AND MALTREATMENT (UNFOUNDED)] [CONSPIRACY (UNFOUNDED)] FOR OFFICIAL USE ONLY LAW ENFORCEMENT SENSITIVE lo b 0164-04-C1D259-80220 2. 11 11/11.11111=111111111111111111111111111.11/1111111111111111111W(NF1) [SIMPLE ASSAULT (UNFOUNDED)] [CRUELTY AND MALTREATMENT (UNFOUNDED)] [CONSPIRACY (UNFOUNDED)] 3. U.S. GOVERNMENT (A COMPANY, 312TH MILITARY INTELLIGENCE BATTALION, CAMP CUERVO, 1Z); [FALSE OFFICIAL STATEMENT] INVESTIGATIVE SUMMARY: 1.2__3_,trip_a__, On 14 Jun 04, this office was notified by CW2 Operational Management -14 1 6c„_ti Team (OMT) 26, 1 5' Brigade Combat Team, fronhorse Base, Iraq, that Mr. and Mr. alleged they were abused after they were detained by U.S. Forces. Investigation established the offenses of Aggravated Assault, s ault, Cruelty and M' lilt, and Conspiracy did not occur as a le d r. r1111.404'016-1/ . The medical examinations of Mr, and Mr, disclosed no injuries consistent with their allegations. All interviews of the personnel present at th i r,1 facility during the timeframe of the incident disclosed the offenses alleged by Mr. and Mr. did not occur. . t - alkeitiit' loc-5,(06 -b F y ' eltigation established probable cause to believe Mr. and Mr. J committed the offense of False Official Statement when they provided statements to A Company, 312° Military Intelligence Battalion, Camp Cuervo, IZ, which they knew to be false. STATUTES: Article 128, UCMJ: Simple Assault (Unfounded) Article 128, UCMJ: Aggravated Assault (Unfounded) Article 93, UCMJ: Cruelty and Maltreatment (Unfounded) Article 81, UCMJ: Conspiracy (Unfounded) 18 USC 1001: Statements or Entities EXHIBITS/SUBSTANTIATION: Attached: 1. Agent's Investigation Report (AIR) 28 Ju ate. g the receipt of the initial complaint; interviews of 1 LT co dination with MAJ RCPT CPT mop and C a nd review of AR 15-6 investigation. rc4c366-5 Ol-riP4-11(a1C-3 lorie3 b6-1.1 2. Waiver Certificate and Swot silt of 1LTAltii.. 16 jui 04, wherein he denied the allegations made by Mr. -land Mr. and further stated he never witnessed any abuse against any detainee by U.S. Forces. ax.4 3. AR 15-6 investigation, 9 Jun 04, which disclosed no evidence of any abuse or maltreatment, directed against Mr. or Mr. 4,0 11111e1MIIIMIIP ir44- 4-1, (Di -9 Not Attached: Retained in the files of 1 5' Brigade Combat Team, Camp Cuervo, 1Z: y 4. Summary Interrogation Reports of Mr. and Mr. ti FOR OFFICIAL USE ONLY LAW ENFORCEMENT SENSITIVE 0164-04-010259-80220 The originals of Exhibits 1 and 2 are forwarded with USACRC copy of this report. The original of Exhibit 3 is maintained in the files of the Office of the Staff Judge Advocate, 1 5F Cavalry Division, Camp Victory, IL STATUS: This is a Final Report. Commander's Report of Disciplinary Action Taken is not required. Report Prepared By: Report Approved By: [ ;C-I 1 196 -1 (901- Special Agent, Special Agent in Char Distribution: 1-DIR, USACRC, 6010, 6° Street, Fort Belvoir, VA 22060-5506 (original) 1-Thru: CDR, 22nd MP BN (CID), APO AE 09342 Thru: CDR, 3 rd MP Group (CID) To: CDR, USACIDC, ATTN: CIOP-ZA, Fort Belvoir, VA 22060 1-USACIDC, ATTN: Ms.1110111119 1e mail only) 4c 4 1-PMO, MNF-I (e-mail only) 1,-ft 1-CID LNO, MNF-1, APO AE 09335 (e-mail only) bic•3 g 6a 1-Office of the Staff Judge Advocate, III Corps, ATTN: (email only) 1-File . 3 FOR OFFICIAL USE ONLY LAW ENFORCEMENT SENSITIVE DOD-DOACID0011 85 _ AGENT'S INVESTIGATION REPORT 0164-04-C1D259-80220 CID Regulation 195-1_Page 1 of 2 ‘21-C-3,1a03 INVESTIGATION: About 1745, 15 Jun 04, this office was notified by Operation t Team (0MT)ii a Ironhorse Base, Iraq, that Mr. and Mr. alleged they were abused after they were detained by U.S. Forces. c-i9E7-{/ mmoingiiiimmimp About 1415, 16 Jul 04, SA advised 1LT ,A Company, 2nd Squadron, 5 th Cavalry Regiment, Fort Hood, TX (deployed to Iraq), of his legal rights, which he waived, and provided a sworn statement wherein he denied the allegations made by Mr. 1111111.1111111 of Mr. (See Waiver Certificate and Sworn Statement for to7c-41,04-4 details) 104-1111644", c.--3 blip '3 About 1510, 16 Jul 04, Slow* Interviewed A Company, 2nd Squadron egimentalficiiiX (deployed to Iraq), who stated he did not remember Mr. and Mr. in particular; however, he stated he never witnessed or otherwise gained knowledge that anyone committed any of the allegations made by Mr..1111111Pand Mr. 1111M111111Mhfc'itb‘9•41 About 1530, 16 Jul 04, SA IIiiiiifcoordinated with MAJ 11 ¦411111111M Operations Officer, l' Battalion, 12 th Cavalry Regiment, Camp War Eagle, I w s ted he was appointed e Officer for the allegations made by Mr. d Mr.111111167c"01"1" MAJ stated his investigation disclosed no evidence existed to support the ta 1-c -N Alt.-3 allegations. /1^6 1,13 foL -1 About 1600, 16 Jul 04, SA I coordinated with CPTIMMINIMINIP, Office of the Staff Judge Advocate, 1 51 Cavalry Division, who stated the legal review of the investigation conducted by MAJ supported his findings. k4c-3( -3 414-31 461;00, 26 Jul 04, this office received a copy of the investigation conducted by MAJ A review of the investigation disclosed the interviews of the personnel involved did not support the allegations made by Mr. 11111111.1.11. and Mr. SINIM11.11111.. (See 15-6 lo vo-f Investigation for details) iqc. -4,W0'44 , AGENT'S COMMENT: Due to the classification level of the Summary Interrogation Reports of Mr. jirlialland Mr. i4 gil,r1112 itthey were not included with the 15-6 Investigation. -6.Office of the Staff Jiiiiig.lcate, Corps, Camp Victory, IZ, on all aspects of this investigation. CPT opined sufficient evidence was present to establish the offenses of Assault, Aggravated Assault, Cruelty and Maltreatment, and Conspiracy did not occur as alleged. CPT further opined probable cause existed to believe Mr. and Mr.." laric.'at 4°6.5 '14;kfrq koc-iibb-Y About 1300, 28 Jul 04, SAliatlibriefed CPT 11111/111¦111111t Chief of Criminal Law, SA1 78th MP Detachment (Forward) (CID) Special Agent,_w1Baghdad, Iraq APO AE 09342 Signature Date: Exhibit: 28 JUL 04 CID Form 94 FOR OFFICIAL USE ONLY AGENT'S INVESTIGATION REPORT_0164-04-C10259-80220 CID Regulation 195-1_Page 2 of 2 141committed the offense of False Official Statement when they provided statements which they knew to be false.///LAST ENTRY/ll (c6-1 Cool SA_78 MP Detachment (Forward) (CID) Special Age t_Baghdad, Iraq APO AE 09342 Signature Date: Exhibit: 28 JUL 04 CID Form FOR OFFICIAL USE ONLY RIGHTS NN'ARNING PROCEDURE/WAIVER CERTII, ICATE For use of this form. see AR 190-30. the pr000nent agency is ODCSOPS DATA REQUIRED BY THE PRIVACY ACT AUTHORITY: Title 10, United States Code, Section 3012(g) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES: Your Social Security Number is used as an additional/alternate mtans of identification to facilitate filing and retrieval. DISCLOSURE: Disclosure of your Social Security Number is voluntary. 144440101°4.4 ip 1. OCATION 1 _ DATE 3 TIME 4_ FILE NO. 1 ttIDUL.-0 / 0 ,S 5_ NAME .S/Av. Fir I,Ct/ leM))1 -12140 -1.x-44 196-4 lti ORGANIZATION OR ADDRESS c.,...ca. 1 /STATUS -215- G. S N 7. GRADE 10,143o fra ,) 0.z-,4-r A-.liccce; rYor ", ) PART I - RIGHTS WAIVER/NON-WAIVER CERTIFICATE.of Section A. Rights The investigator whose name appears below told ine that he/she is with the United States Army Criminal Investigation Command (CID) and wanted to question me about the fon/ ng oftense(s) of which I am as a Special Agent . —suspected/ A-oda.,,fecif Ar,:fa.,,ri P.-Lip/ 0(2, al,,,ciplat iittlitAptrz (two e,(6,11 Before he/slrginni me an uestions about the offense(1), however he/she made it clear to me thari have th followag r guns: I I du not have to answer any questions or say anything. 2. Anything ! say or do can be used as evidence against me in a criminal trial, 3. t Fur personnel sub.( ea lo the UCMJ) 1 have the right to talk privately to a lawyer before, during, and after questioning and to have a lawyer present with me during questioning. This lawyer can be a civilian lawyer 1 arrange for at no expense to the Government or a military lawyer detailed for me at no expense to me, or both -Or •., (FOI'Civiii011.5 no, sobjecr lo the ()ow) I have the right to talk privately to a lawyer before, during, and after questioning and to have a lawyer present with me during questioning 1 understand that this lawyer can be one that l arrange for at my own expense, or if 1 cannot afford a lawyer and want one, a lawyer will be appointed for me before any questioning begins- l sin now will i ng to discuss the ortensets) under investigation, with or without a lawyer present, I have a right to stop answering questions at any time, or speak4- if privately with a lawyer before answering fur -titer, even if I sign the waiver below. 5. COMMENTS (Continue on reverse side) Section R. Wain er P I understand ray rights as stated above. lam now ing to discuss the offenses) under investigation and make a statement without talking to a lawyer first and without having a lawyer present with me_ loc-.4 pkG-ef WITNESSES (If available) 3. SIGNATURE OF IN1t.1¦._ 0 16 1-c -9, 6 N Is.NAME (Type or Awl() b ORGANIZATION OR ADDRESS AND PH )0/C -. I k kiz' —) 2a. NAME f Type or PrOpt) 5. -Valiii/MialPitiniUMV1'1OR SA Iii-C-Itt*-1 b. ORGANIZATION OR ADDRESS AND PHONE C. ORGANIZATION OF INVESTIGATOR 75th Military Police Detachment (CID) Baghdad, 1Z Sectiot1 C. hkiii-Weiver I ..I do not want to give op my rights. ¦1I want a lawyer. IN I do not warn to be questioned or say anything. 2 SIGNATURE OF INTERVIEWEE ATTACH THIS WAIVER CERTIFICATE TO ANY SWORN STATEMENT (DA arm 2823) SUBSEQUENTLY EXECUTED BY THE SUSPECT/ACCUSED 1R.R1 NOV R0 r' • rt LAW ENFORCEMENT SENSITNE t..L3) IT DOD-DOAC1D001188 PART Ii - RIGHTS WARNING PROCEDURE THE WARMING I 'iVARN1NG - Inform the suspect/accused of, u Your official position b. Nature of offensetse c The taut that heiehe is a suspecilaccused. 2. RIGHTS - Advise the suspect:accused of his/her rights as follows. "Before I ask you any questions, you must understand your nghts." z. "You do not have to answer my questions or say anything." h "Anything you say or do can be used as evidence against you in a criminal trial " c (For personnel subject to the UCM.1)"You have the right to talk privately to a lawyer before, during, and after questioning and to have a lawyer present with you during questioning. This lawyer "Do you understand your rights?" (If the suspect/accused says "no." determine what is not understood, and if necessary repeat the appropriate sights advisement. If the suspect/accused says "yes. -ask the following question.) "Have you ever requested a lawyer after being read your rights?" (lithe suspect/accused says "yes." find out when and where. If the request was recent (i.e. fewer than 30 days ago), obtain legal advise on whether 19 continue the interrogation. If the suspect/accused says "no," or if the prior request was not recent, ask him/her the following question.) can be a.civilian you arrange for at no expense to the Government or a military lawyer detailed for you at no expense to you, or both." (For civilians not subject to :he LICM7) You have the right to talk privately to a lawyer before, during, and after questioning and to have a lawYei present with you during questioning. This lawyer can be one you arrange for at you own expense, or if you cannot afford a lawyer and want one, a lawyer will be appointed for you before any questioning begins." rl, "If you are now willing to discuss the offense(s) under investigation, with or without a lawyer present, you have a nett to Stop answering questions at any time, or speak privately with a lawyer before answering further, even if you sign a wa iver Certificate. - Make certain the suspect/accused fully understands his/her rights THE W AIVER "Do you want a lawyer at this time?" (If the suspect/accused says "yes," stop the questioning until he/she has a lawyer. If the suspect/accused says "no," ask him/her the following question.) "At this time, are you willing to discuss the offense(s) under investigation and make a statement without talking to a lawyer and without having a lawyer present with you'?" (If the suspect/accused says "no." stop the inierviev, and have hint/her rend and sign the non-waiver section of the waiver certificate on the other side of this form. if the suspect/accused says "yes." have him/her read and sign the waiver section of ate waiver certificate on the other side of this form.) . SPECIAL INSTRUCTIONS WHEN THE SUSPECT/ACCUSED REFUSES TO SIGN THE WAIVER CERTIFICATE. If the suspecliaccused orally waives his/her rights but refuses to sign the waiver certificate, you may proceed with the questioning, Make on the waiver ceriilicate to the effect that he/she has stated that lie/she understands blither rights, dues not want a lawyer, wants to discuss the offense(s) under investigation. and refuses to sign the waiver certificate. IF WAIVER CERTIFICATE CANNOT BE COMPLETED IMMEDIATELY: In all eases the waiver certificate must be completed as soon as possible. Every effort should be made to complete the waiver certificate before any questioning begins lithe waiver certificate cannot be completed at once, as in the case of street interrogations, completion may be temporarily postponed. Notes should be kept on the circumstances. PRIOR INCRIMINATING STATEMENTS: I. If the suspect/accused has made spontaneous incriminating statements before being properly advised of his/her rights he/she should be told that such statements do not obligate him/her to answer further questions CINVINIFNTS REVERSE OF DA FORM Mt 871/02685 2. If the suspect/accused was questioned as such either without being advised of his/her rights or some question exists as to the propriety of the first statement, the accused must be so advised. The office of the serving Staff Judge Advocate should be contacted for assistance in drafting the proper rights advisal, NOTE: If I or 2 applies, the fact that the suspect/accused was advised accordingly should be noted in the comment section on the waiver certificate and initialed by the suspect/accused WHEN SUSPECT/ACCUSE . DISPLAYS INDECISION ON EXERCISING HIS OR HER RIGHTS DURING THE INTERROGATION PROCESS. If during the interrogation, the-suspect displays indecision about requesting counsel example, "Maybe I should get a lawyer."), further questioning must cease immediately. At that point, you may question the suspect/accused only concerning whether he or she desires to waive counsel. The questioning may not be utilized to discourage a -uspecuraccused from exercising his/her rights. (For example, do not make such comments as "If you didn'l do anything wrong, you shouldn't need an attorney.)" •U.S. Government Printing Office, 1990-261- r-- DOD-DOACID001189 SWORN STATEMENT For use of this form, see AR 190-45; the proponent agency s ffic o ior' spett4I'lf tpp. for Personnel. DATE TIME ell FILE NUMBER LOCATION t,9‘ i Ct4 5"1 LAST NAME, FIRPNAME, MIDDLE NAME 6 c.,,i kff,,-1.4 SOCIAL SECURITY NUMBER GRADE/STATUS la-34-44 Vr"4 OZ /14f) cm6i 0 iettewL,.rkap/of,A0_4,„,6) , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH: de ii,c_ck A-he.c) r .srici-orop FAA. LE--6,.e.i-at , e -.c,3e...re.Lc p t re., r- e.-(--e.q,--,rk e 171;.A our (k `1..er ruait:cQ H f-'01. •• - Co-e-c[e oc, +5 "--) A 1?'. r-‘ -12 cr--r-le d). P-k-r-),,ic.• P*•-• 4-14-4 e I e,e-.3 111111/176441141.-li 0,3 er. c :1-,o-1-1-1_.iper . Wu-st4.oc-1,66-1 67e--q, b6.4 ivkAeoitYoyEl-rcri ra-f-.A,o3 cAV-o,Aiss CAI A dv _ pr.N.e, 4-.1-;. tact 1691,).euvette L4+ dal,/;' 4:4-awe 64111,649 47) s 7 pr.No a-Dia 0 Oh ice CA, piaoC.. .5ied.614a,-ett-.tee? Pr:.N5 D.01:-"ScauCe cp(orLe.c62-1-'aicfec -­/1-7 +.3 LJ Cie4g. -kees.ir&.pitzpiltr Hz icc.fe.s 0„.4 )01.: ,,a--Q,Acs­622 tueg_ -\iaz _,6,40:oitee5 ,seiti-exeo34-04,Aief7 1/4-:.I so%-9 4%. S 511-q^d-+1,e. 5 c-n u ,N4-Q iji2Vd2. 44,(rge &V (Pali's -4/ 4i .1134,Aiegs -40 sed fo,-, 4.ao0, e iat,0 e.: cie. ee EXHIBIT INITIALS OF PERSON MAKING STATEMENT 10G -ii IE. LORe' q f 640-Li PACT1 OF •-101M.IFAGF.S. 1.ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OFoTAKEN A T DATED oCONTINUED." THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND BE I INITIALED AS "PAGEoOF PAGES." WHEN ADDITIONAL PAGES ARE UTILIZED, THE BACK OF PAGE 1 WILL BE LINED OUT, AND THE STATEMENT WILL BE CONCLO II IQN THE REVERSE SIDE OF ANOTHER COP .... A, pr II .1 gE F1. St) E 1)A rir4lUt '!CH WILL BE US A XII. DA FORM 2823. it 1- 1 JUL 72. LAW ENFORCEMENT SENSITIVE, DOD-DOACID001190 FILE NUMBER: /94 &.""ff“'"I', b 1C bictilbtTATEMENT OF/0-TAKEN AT6m, 411: 1/559 47 DATEDI MULX-4 CONTNUEDOW .V TAti dataike 4'0 tar (WELD 7 Y -k4tdr & r) .ilkile,00y4/.61.4 3.(),-1 1IA.42)..Y2(1) Nt) coide At ictitil44L, 6'034, 14? kiitd 0-41c,c ottia. Cca rvi _ fi gi4x is 4( e4/ Gt Co4o LJ 60iarkeer A-=.to 0 Afrwee 4: 410 bIc.e 106-`( fr' No pcci pcitQt?. r1ofrale 4A-e6,,a7o43 4fikiK efatamee,o-. 14= Loci yfiv Apooeativek,haitAt -)e)ofidotw-/ suint_ • ,11-4fic/j2.s it" O be-va-o8;1r5 io&-q INITIALS OF PERSON MAKING STATEMENT: PAGE 1111111WOFFICIAL USE ONLY LAW ENFORCEMENT SENSIMF -7C.Lmmm . 66 • c( b^c 456-4/. E.;S FILE NUMBER: * TAKEN AT l'A'" a.T.ONTINUED • --- . STATEMENT (Continued)o 10 44 66-Lio NOM (iSq 0 -..--- if) c- iio AFFIDAVIT , HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH BEGINS ON PAGE 1 AND ENDS ON PAGEIIIIIirLY 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 PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, alD WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT 61c-Y(66-1 ( rgna ure of arson Making Statement) WITNESSES. Subscribed and swo to befo r9e, a person autOrized by law to ad inisier oaths, thi a of J 16 , 20 Dr at iSrikt+ bqc-i 069-t ORGANIZATION OR ADDRESS (Signa u ng Oath) Ni-/ , 66-I (Typed Name of Person mister-gig Oath) ORGANIZATION OR ADDRESS Alrf (3 bideATo10 (Authority To Administer Oaths) INITIALS OF PERSON MAKING STATEMENT PAGE 3.OF.PAGES FOR OFFICIAL USE (`-' LAW ENFORCEMENT f'r" EXHIBIT # Page(s) • • Referred to: U.S. CENTRAL COMMAND 7115 SOUTH BOUNDARY BLVD ATTN: CCM-DM MACDILL AIR FORCE BASE FLORIDA 33621-5101 - MS. JACQUELINE SCOTT scoL (CtA„ e...11 CC. Uri .I (813) 27- 5341/2830 J. 1 N l' ..V 1 A • _JI A. 'A A A • ALA1A 1."-L11 1 Ult4-u4-C10295-50220 DATE OFFENSE VICTIM/ .4 cm,-c{ ASSIGNED TO: 14 Jun 04 Aggravated Assault Mr UMW CAL -1 1 (04, -( -i DATE1DATE PLANNED ACTIVITY COMPLETED NOTED 14 Jun 04 Locate, fully identify, and interview Mr 11111111111111.10 IA4 -Li chc, -if 14 Jun 04 Locate, fully identify, and interview Mrd b-tc-4 ( 196 -4 14 Jun 04 Coordinate with Titan regarding CAT 1 linguists at Camp Eagle 14 Jun 04 Determine what linguists were involved with the capture of 111¦11111. 1,17x--ci :frheei 14 Jun 04 Locate, fully ID, and interview SGT MINI. 1.4.)Ati*--144 (te,t2to-'1E;r1).1r..,„ kric-349t, -a 14 Jun 04 Locate, fully ID, and interview SPC 41¦1111110010(A CO, 2/5 CAV) i \ ta4C -3 4196-3 14 Jun 04 Locate, fully ID, and interview SOT 1.1111M1111111111111.A CO, 2/5 CAV) ) 431.4.-5 (k.-3 14 Jun 04 Locate, fully ID, and interview LT WNW Lu,kve4-ort f(rAlai) 4c.44 Az. 4 ,­ 14 Jun 04 IntervieANIEWF1), Medical NCO1C, BHA, Camp Cuervo1C-3, 0-3 14 Jun 04 Locate, fully ID, and interview SPC IMIIIIIIMMII, 1BC7, BHA 4344 -1 ilot• --3 19 Jun 04 Locate, fully I ID, and interview CPT MIIMMI111111111. (HI-1C, 2/5 -V) lo 4.-c-,i5e.-3 r . . MISCELLANEOUS ACTIVITY ACTION COMPLETED ACTION COMPLETED INITIAL CIC REVIEW FINAL EVIDENCE REVIEW . INITIAL SRC/ REVIEW FINAL CIC REVIEW FINAL SRO REVIEW CONTACTS/PHONE NUMBERS INVESTIGATIVE STANDARDS ACTIVITY/PERSON PHONE NUMBER VICTIMS INTERVIEWED124 hours CW2 CI, IBCT oNVT531411111MIIP EYE WITNESSES 24 hours lo3.(bb -3 INTERVIEWED t C.1/G:-ab EVIDENCE DEPOSITED 1 duty day sAb--5 LAB REQUESTS 5 duty clays RFA'S SENT OUT 5 duty days MEANINGFUL NV ACTIVITY.10 duty days RFA FOLLOW UP.15 duty days KNOWN SUFI; FINALS.15 duty days UNFOUNDED FINALS.15 duty days _ - UNKNOWN SUBJ FINALS 30 cal days ACTION TAKEN. 30 cal days CID FORM 66 I. DATE 2. TIME RECEIVED 7. CASE NUMBER 1745 14 Jun 04 0164-04-CID259-507 20 3. OFFENSE 8. ASSIGNED TO Aggravated Assault / Assault/Cruelty and Maltreatment/Conspiracy 194c --tom, t 4. SUBJECT 9. TYPE OF ACTION GC Unknown - 5. VICTIM. 101C-1i ibi -411.14-4 1106-4 10. Mr INIIIIIIMIIIIIIIIIpand Mr .11111.11111.111.0M111.1111 REPORTS TYPE SUSPENSE COMP 6. CATIL1A4capl'ION I N Ipq ,-------15:30/0 Mr and Mr Illiiraiaigillalleged they were abused c-AQ— 1O ::f UAB 3[) :71—UA) after capture by U.S. Forces. . SAS P-41-1.X.. it4304-5-AC ..2­ c4131)/--Jube 11.oOTHER ACTION 12.1CID FUNDS nA) 12 At .) ACTION RQRD COMPL DATE AMOUNT 7.6 xorr oilmic.... .29 3..,,, L'ff.-' , 7FSIke_ — IA A0009 F ¦. U2 ^caS . (CID Regulation 185-1) 0 164-04-c1n259-60220 TIME, DATE, AND AGENT' SUMMARY OF INVESTIGATIVE ACTT/VITT 1745, 14 Jun 04 MOMMINOIMMP bqc-(1(c4 -i BASIS FOR office was Management Ironhor Mr after they INVESTIGATION: About notified by CW2 Team (OMT) 26, 1 st Briga Iraq, that Mr alleged they were detained by U.S. Forces. Jun 04, this Operational Team, and were abused Assembled case file. Drafted Initial Report. To SAC for Review. 5-4211.-ew;. 15 .-u ro1,„p. 6,i)(0 P 5//) *7 -521 ' 9,Armv1501c. fiv;40 . x,441,1 MP aef A LIA" itrAtal ÷/u.itkp .affel A.ta tco rtCelphi t4144% g Girt eCYCIV Mins wn tbkuoti$ uP00 2qUuM Cef-444. 461, cm p,"4 ANIapoxtv Ntalks iv 0NA% 40 CAIT Cig.00 -766-1 4 44) 144 etAlainj.k 4ttlf Ae 1.411A.S 1*M/ar ani WOO " e -4 h eir •6/$1 ea" VCIOPI gres.f71 ea/2 CM/VI °- 6644Tellet LoirLdoiT4 1,44044 0,1,101 6-61e Ai /WI 1-0.40dais . 1,64i.CiedoaiS troJk-e5 o4htt6"0-14tEdi L,21001 ho pc1 f1 :1 61"1" &i'°' ut0s74,Ztg4 CU ea. PO CatriV 04.16? 041 q/uteOzi. 11,4.10 gfiabons. (gm av1 otisiximpige( Ate were CQoV. ab Le- °Art, 644A eeA se4ortin -RAL-a/oka-se kur Are Ao. /40046,4 0416. 44 Lzitu.-64-.h •frimf, . 6fgoi 400, vat, N4011,4 Mx.. writ 04-alf,. Jrag Cfrr.. 1 m. 's/ 5A-c_ Po/ (u :1 5Ac-. -in thiyta.l II -N. (105./‘ s 66-0 ' gelfah) te5164 1.-Thizok (12xP.a , 0())-1A-1A vri Act (.4 AA5 en M. 601/4-(11\rt Ari-s NtAg Rrglivp Gsot-t„,. e4.0771'ill";,7h r ,- . cID FORM 28 PREVIOUS EDIT/ONS OF THIS FORM WILL BE USED UNTIL EXHAUSTED 1 Oct 80 CONTROL NUMBER (CII) Regulation 195-1) oitaq-.czo. TIME, DATE, AND AGENT go22,0 SUMMARY OF INVESTIGATIVE ACITIVITY 36-3.),04 fa 54c eevi,LJ: •-ca /. /../0(41". Z. it):// t,ph-fe r(lar­ 3 . tiufr I. `4. cu' (/ A ... ,3(6‘-3 d')w / Croickta. Mir TTM Ctlx`'`v:t)1. 6rizer, Zew gVd-„41Z z.7 LAc.­ o9,,tra 42 hill a F Ceffou- 3-Y 4-0-5 Al u,h /-a-,44:;e7 a ?4 ,1-Ac4(0-fo(v -/d +Li II cJild kr/ /lave a e67 5.5oCarie it/z(17Xf Mei Atir j 5`,46,61C/heo '14AJ 1,40 , 304-04 74, - CieedIku1vd tul Set'. w' be-rozb) c-ceicscoLvew7 ce,14 6. ,5,---444o11111111F Ca4ctid Ci..10-11/0o•3 jut-ads fob-i ti56l 7 ,11-04/ 4t) ecofi&eate.fisayz;t v ,S,1-1207 )44-164.,p ,fr_rj 1 o -1 -.wp-ectAie Avg, yzeaa/Yeetrf ,2•0 60,6c4zr--A3g-L-c-1 11111111r 43.74 -1f 66-( VA.) f&.• 73uz-0-Eve,f/dive,e,e (wdol(ger,1o54-1111Y1,r/.1,,iwoOs I'L;607-406-2 Caxy aeo.10 c00--Facjo 04-1,0G-) 70L-0' na,Pd U Sc-1 4`, C-15 "ab acp5e/ coo , 7,),i&or-L o v o 6,31A-04oA 0SOI 6. 6-K-1006 / sjuz. ocb idiveil I.) 88 x . Die Teo pt)4,7_ .1,11)4"61a6tf/7/ OM". OCO dtam /0 ppo12­ wirr IR! 4741)10 YjuL cr( kio-kf;v1 wzi1111.1..1:16 ite 4.,071/47‘17040-fil-40e4 Viiirrb4 (1 106-/ uc_oq-alho,-ted wi 54 •.376 4' op.Aiwa cop,-0 C"r UGL,'o0") 12-0,oLidz_ ez,1oepotezoi e.,7A 11111111, 64.C.-( / ‘4,-/ k-:76 116,11r$ •-t ,zi;e4 dp,c4foimuiwo44-, sditia,viel11 A, (t, luLock SChe(itAtti COINVO6-kt CPA 0641LiA V4d) 11117141011 re54/G6g I..'A 5 • 437, 4. _s e „m elt Scivkauted. l(plutoi4 ttYloo. 109c-lo.00.--f F1N7 D FARM 28 itc,p.• r,o„ _ . PREVIOUS EDtTO LCInlyiStIn _ l4,,E3t.3.7SED UNTIL EXHAUSTED (CID Regulation 195-11 0164-04— CID259-80220 TIME, DATE. AND AGENT SUMMARY OF INVESTIGATIVE ACITIV/TY AI( Yexiew. 9C e-e6re_tA.): cis -e-Nfrei Comefti Ao 6.9 \r3,-orci0 iuuktur:i- tojc -Litb -V 61;y_d 1L-T M11111.0, ‘pyt,( tn's 1,0 t,tu c4 iuoVol, cuaiiwv 64,1n 41r.etariLeh1 F dills 4%4 Auceed,s . (see /11-4-k/ deirol0 4141MiSSP61011• h.-Se. 01 7401,to .ed 6(str 111.111 -)he 6Cd.174-1 ‘A.I1. crAMiagItUvret. .2 e blitz 4., 04,-4). 6-4-3 16C,-3 4041).orxt-ed 6,1 CrT., -1k,tec/ 6671 liallit4'11"L"e(447 474,2.ye t/ 6_ ti4,1„slor 4t4 latur5,47/01):)r,,oea,rilopeite (IA .fir jxviiiiritd-Rd Lot 4tty, 1)1z.e,gu, 64.A iva,eay, uvw Skked.Cevduckdot. /14,_x Wkittc,(4 okkCiloWl no cifivtaigai(1,gs piteaf,3 63A, ..1-CAV , 14,4 , VICA OAlt el,. edo )A6 100oEV IA,k5 6z,tits C-kr ailliallS4-rai4sd 41 Ofoo serAao/S-:-6r 740 5.1fuer, who shzted k C fd kid iigudg gtatt ,A10.01464, 1r an -3;1,6-3 rte(. o ro cfr luotl itig 5-&-rioA; ca..gro-Citiktjo11111111.1 Lkc, 54.00 vi{o(61 b-or ofri 42,,/ teFj (A- -tt 16-to tA4kAtLi .S-r3bL ,, C . L/ o, Z./ ,P-61 Fen. Li Vi 11-11111r4.44-na,,,, _ CID FORM 28. PREVIOUS EDITIONS OF THIS FORM WILL EE USED UNTIL EXHAUSTED DOD-DOACID001198 (CID Regulation 195-1). 0164-0 4 ­ CID254-80220 TIME, DATE, AND AGENT 22-Soot'q 111111111111/ 0(2 -I 2.7,JkJLO/ !riff -1 toic-t k b6-1 2 Zu 1/4,0`f 104A- -( 1 DC.- (131-c -1 1 Zjiatic,04 1111141 104L-1 106 - I k}44-1 4(9 -..1 bqcji012~) ‘-7(Rilma`P 11.1‘07-1 ( 647 -( 1) °c2a 0 t*k 1044-t i l% -( cin FORH 29 • --- SUMMARY OF INVESTICATIVE ACIT/v1TY ki ,raWit),4 3 a 00-zocult! iorts t-tit 146) c) Lfc Ciuti joatice, 1 64-u , 6).6(o0f-6Q,. kam,c/06410-...5+W. ,r.,C• Croon 6ri-c •3 6b&-3 tit.v4 to44•31e*3 5a*.+el [lc 11111111111,1,n)4(dfer isv 104c-3 404-3 o iocrow./1,1,,sk,,e,c/ 711, gc-,wi email ilv 1-° C71111111.0c-3 ,k6-3 s 4,t/pm.E..61 Mktikykal.oiAtti() 16114) -r)vw i4i1ifin or, 2,4) JUL 101 (1. 3 -112y,„ bid. bitmtdoPrq frkktivigjA.N. cx2 . 1A-th;of2 a.6-is 3h.L44_ .rt. cl Y10,- mut-. CCOttcbct..K LLA-Ct..aikeit ablaca of-pw, brbrdu5.-0 io 5A-c-ray 54c Poiip2.44); , 1, 6(r00 Goo f$ o Yra;N gILIA2-4`CortSo 7 'A 447Culep 01 -44e) ,,5494e/P* c2PA Jr/A­ eke+ vy 5­rek4"lbeeLC7lar- aAQ rollg6f5o A'aPa-k- w &is ok )A, S A *lir USE OHL -. eREVIOUa EDITIONS OF THIS FORM WILL SE USED UNTIL EXRAUTIED DOD-DOACID001199 Loncrol Number (CID Regulation 195-1) Cl 64-04-CID2 5 9-80220 TIME, DATE, AND AGENT SU IABP OF INVESTIGATIVE ACITIVITY Pwlate 5*c. feciAti Me4-Pl. (jamT19(0-/ 3.. if. I( ekle Oped Frefwe 7-057W-7 121L-kt, Laasfia opAlci en riao 4{,i 0;003 prdo Y ID 342 44,,,(64/ tied ildigrailir ,46/beiee FtL(St9 Dikld cfS aaki 5ttafiJ 40'4- PAL-cote (32,6 e )04 a "4 "PIT. lb op41 cit99 gri°1 . I\JA Papont eiTel ‘1316 ‘P4/ r/a6(60, )ralarned Fa.c.s-U-o s.Cior• Yrk_i\Z-.(1-2r_mn-0 c.h, 2... f'or -CC-13 — YN1 G 1111111111111, e_op.\.- OY. e\Hc:\ 1034 -a l 66 -a. L \ d'.••.I • 1.• l•.s,. . CID FORM 28 PREVIOUS EDITIONS OF THIS FORM WILL HE USED UNTIL EXHAUSTED . CW2 io From:. CW2 Sent: Friday, 11 June 2004 10:06.A To:. 11.1111.111111.M SA: W3 Subject:. FW: 1 BCT Detainees SA Thank you for speaking with me a couple of days ago when I called. lol-c -I- (90 Please read the below e-mail, which came back undeliverable to SA 111.11110wit h whom I have spoke with on other occasions on other matters. Bottom Line Up Front -- Detainee abuse is a recurring theme, and needs to be addressed. Currently. we still have at the BHA, while*Widia(was released for transport by 2-5. This PPT Was produced by the 2-5 S2 yesterday (although it is dated 2 JUN), and provided to us due to the fact that he wants fie-detained and re-engaged by my interrogators. Also attached is copies on...CPA Apprehension Form and the related SS by the capturing unit, which I would like for -you to review. Know that I am the senior Counterintelligence Technician (Agent and SAEDA Investigator) for the Brigade. and have worked very closely with CID previously, and have a duty to make you aware since it's your lane. Thank you again for your attention to this matter. In light of recent events in AG, I appreciate any advice or assistance you could provide k mp iGrif vtr CW2 agi 4.--1 ., (Again, if you see CW3 /MINIM tell him I said hello.) fe tD4et Pt gis~11110 c1/412)17t-fiki-i Original Message---liamic likitolc47-H w2 Sent;.Sunday, 06 June 2001 17:34 To: 044-1 ("•-1 01 (1CD SA) Cc: Subject: 1BCT Detainees (ol-C- t 1 :(,:r i sworn statements til (0.e-t SA .4r-Please see attached Sworn Statements owandlilliUlalit-.6-6They were IM(1111111.11.11.11111 detained by elements of 2-5 Cavalry, and according to their CPA Apprhension Form, were held for questioning only--not for illegal acts. They were relatives of the target subject, who was not found during the operation. Allegedly, the Iraqis referenced in the SS are Category One linguists (Titan Corp) assigned to CP Eagle. They are both currently DETAINEES at our Brigade Holding Area (BHA). My soldiers are interrogators at the 1 Brigade (1BCT) BHA and forwarded me these SS, executed with the S-2, 1-62 Field Artillery, at Camp Cuervo. In the recent past, I have spoken to a CID agent, who was conducting an investigation about other detainee abuse, and I wanted to make you aware of this one as well. My soldiers and I feel very strongly about treating detainees humanely, and within the prescribed regulatory and SOP guidance_ Today, my soldiers made me aware of the i r questioning by an appointed 15-6 officer, -who they believe is just_going through the motion. NINIIMIl1111 CW2) (The officer was from 2 -5, and according to my soldiers, seemed di4iiitereseli 011w at.ehq'had t4 provide) 4:k1L' ir (49-1 t:8 ,1 C4,G . 11.1‘.., 1, w 1.4442 11160.61. riease auvise (And tell.to give me a yell sometime out here on this side of the Tigris.)tvG Respectfully, 11:47-41 CW2. Counterintelligence Technician Operational Management Team (OMT) 26 BCT, tronhorse Base lragna DNVT !Mar°4C-4‘4-44 Page(s) • • Referred to: U.S. CENTRAL COMMAND 7115 SOUTH BOUNDARY BLVD ATTN: CCJ6-DM MACDILL AIR FORCE BASE FLORIDA 33621-5101 - MS. JACQUELINE SCOTT sciottj i i. (813) 8275341/283O c-i-s„tr For use of this form see AR 190-45 and AR 195-5; the pm:Ronan/ aganey Is US Army .cscl REPORTICID ROI NUMBER Criminal Investigation Command RECEIVING ACTIVITY . LOCATION ‘ .W1-.?-) \i\\"¦-• Oi.N E A.\? LuE,14\o \I•S (.CAVNAME. GRADE AND 'TITLE OF PERSON FROM WHOM RECEIVED .ADDRESS (Include 27p Cock) A OWNER bc -.kf-ni.OTHER LOCATION FROM WHERE OBT.ED. REASON OBTAINED.TIMEJOATE OBTAINED ailL.P..k lOPC171-7. \ACOLAI f.C.-1.A,913,_..-;-\Ft----.1:_FF.Pk.)E,.L2-`-ti.att,\E C2't ITEM.DESCRIPTION OF ARTICI Fs QUANTITY. NO.. (Include mode, aerial number. condition and unusual marks or ,stratchesi I.1Z1‘‘')C1 t-iejrCk/ C•13nti. 0(20 Lrl V141 1.19-13k1 CkV,-?•VQ4-‘{ I 50 Dim-Pis. cAddlress N000V:— w/ p_,Wgcs- rkariAolc_ vs.irrk\TrA I. MI 14%. - CC), rds -7,--. pope,i2- ,A t V CAT. ID'OS CO\-0V-21. -'4 k12-A \'011. 1,---111 ,-,,,„5 I ,,,.c 0 0V-eck 0.1°A.° 1.t`..\- c-.stickePs , Gola ••.1% r‘Trit .its AQ.ANDic i.Fct-1 c2_ le-I Ozz.Foki-a) S..,1/ %,--0.". i."4-11" I Fe'..tr3 St(-1.e., I.0 cke- e::-_:-- \-1 I (Z--\- -t-Pc5r.J--FE1-i CHAIN OF CUSTODY ITEM DATE.RELEASED BY. RECEIVED BY. PURPOSE OF CHANGE NO.. OF CUSTODY SIGNATURE.5 EINATURE. I..tfAC-4 ildC-t4.4c*--- 3,k‘-3 -s-0-21,1.kr- jt) i st:. TIT ( . 3. .. — NAME, GRADE OR TITLE.NAME, GRADE OR TITLE SIGNATURE. SIGNATURE NAME. GRADE OR TITLE .NAME, GRADE OR TITLE SIGNATURE. SIGNATURE NAME, GRADE OR TITLE.NAME, GRADE OR TITLE SIGNATURE. SIGNATURE NAME, GRADE OR TITLE.NAME, GRADE OR TITLE . 2 b ,...,.::.;,..__;,.• ,.,:i,.;.,.,.",.. Replaces DA FOAM 4137, 1 Au° 74 .-.. --.--oUSAPPC V -. .(10 OA FOAM 4137-R Pnvecy Ace51,1 1. 1bnl. ; %o DOCUMENT • .•.•.-.• •,.••.•. •. • tAfgagegNENIMENNIMEMEMERNINIMIMMEM ' NMRF'7 : ;1_ -' '.4`7 ql7 : : DATA REQUIRED BY PRIVACY ACT AUTI•IORITY Tale I U. United States Code Section 3012 (g) ROUTINE USES: Your social security number and other personal information Are used as an additional/alternate means of identification to facilitate and retrieval. PRINCIPAL- PURPOSE To provide commanders and law enforcement officials with DISCLOSURE: Disclosure of your social security # is voluntary means by which information may be accurately identified. I., Ree Code, 1 2 Action Code. 3 Date 4. Ret in Case: Control: 6. Sequence AoYear: 8_ 011ice 9. ROI NoOffense: r 5. Conol: 7. (o n ci,oSt2.2.0 :,.,..,,,,.. . ....,!.2.-.-. i. ._.,....,,,.,., 14•Mre&jP-;•-¦ *•1 ..4 t4....*:=1 :''' .;:;.::*IAi4.014AS&IkSt.MVLT.ff ,. io. Last Name:.'1.'74-14 VD(' -4-i I 1 . First N..,.., ...l . I I,.0/."X," loc-qiu,c-f 4. . 19. P013 Zip: -1( h6-41 20. Sex: 21. Race! 23 eight: 24. Wei lit: 26. Eiteplor: , 27. Citi 28 46t:. 29. Plorlitrd. 30. In tat: L • e 41.". 0 31. 32. Job Description/Loc tion: 33. MC: 34. SycT6ry Clr: 35. Physical Marks.' Tattoos: 36. Spouse Military: Branch: Yes: . No: . . / 5 dEC, 37. Alias.,Jclalapies. 38. Alias/Nicknames: 39. Alis /Nicknames: =--jig- , !.;6Fit/ ganiz tio21 : rehif 41. Unit Phone Number: ager: 42. Military Sell ice. 43. Sub Unit: 44. FX.City;t 4c1,/ 45. State: 40_ Country: 47. Zip Code/APO: 48. Home Address: 49, City: 50. State: 51. Country: 52.4p Code/APO: 31-r-- iswQ:1::5:,;:mk 17 11EEraktP.M0-r_ ;.:M!-Z. - .W:q.14014 6 -ligniamtivat-wit -----(mo 53. WV: 54. Family Rd: 55. Last Name: 56 First Name: 57. Middle Name: it 58. Social Security: 59. Grade/Rank: - 00. MC: 61. Unit: &_ 62. City: 63, State: 64. ZIP/APO: 65..Phone ..Wk: l-lm: 2Zariali t.FAMPI:MT •aW_MAENAME- :"1.• MMMIN-4.18=t70.=3: 1L 66. OtTense Cade 67. UFC: 6S Offense Code. 69. UFC 70_ Offense Code: 72_ Offense Code: 73. UFC :;:,,1 .-Aitt:114!: :i.,-zItsA.e,VW,:q31'JI,--0:a:A9gitat-,I, griUtiA.Zg i Wfr.3,17;WW".•;•1 :. =,2:3'.:!'.q73:77177A5:, i Telephone. Ers: PCS/DEROS: Date 1 Time Interview START: Date Time Place of Interview Dale! Time Interview END . Dare: Time. - 7.1:c•-• MEICEMMilkiati*WkaiTA'M7z-Mr0.75.1M.N • Mk ' WO Ar''•;IitaNb. ''..- , ./ 4)1 :ite:41:17.2f.:= Zit,: 74. Category: 75. Type: 76. Recovered: 77. Value 78. Insurer: Policy: YearlDate Exp: Yest] No . . / 61_ Model: 82. Vehicle Style: 83. iial Doors 84. Calor: 85. Size: 36. V l.N: 87. Licence Plate: • 88 State: 89. DOD Decal Number NoTEs, ~let Om = 111111111111111.111W-ic--4,Y loyiE OF RECORD STREET ADDRESS: •I.AST HIV TEST: ._ 1D FORM 44-R-E FtNt . LAW 27 DATA REQUIRED BY PRIVACY ACT AUTFIOPdT Y Title 1U. United States Code Section 3012 (V ROUTINE USES -Your social security number and other personal information Are used as an additionallellemate means of identification to facilitate and retrieval. PRINCIPAL PURPO‘SF_ Tu ptuvide commanders and law enforcement officials with DISCLOSURE: Disclosure of your social security # is voluntary means by which information may be accurately identified. 1. act Code 2 Action Code: 3. Date: 4. Re! to Case. 5_ Control: 6. Sequence II.7, liar: B. Orrice 9. ROI/ Offense: 2Z-10 ,,,,,,:...: ...X.1 4 .m. '.•:' . c-..Att,SIsi ' • .iii-", .••••.: ,,.' kz:•.],yVil-1141,1i),, I S . a .,":4_ I .:iitlft777-:i:-.•'..J2,z.1Zfj,,,,-_'--.',777-.r57,"_: t - ' ,;.".7771.•:7--,. . .. --.• ;•-i r-s, a lir ..,..to . - M. Last Na . 15....--tl. ' I I . First i.; i ri;;;11,1•I'P r--12 arne: 13. Grade/Rank: Via-3 14. Social Security Number: I 5. Other--5 ID Number _3 a ,.Date of Birth: 7. POB . 18 ,'• • 19. POB. Zip: 111111711111110 20. Sex: 21, Race:.2.Ethnic: 23r,Heighr,, 24. Weight: 25. Hair: 26. Eye Color: 27.12ren: 28. rdi 29. norlrord: 30. Marital: MoP 5-' 7 /s--0otib Ji 11 .IVIOS: 32. Job Description/Location: 33. MC: 34.Sgs,urity Clr: 35_ Physical Marks/ Tattoos: 36. Spouse Military: Branch: ,r,„0 N.,0 /7 go. ,z--fn.11,-711_,,, ,5c. c_ 37. AliasfbJ icknarriw ‘, 38. Alias/Nicknames: 39. Alias/Nicknames. =-- Pt dp_iiniliOrgan"VI°"' SI, Una Phone Number: Eionie: Cell/Pager: ig--WAP41:-1 42. Military SErvice.' / 43. Sub Unit: 44. FortiCity. 45.State: 46. Country: 47. Zip Code/APO: -3.- 3 -.....ddre •. 'Prilit 52. Zi. Code/APO: ;,.:21=24615 . firtg7--ri,3374,..-..,. :: 53. JUV: 54. Family Rcl: 53. Last Name 56. First Name: 57. Middle Name: 58. Social Seeittily -59. Grade/Rank: 60. MC: 61. Unit: (12. City: o3. Stale 64. ZIP/APO: 65. Phone:.Wk:. Hitt: il :' L.,'.V .$ii.7"•ifY, A-43M%10/21 ftie,065Vigi.g4.1!:',.r;A 5trIc;;:fg14a-Tl1.41"'A ,i'1 71g1,, Z444 ta: • -1g4WZ; _k-.i.. 04.KTRa:MLs.,:, 66. OtTense Code-. 67 UFC: 68. Offense Cede: 69. UFC: 70. Offense Code: 71. UFC:.72. Offense Code:.73. UFC: Oa ' i '...0:,i;e:ii).::•-:,0 ;7:NkiiiI-4(:4:',5N4::Mj)v50.W.14., ---, mt.51k.1100XI*Mtlag.;-14.0.100/14INNAMMEMOMiann Telephone: 1 ETS -PCS/DEROS: Date / Time Interview START: Date:1 Time. lace or Intervien,: Date / Time Interview END: Date Time: Jisposition: telre?e4lAW-i:!::--'''Y•.''`f4il-WilPeliM4-Wt lfaitialrr 511SRMEWEGAIKO'Lr -*i'l:f/:e-2,0Ttirl z.. o' ... t'iT44' 7.115217*.Tfir:11';. t-, '4. Category: 75. Type: 76. Recovered: 77. Value: 78. Insurer: Policy: Year/Date EAT): Yes: . No . / 8I _ Model 82. Vehicle Style: 83 # or DOcirS-. 84. Color: 85. Size:- :6. VIM: 87 License Plate: 88. State 89. DOD Decal Number: 'TOTES: 49.610/ 7,./41(.4-)4t/ aLip elftiv ojeoe.igo-zit&o/ iters L,A4f-esve,tu/tatweo;11(-, c/f14,1:tiore 5 -b254, 47oild1/16/ oirodi&-laie._ 10ME OE RECORD STREET ADDRESS: ,AST HIV TEST: E". :ID FORM 44-R-E 16 .!.11!1..r I (f•. , . •. ..t•.• 28 DOD-DOACID001206 Page(s) • • Referred to: U.S. CENTRAL COMMAND 7115 SOUTH BOUNDARY BLVD ATTN: CCJ6-DM MACDILL AIR FORCE BASE FLORIDA 33621-5101 - MS. JACQUELINE SCOTT (2) r-.rvrp in (81:3) 827, 5341/2830 rt

Doc_nid: 
2314
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66