CID Report (Death): 0046-04-CID389-80649

DEPARTMENT OF THE ARMY •
11 MILITARY POLI.C,g_MTACW4,NTIOIDT(FVV0).
3D MILITARY poLicE OROUP (CID)
um-rFp-sTATEs ARmY cRimINAL INVg$T[QAT1ON COMMAND

. . CAMP. VICTORY,- 5AOHDAD, IRAQ. 'APO AE 09342
C1RC:ZA:OP 16 Oct 2005
MEMORANDU1VI FOR SEE DISTRD3UTION
SUl3JECT: CII) REPORT OF INVESTIGATION — FINAL, SUPPLEMENTAL - 0046-04-CID389-80649 - 5119B
DATES/TIMES/LOCATIONS OF OCCURRENCES:
5 APR 2004/0200 -5 APR 2004/102 15;
, MOSUL, IRAQ

DATE/TIME REPORTED: 5 APR 2004, 1700
6,)

INVESTIGATED BY: SA
No SA ,
(biz)"
SUBJECT: 1. (NONE); ETERMINE DEATHS3 71) (.0.6 Ro, 'VICTIM: 1. DECEASED); DETAINE
‘ E #
IRAQI; CIV; M; WHITE; XZ (NFI); [UNDETERMINED DEATH]

INVESTIGATIVE SUMMARY:
"This is an' Operation Iraqi Freedom InVeStigation"
This office was riotified by Mortuary Affairs, MosUl, Iraq that the rernaing of an Iraqi detainee had been deliverned by 67th Combat SupPort Hospital (CSH) persormel.
.
1'4* Investigation disclosed Mr. as detained by personnel and subsequently in ettogated. During the niPPlitil P t 04, Mr.
wag allOwed to. Sleep and when checked b waS ibund; to be Unregponsive. mr. s orted to the 67th H Where he received emergenCY.medical tare. Mr. Was unable to be r vivecl and subsequently
.
f unknown causes.
1

Mo
FOR OFFICIAL USE ONLY-LAW ENFORCEMENT SENSITIVE
0,.5032
000001
(R) C)-7 OVrs1 0046-04-CID389-80649
(45.V't1 aCfL*?0:1-onducted by L,TC
On 26 Apr 04, a .topsy o he remains of
(Dr.) SAF, Deputy edical Examiner, OM of the Armed Forces Ica xam AFME), ed Forces InStitute of Path ogy (AFTP),
Rockville, MD. Dr. elated the use and rna.rmer of death We both
Undetermined wit.h no obvious signs of homicide or of a natural death..
On 11 May 04, the Naval Criminal In estigative Service (NCIS), accepte investigative responsibility for this matter.
On 4 Oct 05, this office received the fi al autopsy report frona the Armed Fo ces Institute of Pathology (AFIP), detailing Mr. cause of death as undete ined and the manner of death as undetermined.
STATUTES: N/A
Added Attached:
14. Final Autopsy Report, ME 04-309, 22 Nov 04, pertaining to Mr.
Added Not Attached:
The original of Exhibit 14 is maintained in the files of the AFLP, RoCkville, MD 20850. ,
STATUS: This is, a Final Supplemental Report. Commander's RepOrt of Disciplina6, Action Taken (DA Font 4833) is not required. 6)()(c)-7-1Report. Prepared 13y: . R.epoA- Approved By:
6
1- pa, USACRc, 6010, 6 Street, Fort Belvoir, VA 22060-5506 (original)
Cominatider, HQ USAC1DC, ATTN: CIOP-ZA, Ft. Belvoir, VA 22-60-5506 1- Commander, 3D MP GRP, 4699 N l't Street, Forrest Paik, GA 30297-5119 1- Director, AFIP, Building 102, 1413 Researchl3oulevard, Rockville, MD 20850
FOR OFFICIAL 'USE ONLY-LAW ENFORCEMENT SENSITIVE
2 025033
0 0 0 0 2

0046-04-CID389-80649
1- Naval Criminal Investigative Service Field Office Middle East, Bahrain, United Arab Emirate§ 1- File
025034 0000 3
DEPARTNINT OF THE ARMY
75th MP DETACHMENT (DID)
UNITED STATES ARMY CRIMINAL INVE5TIGATIQN COMMAND
LSA DIANIONDBACK - MOSUL, IRAQ
APO AE 09334-6169

REPLY TO
' ATTENTION OF

CIRC-INBE (195-2) 15 May 2004.
MEMORANDUM FOR: SEE DISTRIBUTION
SUBJECT: CID REPORT OF INVESTIGATION FINAL-REFERRED — 0046-04-CID389-
80649-5H9B

,
DATES/TIIVIES/LOCATIONS OF OCCURRENCES.
1. 5 Apr 2004/0200 — 5 Apr 2004/0215;
osul, Iraq

(6) )(DATE/TIME REPORTED: 5 Apr 2004,1700 / I 1
0-
C6) 6A
-INVESTIGATED EY: S
" •
SUBJECT: 1. (NONE) [UNDE1' ' II EATH]
tqb)(c)--: (c)(9)(r.Y-`)
ECEASEID); ETAINEE # RAQI; •
'4v1111 D DEATH]

G\TFD
INVESTIGATIVE ST_IMMARY:
"This is an Operation Iraqi Freedom Investigation"
This office was notified by Mortuary Affairs, Mosul, that the remaini of an Ira.qi detainee Iliad been delivered by 67th Combat Support Hospital (CSI-I) personnel. (6) VIC C\—$1
, CI-11 tbta) -2-
Investigation disclosed /vIr. was detained b A edl tacncl
: e, s o. nn
.
subsequeritiy interrogated. e monling Of 5 APr.$ ' , Y-sleep and when checked by as found to be unresponsive. -
"th
-was =sported to the 67 CSH w ere e re iVed emergency rnedicil care. Mr. was unable to be revived and subsequently died of unlmown causes. ', , iiiiiiiiil -tt
1--)t)14— a (1)("i.)16)---Z,
'
On 26 p 4 a.n autopsy o e remams of IVIr. was conducthd liy I,TC (Dr.) USAF, Depiity Medical Examiner, Pffice of the Arnied Forces Meclical mer , Armed Forces Institute of Pathology (APIP), Rockville, MD' . I)r related the cause and manner of death were both undetermined with no Obvious signs o a
0 2 5 0 35 -000 0 0 4
DOD-050587
CrRC-W13E
SUBJECT: CID REPORT OF IIVVESTIGATION -FINAL-REFERRED - 0046-04-CID389-80649
On I 1 May 04, the,Naval Criminal Invettigative Service (NUS), accepted investigative
responSibility for dig ina*.

, STATUTES: N/A
EXHIBITS/SUBSTANTIATION:
0.44s„scA A ched:
Agent's Investigation Report (AIR) of S 2 icatiori; coor 'th Mortua Affairs, Provost Marshal, CIS and CW4 f SI'C GIvIl d S 9 amina.tion; and a.utopsy.
(-',,t-2r..)
)t1/47\), \
2. Certificate of Death (Overseas), 5 Apr 04, WitHiglielVIr.ffialliff
Photographic packet comprised of 23 photograPhs. (Mr
.
1 IIli i I I I IF C.61 LY i 1
.- ,r i . , (.\-1?A(L).-5
Packetccntaining unit isters, medical information, and steements obtained from . 0 -0 ;:-Z. hiA,,-7.-
... (9)1CV:C— i
1 5. Waiyer Certificate and Sworn Statement of HM2111111.11 7 Apr 04, relating lie provided treat:I-lent-to Mr. fter he went into car la rres .
(1'. (5)m- SSt 7 Apr 04, relating he assisted in the primary treatment o
pr 04, relating he administered primary aid to Mr.
k,r5(.) -
8. SWorri Staternent:.4fRIVIC Apr.04,1elating he MI5 on duty when entinto cardiac arrest.,
(0(0 --‘j ' (,6 mop
. 9. . a ver ertifica, w‘Irri Stite ent of' GIvIl Apr 04, relating he was on detairiee vvatch while NI.r. as in custody.
. 10. .Sworn Stateme )(Lq-- '2:19(1.q()72a '
pr , 4, rela n e provide primary
;treatment to Mr. into cardiac an-est.

\ (gX9Y(,),--
025036 _B00005_
DOD-050588
CIRC-VVBE
SIJEJECT: CID REPORT OF INVESTIGATION :-FTNAL-REFERRED - 0046-04-CID3 89-80649

12.
Phbtographic packet comprised of 11 photographs. (scene)

13.
Compact disk, 040046.389, containing originals of Exhibits 3 and 12.

, Not Attached: None.
The, originals of Exhibits 1 and 5-11 are forwarded with the NCIS copy of this report. The original of Exhibit 2 is retained in the files of the 67th CSH. .The originals of Exhibit 4 are retained in the files of11111111111111pCoronado, CA.
(Ott) ,
STATUS: This. is -a Final Referred Report prepared TAW CID R 195-1, Para 4-1 0a(1) tri that theArmy CID does not have primary investigative responsibility and NCl/ has accepted refetral
P
'of this investigation. -
"
Report Prepared By: Report Approved by:
_
(.,q /0-1 ,k`-)(31,0-4%
pecial Agent, asi rt,.:17).).pecia gent m Charge
, ,
DISTRIBUTION: -1 - Director, USACRC •
_
1 - NCIS Field Office Middle East, PSC 451, Fpo AE 09834-2800 (originals) 1 - THRU: COmmancler, 22nd MP I3N (CID) (FWD), Baghdad, Iraq , THR1J: Commander, PI MI! Group (CID), Ft Gillem, GA
• TO: HQUSACIDC, ATTN: CIOB-COP, 6010 6th Street, F'1: pqivpir, YA 22060 1 - Director, OAFME AF1P, Rockvilld, MD 20850
-Chief of Staff,1111-mail only, less eichibits) ft) 1 - SJA, -rhail only, less exhibits) /k-4-11 - PM0, (e-mail only, less exhibits) 1 - File
5
' . . .
025037

ROI NUMBER
AGENT S VESTIGATION REF'ORT
0046-04-CID389-80649
CID Regulation 195-1
PAGE 1 OF PAGES
DETAILS.
ASIS FOR INVESTIGATION: About 1700, 05 Apr 04, this office was notified by the Mortuary Affairs
ffice, 67' Combat Support Hospital ( S , LSAMINIMIk - Mosul, Iraq, of the death of an Iraqi -
detainee. '

6 10'1
bout 1900, 05 Apr 04, SA and S

, this offi e, coordinated with SGT
Mortua Affairs 67th CSH, who provided the death certificate ident ing the deceased
I). Mr. as pronounced ad at 0250, 05 Apr 04, by
S eath Certificate) SA conducted a preliminary
xamination o ody whic ruising and abrasions on the knees and elbows. Mr had
eyes and on the bottom of the chin in addition to a swollen nose, Mr.
suffered se ral small cuts on the ',eft side of his forehead and a large bump ,94vi the right side of his forehead.b;)
SA exposed photographs of Mr.MNIIIRPemains utilizing a Sony digital camera. (See '

ho(t_o4rLacs _i \c Pactm ov_z c9(c) .3-1 (G)010-ti
K:
bout 2030, 0KcAC),-71SA nterviewed
7 CSH, who
elated he was the medic on du w en Mr. was brought into the CSH. SPC ated
about 0200, 05 Apr 04, two ersonnel came into the CSH and related ey would be
ringing an Iraqi det

.ayin-M for treatment. SPC . •• Nt0.2
o individual
ccording to thellill.ffsonnel, they were taking the ingividual to the detention facility when he collapsed. (
orpsinen imrnediately began conducting cardio-pulmOnary resuscitatipn (CPR). SP he
elated Mr. as brought in about ten minutes later g which time he began performing 11 e saving

easure .. C ated that at no time did Mr. alallipthow any signs of life. 'D trki01.41 ( j..) (6\ ---7.
cok 1 (ig(C\ -(6 4 6-6) -a-
bout 2200, 05 Apx 04, SA coordinated with LTC , PM ,
,
osul, Iraq, who related the Naval Criminal Investigative Service CIS) would be handling e ffivestigation
and U.S. Army CID efforts would not be needed. SA recommended to LTC at the
emains of Mr. 1.1111.be held so that an autopsy could be conductelbymembers of the Armed Forces
edical Examiner (AFIP).16)tel -44(.N -\Vr1

.',C\ V4-4iiiime(('\ ' \ t'al." (,) 6V1
bout 1330, 07 Apr 04, SA as notified by LT
, Naval J-udge
d-vocate General (JAG), Baghdad, Iraq, that NCIS declined to investigate i ent and that the Navy was
equesting U.S. Army CID conduct the investi ation, .‘...4))(.61
,..--------, L, (61-
bout 14 07 A r 04 SA d SA this office, coo ated with L
and LT AG Manual Investigation Officer, Baghdad, Iraq

rovided the folloWing synopsis of the incident as it was related to him. Mr. detained on 02 Apr 04 during an operation involvin )(s0)--1
and Polish coaliti
TYPED AGENT!S NAME AND SEQUENCE mr•TivmE ORGANIZATION

Z_

T*101
75th DET ClD , SACIDC
SA 1.

tro - Mosul, Iraq APO AE 09334
SIG
DATE EXHIBIT • 12 May 2004
025038
IT),FQRM 94 FnR OFFICIAL USE ONLY
I FEB 77
000007
ROI NUMBER
AGENT'S INVESTIGATION REPORT
• 0046-04-C1D389-80649
crik.Rftiotyil.-4
PAGE 2 OF 6 PAGES
-' DETAILS: '
•
.
The house i which Mr. found contained si)i fully functional Improvised Explosive Devices
(IED) and uinerous.Pieces of bomb-maid g materials. The Iiolish coalition forces entered the houSe and
captured 111111111Pho attempte o resist and Was very aggressive even.after being handcuffed.
During the tercati n Mr. as hit in the face seVe • attempti to restrai hi Once

estrained was taken back to the compoun *(6 2 —2-
,
Mostil; itaq. By regulation, Mr e held at e compound for up to seventy-
-tWo hours before' having to be p.trnelin to a de ention facility. Mr Was held for almost the elitire

seventy-tOo. hours during WhiCh time he was extremely aggressive and uncdoperative. Mr111111111111Winally
began to wear down towards the end of the a:Hewed titne period and began givirig information to ititerrogatbrs.
Mr as then. allow ,d to sleep: During the entire period in which Mr. was being

b ai-e_
• held , e was nitored by men that ensured his:vital signs were good an that s not injured.
(=point while was sleeping the corpStnen discoVered he did not have any pulse s not
breathing. Medic as immediately administered and was transported to the 67th MI
where he was prono ead. L ed c ies of the unit Tipster; detainee, guard watch,
medical records pertaining SOP's,and statements bi'Polish coalition

personnel: (See Documents) (1-7-)01CC)--"Z_ , .
10-'1 4,
6
A \L 71
(.,rid.1);-olu.ti5, 07 Apr 04, S dvise Corpsmanara f his legal rights which he waived providing a sworn statement r ating he pro*ded primgy treatment to Mr. after he went into cardiac arrest. stated he did not harm Mr. g to do -with his death. (See Waiver Certificate an Sworn Statement)

C-91Z))-e,,
orpsmanallp
osul, Iraq (Coronado, CA), who provided a sworn statement relatin heassis e ary treatment of Mr. 111111111Wafter he went into cardiac arrest. HM c611A,Ze___stated Mr. was treated humanely and no interrogation tee ',clues conducted on hint would have 1-5 caused a cardiaearrest. (See Sworn Statement) C& LCV1
(LAM(C)-1 -11 1(0\ ..71,
66 Zi1
About 1736, 07 Apr 04, SA interviewe 1 Corpsman
1111111who provided a sworn statement re/ating he respond d to the scene immediately after Mr
went into cardiac arrest and assisted in administering oxygen and CPR. (See Swo Statement) (4,\/Q_Gi

(At)-Z. C.' 'I 1 (qt)Y0 -1.'f (0- i (,)f,y0 ,,i,,,
About 1753, 07 A terviewed HM , Sempr f
,
Corpsrnan ho provided a sworn stat ent relating he was on duty dun the monthig of 05 '
Apr 04 when Mr ¦ ent into cardiac arrest. her relate h.e relieved the

. mon am.
or!. 1, I
no time was Mr esponsive to any of the treatments administeredto him. ( worn Statement)
l_kc\-`1, (;)0)(0--.Li
TYPED AGENT'S NA_ME AND SEQUENCE NUMBER ORGANIZATION
75th MP DET CID (-), USACIDC coa)z-_ Mosul, Iraq APO AE 09334
SIGNATURE EXHIBIT
12 May 2004
0 2 5 0 5 9
ID 0 :
"
OR OFFICIAL USE ONLY
1 FEB 77
0000d3
DOD-050591
ROI NUMBER
AGENT S INVESTIGATION REPORT
0046-04-CID389-80649
CID Regulation 195-1
‘;) ";) (dt)-PAGE 3 (c1F.46196-
DETAILS. (500*1 \ 1(a
About 9 0, 07 Apr 04, and SAIIIIIIIIIrordinated with LCD

.
Commander nd briefed him on all aspects of this investigation. LCDR lated his team was,supposed to fly bacic to the U.S. on the evening of 07 Apr 04. It was related to hat if,NCIS was willing to conduct the rema,ining int.erviews of unit personnel at Coronado, CA then his unA would be allowed to fly out that evening. ,
)(4).-1 (i6 0 -1
About 2000, 07 Apr 04, SA advised GM1 erator
uni of his legal rights which he waived providing a sworn statement relating he was n detainee watch during the time period when'Mr was-in their custody. GM1 rther related neither he nor atyone else physically abused Mr. hile he waS on detainee watch. (See Waiver Certificate and sworn statemenki,,,INN.

(G)LLy-ti
6, About 2100, 07 Apr Keoordina ion was made vvith SA CIS, who related he would coordinate to -have the remaining interviews of embers completed at Coronado by NCIS agentsa-, _— --2_ 4)(2)-2-
X
d) About 1200, 0 Apr 4,''*‘104 0 " -1 t'' t
terviewed LTC (Dr.
• Mosul, Iraq (Fort Carson, CO), who 'Provide a sworn statement relating lie conducted a
i examinat hen he was initially detained and noted several bruises on his 1/4, - ce which was consistent with the actions that were taken on tar et to restrain Mr../W. LTC ' IIIIIIIIIIru-ther iilated he provided treatment td Mr..., hen he went into cardiac arrest as
unable to revive him LTCIIIIIII.kid not think any of the injune stained by Millallaprn th
initial altercation had the capability o ausing cardiac potrest. (See Sworn nt) i tr_1(0_,L1

' 67/4.1-7,,_ LC1-6\'I ----,....„--44,A. 4 ,,,),1-„isitc.)-1 ,21bout 1140, 08 Apr Q4, SA terviewe&SPC edi4-67' CSH, k.' who relafed she was On duty unng e morning of 05 Apr 04 when Mr as rought in. SPXI attempted to warm him up
, further related she assisted in performing CPR on Mr utilizing IV, blankets, and heat pads. Mr ne every five minutes but was never revived. SP ated they attemp vvas
r pronounced dead at 0250, 05 Apr 4.
y.,1(
0(C)-(1(.7
4(.‘
DEATH SCENE EXAMINATIO : About 4 , 08 Apr 04, S onducteetatinafion of the
s cietainee holding area located in,,th

-2--
Mosul Airfield, Iraq.
CHARACTERISTICS OF THE SCENE: The
AME SEQUENCE NUMBER ORGANIZATION
75th MP DET ClD (-), USACLDC
2-
Mosul, Iraq APO AE 09334 (--42--)
aAnll
---111111111111C-1(-H
DA E EXHIBIT
,
hito,N 12 May 2004
02509
le • Z L4 • A
I FEB 77
0000d9
AGENT S INVESTIGATION REPORT ROI NUMBER 0046-04-CID389-80649
CID Regulation 195-1 '
PAGE 4 OF 6 PAGES
DETAILS:

There was at-) 1 I- -LI ooden ent oca .. . • as o t e bench there was a fire pit Q 'Ir-}1
.
apprctimately eight feet by six feet. To the east of the fire pit was a sheet of plywood where Mr. ad been laying when he went into cardiac arrest. , Another sheet of 1 ood laY at the south wall of the area. Several stacks of tires were loc•t- . 1 • - • • . -
ae.k.--2 u.AL.P.a..4 rencv-i-ed
CONDITIONS OF THE SCENE: e interro ation area was well kept and there was no debris anywhere in or around the vicinity. According t el, the atea Was a temporary site until a hard structure could be
4:
uilt.
NVIRONMENTAL CONIDITIOPSI The weather was slimly with a temperature of approxfmdtely 80,1, degrees
ahrenheit.
ACTORS PERTINENT TO ENTRY/EXIT: Th
C-q"\ Scene Documentation: SAMMIlik pared a rough sketch of the sc4ne s photographs utilizing a Sony digital camera. (See Sketch and P togranhic Packetl •it .
V(CA, tAn(CYtt CV bout 1930, 08 Apr 04,,SA terviewed Media, 7th CSH, ho related she was on du dunn the mornin of 5 Apr A 1/ as brought • by alga
corpsman, a and Army colonel'. SGT ated she assisted in providing resuscitation treatment to Mr. for appromately thirty minutes. Treatment included CPR, oxygen, several shocks from the defibrill tor, and at least ten dors of epinephrine. SGT
elated M 1.. • already been in bated before they brottght him into the CSH. SGT ated none of the treatm.ents tered to ere able to revive him and they iscontinued treatment after he was pro %ince
--t_ (,-) 'WO -2
I?101 About 1900-, 14 Apr 04, nterviewed CPT (Dr.) onfinned that he pronounced Mr.e decease at 0250, 05 Apr 04. CPT ted he noticed4ome bruising ,,,,,,,,,„.
.
ER ORGANIZATION
s,. .
75th MP DET CID (-), USACIDC (69(_2-Y--2--
-
Mosul, Iraq APO AE 09334
11.11111111111

EXHB3IT
12 May 2004
. • . • "
ROI NUMBER
AGENT'S INVESTIGATION REPORT
0046-04-CID389-80649
CID Rezulation 195-1
,i4.-..ttc,),--2,
h(")`Wi pAGE UF 6 PAGES
DETAILS: (0)° 1 C.1)--4s
underneath Mr. eyes but noted no other injuries. CPT stat ardiac arrests on
younger individuals were many times caused by a blood clot. According to tan individual is .
inactive for -a long period of time and then..starts moving aroUnd, the increased blood flow Could cause a blood
clot to be forced through the bloodstream eventually getting cauQht. b d then backs up to thel.eart and
does not receive any oxygen causin a.n arrest. Vit°
-, 4tAtt? cqi
AbOut 1610, 21 A r , SA )-( te wed S ( 11111111111111ro . sh Speci Forces , Mosul, Ira ho related e was a meraber of entry team n 2 Arnfigriti r. as detained. SGT .ted he and S ' ish Special Fo ces, entered the room and discovered ith a Woman and two children ccording to SG
tunped On him A d they began fighting. SG e ated Mr •-t him once and then he lu k. ith the butt stock. of his w.eapon. SG en hi f • the face -with his fist an Ily t ew MM. toithe groqad on his stomac SG tated e was then able to twis
. ba so that he coulerhOdcuff him. SG relate Mr. as extremely aggressiv and co t nu:11y tried to et out of his handcuffs. S el at d he esco t-, the collecti poin, r as taken back to the d on Mosul ' *rf -Id V-2 where he wa turn-I 1 er to m bers o
(2\ h. 1 (qL)-(1
.AL\\)A,
-0- -7-. --, si)l.-C\l" -( (c,
' irout 1 1 Apr 04, SAIIIIIIIIInterviewed SGT who rerat he entered the r with SGTIL2 Apr 0 they detained Mr G111.1,tated jumped on SGT
d they begansfightin . related he.was coverin the wo n arid tvvo children who. were . sitting in the corner of the room. SAM"stated Mr hit T ut then SGT as . ab to butt stroke. the head and hit him in the face his fist. SGAIllien t elk Mr.
own o the ground and was able to get Mr. cuffed G•tat he as sted him with corting Mr. the' collection point.. fiA) C, -1-k.-67)(tA-97 -
it-1-1 ---7-'Th -
1 1 26 , , and SA , ice, a en eIttql&f:4Mr. , performed by LTC (Dr.) , USAF, Deputy Medical Exa.miner, Office of AboStilr pr 04, SA Infs o e autopsy of.
-. .
the Armed Forces Medical Examiner (OAFME), Armed orces Institute of PathologY (AFIP), Rockville, MD. Dr elated the-cause and manner of death were bo undetermi6ed with rio dbvious signs of a Homicide or of a: Natural Dea (q(z.\--Z-
6.2b)tfC,YZ-
About 2300, 10 May 04, SA orie e in person LT in the preliminary autopsy results..
On 11 May 04, SA oo dinated this invest ion with SA CIS Field Office
,. , km,.... I•v./.a
of this investigation. , -•
r..
i..
TYPED AGENT'S NAME ANI) SEQU4NC it ER ORGANDATION .1
. I . (,(0•00)—f 75th MP DET Cli) (-), USACIDC NEZ._-) -2--
SA 9 L, .ul, Iraq APO AE 09334

SIGNATURE DATE EXHIBIT
e(DM 12 May 2004
kA _
1 FEB 77
BO 00 11
ROI NUMBER
AGENT'S INVESTIGATION REPORT
0046-04-CID389-80649
PAGE 6 OF .6 PAGES
DETAILS:
On 12 May 04, oordinated this investigation with CW4 Operations Officer, 22nd MP BN (CID), Baghdad, Iraq, APO AE, 09335, who approved the referral of this 'nvestigation to the NCIS. ///L,AST ENTRYN
(6,UE14E NUMBER ' ORGANIZATION
75th MP DET CID (-), USACEDC 111111111111111 - Mosul, Iraq APO AE 09334
DATE EXHIBIT
1

12 May 2004
02,5143
"MEM 94 OFFICIAL USE ONLY
FEB 77
000012

T..a.g00)

•
. ReferrP0.0.:
ARMY AfEDIcAL..COMMAND,
FREEpom •QF •NFORMATIONL

• TIOYACY ACT:OFFICE • •
ATTENTION:, Nicyp.,. •
2osp -woRTH suirm •
FORT SAM j---TourroN„ TwcAs- • .
7s234-600...

jOI--.1N. PETERSON • J.01:4-PetersOni . (21o) '
025044
0046-04-01)389=t0649
PHOTOGRAPIIIC PACKET
NUMBER DES. CilIPTION OF PHOTOGRAMS 11.4 4.,,Y1
1. Photogaph depicting full view of /vIr.10111111 \
.
2.
Photograph depicting identifying view of Mr.alligallr

3.
Photograph depicting upper body view.

4.
Photograph depicting lower body view.

5.
Photograph depicting feet and ankles.

6.
Photograph depicting calves a.nd feet.

Photograph depicting left knee. Photograph depicting close-up of left knee.
7. -
z
9.
Photograph depicting right knee.

10.
Photograph depicting close-up of right knee. Photograph depicthig left elbow.

12.
Photograph depicting arms and bound hands.

13.
Photograph depicting tlose-up of bound. hands.

14.
Photograph depUting left- S'ide of forehead..

15.
Photograph deticting left side of forehead with scale.

16.
Photograph depicting nose and eyes with scale.

17.
Photograph depicting chin.

18.
Photograph depicting chin with scale.

19: Photograph depicting back upper view of body. otograp epic ac o r vie
USE ONLY
025045 filigt114
DOD-050597
NUMBER DESCRIPTION OF PHOTOGRAPHS .21. Photograph depicting right elbow.
22.
Photograph depicting right elbow with scale.

23.
Photograph depicting side view of bound hands.

FOR OFFICIAL EXHIBIT
USE ONLY
025046
000015

Page(s)
English Translation:
...Wit.h.h.eld due to:
Foreign Language Photos depicting Americans Photos depicting foreign nationals Civilian Agency Records AudioNideo depicting foreig-n
nationals and Americans
025047

Page(s)
4,20

Referred to:
PEPARIVIENT OF .11-1E, NAVY CHIEF OF NAVAL OPERATIONS :ROOM DN536 , 2000 NAVY. PENTAGON WASHTNOTON., :pc. 2035Q-2-000
. :MS, DORIS:LAMA
:(2:02)':685-6544/5/6
025048

-04/ -c.,03n-F04,41
1
. PUGH!, WINING PROCEDUREVAIVER CER1 'ATE
FOr use of this lerni, See AR 1„80-30; the'PrOpOnent agency ODC,SDPS.,
,
L...
DATA REQUIRED BY THE PRIVACY ACT
. . .
AUTHORITY: Title DO:kilted States Code, SeCtiOn 3012(0 ' ,
pRINCiPA1.. PURPOS To.provide conlrnender8 end laW enfomernent OffiCialS with' means by which information may be acdurately identified.
ROUTINE USES:: Yolk oe.ial 80OlifilY NonthP,r used Ps an PddikiOnstialtemPie.Ineans of identikatiOn tO facilitate filing and retrieve!,

DiSeLOSURE: . , OliSC.1001.we 01 YoUr SOgiBl gegUrity 19i.ggl*Ir iS vgluritatyt- , . ,
DATE11110!
/1-70,ri(Z /2410 7,4//rie D
NA-itAE

ieaei
4"/
PART! - RIGHTS WAIVER/NON-WAIVER CEFITIFICAT
ection
vestigalor whose name appears belo toki me.that he/she is with the United States Army ' C.7,4":44-1/ /Ai telr.„1"7",.04 4 770P.A..)
2)) V./.1") and wanted to question rne about the following offense(s) of which I am stianetedlecoUeed:.
efOre he/She asked -Me any ctOestiOnSeboirt flerise(a)„,, hOWeVer, he/ahe made it clear M rrie that I haVe the following iightS.:
, , „ _
I, de not haVO,M ansWei arrY gireatiOnS, Or eaY anything .
Anything I S.ey or dO, can be USed art evidende egoins-t me in a criMinal
(eor eetsnhel subject to the­
. , I haVe the right to talk priVately to a Islip,* before, during, end after questioning and to have a laWyer present with me during queStioriirig, -This laWyer can be a civilian lawyer I arrange for at rio ekpanae ta the DovernMent or a militarY lawyer detailed lefrite at ne..exPense to Me,
„
or both,
-Of = (For civilian; ne l subject to the cigar) I have the right to talk privately to a lawyer before, during, and offer. questioning and to have a,lawyer present with me
,ring queStloning.,1 understand that this lawyer can be one that I arrange ior at my own expense, or it I cannot afford a lawyer and want One: a lawyer will be per:tinted for me beim any questicining begins.,
. „ , . . '
ant how willing to diScuse the offense(S)Under investigation, with or without a laWyer present, have .a right to stop ansWering questiOns at any time, or speak
• .
priVately with a lawyer' befoM anSwering, (Oahe% even if I sign tho waiver below , •
COMMENTS (Coniinue op reverse side)
Section 13# Waiver
I understand my rights as stated above. I am now willing to discuss the offensels) under investigation ancl make a staterneql without talking to a lawyer last andwithotit having a lawyer present with Me.
WITNESSES (ff available) SISNATIJRE, OF INTERVIEWEE
la: NAME (Type or Print)"
ORGANIZATION QR ADDRESS AND PHONE
2a. NAME (Type or Print) T*F.pi? 10,10kOF NyEsTiGATOF(.1.--.'
. ORGANIZATION OR ADDRESS AND PliONE . ORGANIZATION OF INVESTIGATOR
Afc,f
7.5 /t7. ? AET­
Section C. Non-waiver
1. I do not want to_give up my rights:
En I want a lawyer. I do not want to be questioned or say anything.
SIGNATURECF INTERVIEWEE
ATTACH THIS WAIVER CERTIFICATE TO ANY SWORN STATEMENT (DA FORM 2823) SUBSEQUENTLY aECUTED BY THE SUSPECT/ACCUSED.
DA FORM 3881, NOV 89 EDMON OF NOV 84 IS OBSOLETE
t-og OrriC4(41, U5( DiJ ?(/-1P25 S 5 1
U00043 DOD-050601
SW01181 STATEIVIE181
•Fts—re•ol this form, see AR 1913-45. th prof:wont ageocy is 00CSOFS.
• PRIVACT act sttr010.1T. '
._ .. „ ....:: .. . ... ._ . ,
I.E4 tg ticc •ectin.i.,*i; *is $.0$0$a**.if i; iii, s.,30 tizie kin4i0ei 2'4,00 asAik ,

AUTHORITY:
tO prothlicOrronOntlOrS. OFol.ligir ontoiceinelit ofOcialS Oh Mania by' Whitt! ipfoonsiitO ffity ht. attOtOtely identitie,r1:

PRINCIPAL PORPOSE
,.. .... ,,... • -RO1111NE USES: -Y.* itcitli.111;Pri.Ii.1.11#01# ii i001 0 0 0iTiii0,4itomite -.. ' . of iiIent):fitotIon 10 foottOto n ''' ; - tn if rotcleviL:
, ., „. • , ..,..:.,..., .,:. ., ,.,., . .:, :: . _:, . ... :.:, ,.,. „ ... . ..,, , , ,::-„ ... , :.
, . , : . , --.
DISCLOSURE: DischittO of ytiu.e incial tecuriti itmilier .6 vOitiotar$1:;,
k_l;) '')t()... 2. DATE ITYYYMMOD1 A. F1LE NUMBER

Z " ioydy
1414U-ee­5, LAST NAME. FEST \

:.§. ORGANITATICRI
I
r.at ea,
011:rit• 24o
.. IPA .1.
t
."
All
(9IGY-Z_ )(c)-2_
(t)
EXHIGIT .11: I SON MAKING STATEMENT
PAGE 1 OF .

ADDITIONAL PAGES MUST CONTAIN THE HEAD!Na "STATEMENT OF • . -TAKEN AT .-DATED-. _;THE 50ITDM IF Eat/ ADDI77014L ?AGE MIST BEAR iff 1NMALS OPE PEILCOA MAKING RE STATEMENT.:#0 PAGE NUMBER MUST BE HE INDICA1TD, ;
_- )
15A FORM 2823, ilEC ups . . DA FORM 2823. JUI:72,IS OBSOLETE . trwo, nips •--or-cirekl.:._ .05S- Otjt-'./ •
: . ea-5
,„;
U00049 s 025052
DOD-050602
co3r7 - "a6v?

INMALS OF PERSON MAKING STATEMENT: VAtk-L-r).v43.-I OF AGES
r4;/?.. OiefIciq C uSC __0(5025053
000051

-o wry
----r-a-c./05
mbt)7— FILE NUMBER:
-
STATEMENT AKEN AT DATED CONTINUED 4-Ac.1/2-446, .7-9P,f?
ek) (biz
oue:-. rye­
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/:-re.'"
INMALS OF PERSON MAKING STATEMENT: PAGE OF 2140IrAGES
FoR or u5 odu'i 6(t-kalr-5
e25o54

000051

7— "V 0Y= C40.5(TY.-4Y66P5$
tY-L
n1J5')(' , A
/111Uvz--9/RIlz 4i Fla NUMBER: STATEMENT OF TAKEN AT.DATED TAVA' 6/1 CONTINUED:..
ISTATEMEW (Cod/Am:xi)

AFFIDAVIT
'1..B 11" "1. -.-* E THIS STATEMENT VVHICH BEGINS 0
Y UNDERSTAND THE CONTENTS OF THE E E STATEMENT MADE BY ME.. THE STATEMENT IS TRUE. I VE INITIALE.D AU. CORRECTIONS AND HAVE INITIALED THE BOTTOM OF
H PAGE CONTAINING THE STATEMENT. I HAVE MADE IS STATEMENT FFtEELY WITHOUT HOPE OF BENEFIT OR REWARD, WITH° HREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAVVFUL INFLUENCE, OR UNLAWFUL INDUCEMENT:
ement)
I, 16,1,7
WITNESSES:
§TibscrIbed and swom to before me, a perSon auth;,rized by law to ad oarrs, da of , 20 O.
0 L
ORGANIZATION OR ADDRESS
((2)( YO-1
(Signature of Person Acirninis
(TYped Wm of ersol Min
ORGANIZATION OFt ADDRESS
gA77: /-P6 2..ec/.c.r\77-
..(Authority To Administer Oaths)
INMALS OF PERSON MAKIN .
PAGE GES
ro-A kr-r)01 14-1.._ v%-• TAR:1 • 3(4er 5
025,055
DOD-050605

C.f 0.2 67 - ot•to 7
SWORN STATEMENT
For use of this form, see AR 19045; the proponent agency is DO CSOPS

, . .,-,.,:: ,.r......:.. emyAcT AcT9TATimp4,-f ';" :. '',.' ,' ,, .: AuTHoorr*: .', : • . : 1190'19pp; Sectioh 391; 'Title USD SectiOn ,2951; 5.0.9331 dated NoVerither 2Z 1943. 0*, , • TO provide COMmandera andlaiki enforceinent official's with Means' fiL y whiCh infontatien May he adeurately identified..
.
PRINCfPAL.FORPO9 , ' . „„ . „ . . ,, . ‘_ .. . . . , .. , . Year:Social security nunther la 1;30 aa go additionallaitentate means of i • ' a ion to facilitate trieval:
RDLITiNENESi' , . .. ,, ...„ ,•,, ,
, ,.. . . , -. : . • -OlSDLOSOREi'i •: Diselosure ef yOur social securitY nuMber ia.voluntary.. •-.- • •
2. DAT ISIMOD) 4. FILE NUMBER /0145-0L /Rig-a 04( 014
' GRABEISTATU
•
, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
6/Q 0' r-Atrz zoo q Fin Yr-e Avke-
1}--N Co ^3 'CA a- f U-54 ft( /44-t t--) Fetav¦d¦ t•JI-V4T.

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10. EXHIBIT 11. INMALS OF PERS G STATE
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STA7EMENT OF -A r pA7ED
THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF 77IE PERSON MAKING 77IE STATEMENT, AND PAC U -ATM,
:
FOR OFFICIAL USE ONLY DA FORM 2823, DEC '1998 DA FORM 2823, JUL 72, IS OBSOLEIT EX1libit IJSAPA V1.130
025056 000053
DOD-050606

0,-10­
c /6 387 -i64467
STATEMEtst `447---(A DATED.CON-TINUED
/4-P/L. 0 (...f

— tii4 oci PEPs 7r-r4--r" u44-5 -7•51.
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INITIALS OF PERSON MAKING STATEMENT: . PAGE 7--Cfrechl-V' PAGES

025057 U00054

DOD-050An7
' , 4k1W6 -04/-aDin- 5cua .
STATEMENT OF . , .ST-ATEMENT . • , • AKEN AT . •. • vt'AC)5C) Twosk-D ATED 01 404 zoo Ll
• -
. •

(c)(?)(c)--2
AFFIDAVIT
, HAVE 'READ OR D READ TO ME THIS STATEMENT
WHICH BEGINS ON PAGE 1, AND ENDS ON PAGE . I FULLY UNDERSTAND THE CONTENTS THE ENTIRE STATEMENT MADE •
BY ME. TliE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH GE CONTMNING THE STATE

HIS STATEMENT fREELY WITHOUT HOPE OF BEIIEFIT DR REWARD, WITHOUT THREAT OF PUNISHNIENT, AND WITHOUT CO CEMF.NT.
' !Signature of &Man Ma kr !Statement/
Subscribed end swam to befor , a perion authorized by law to fia t -2.001/
WITNESSES:
GO) t
ada
at
ORGANIZATION OR ADDRESS Administering Oath,
,
(9(6"
ype ame of Pelson Administering Oath1 /
C 7,'6
ORGANIZATION DR ADDRESS (Authority To Administer Oaths'
‘3,
INITIALS OF PERSON MAKING STATEMENT PAGE • OF . PAGES
USAPA V1.00
PAGE 3, DA EOM 2823, DEC 1.998
rog WOO oh, JS6--or,114
gOt) 57 re /ft
025058
U00055
DOD-050608

-Oci-cdo.37?-roelst?
. •
, SV0011111.3TATEMENT
, .
•• For ute of this form, set Ali 190-45; the proponent agency is ODCSOPS
• PRIVACY- ACT STATEMENT, •
AUTHORITY:-Title lfi l'Sc Section 301; Tido 5.Section 2G51; E.p.. B397 hied NOveinber 22, 1943 (S;4). '

,
.PRINcIpAkpoRpos.provide pornritanders.nd law enforcement officials with means hy Which information may be accUretely identified.

ROUTINE USESt...YOnr social teturity number's uted at additiOnallaltemate meen's of identificetion to ficilitote ffiing and retrieyot • '
: -, ; ; , •
DISCI.OSURE:..;.DitclOture of ybUr sociat tecurity norther it yokintarY. , '
Z DATE 1,717MMDDI 3. TIME 4. FILE NUMBER,
APO qoq-01-

'
A E THE FOLLOWING STATEMENT UNDER OATH;
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10. EXHIBIT. 11. INITIALS OF PERSON MAKING STA ENT AR
. PAGE 1 OF GES,

'ADDITIONAL PAGES MUST CONTAIN THE HEADING "STA7EtifINT OF TAW(-pa rED k_L7'-ere"-THE BOTTOM OF EACH ADDITIONAL PAGE MUST DEAR THE ININALS OF THE PERSON MAKING•INE STATEmyr, 4No PAGE NUMBER MUST BEBE INDICATED. . .-• FOR OFFICIAL USE ONLY .
DA FORM 2s23. JUL 72, IS OBSOLETE Exhibit 7 USAPA V 1 .00
DA FORM 2823, DEC 1998.
0.25'0.59" • . 000056.
-
DOD-050609

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t(;)(7)19‘)-17-
FILE NUMBER: .
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CiAL-
DATED ;:looLf cq-CONTINUED.
STATEMENT OF TAKEN AT 4„pi/to

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INITIALS OF PERSON MAKING STATEMENT: .6)(0-71.._.PAGE "A-.PAGES

7
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025060' 00.0057
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AF VIT
• I , HA EAU OR HAVE FIAD READ TO ME THIS STATEMENT WHICH 13 S ON PAGE 1, ENDS ON PA FULLY UNOERSTAN E CONTENTS OF THE ENTIRE STATEMENT MADE , BY ME THE STATEMENT IS TRUE I HAVE INITIALED ALL CORRECTIONS ANO HAVE INITIALED THE OM OF F.ACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, A WITHOUT COETICION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
g Statement)
WITNESSES: Subacrted and ;Won: to before anzAlk ad " of A-PRIL -,2Oo9
at
-tRA
(6'14—

ORGANIZATION OR ADDRESS
Ane,/,,r•-voiL T
ORGANIZATION OR ADDRESS qh(0---2 (Authority To 4dminister Darks)
INITIALS OF PERSON MAKING STATEMEN
PAGE OF PAGES
DADE 3, DA FORM 2673,PECID98 USArA V 1.01)

hg q5E-‘y,their 7
025061 000053
DOD-050611
--ro-Oq_co3 Si - 6y? ,
SV11011N STATEMENT' Fox usg of this forrn, see AR 190-4E; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT "
Titie 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 2Z 1943-iSSN).
AUTHORITY:
TO riroyide commanders arid law enfofearnent offirjals with means by: whicli information may be accurately identified:
PRINCIPAL PLUMOSE.:
Your social security number is Used es an edditiCrlabiterllate rITHIIS of identification to facilitate firing and.rgrieval.

ROLITINE USES:
DISCLOSURE: Ms. cfoiure of yourSocial security number is voluntarY.

2. DATE [1117MMD11)-9. TIME 4. FILE NUMBER
Ala5 U L ma
7. GRADEISTAT
E
ORGAIJIZATION'ORAD C.)
, WANT TO MAKE THE FOLLO G STATEMENT UNDER
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AODIRONAL,PAGESMISTGOIVTAINTIEHEADINGTTA7FAUTOF
THEBOTTOMOFEACHADDMONALPAGEMUSTBEANTREINITIALSOFTREPEDSONMAKINGTHESTATEMENT„ANDPAGENUMBERMUSTDEBEINDICATED.
FOR OFFICTAT, TJSE ONT,Y
DA FORM 2823, JUL 72, IS OBSOLETE. USAPP,V1.00
DA FORM Z8Z3, DEC 1998 Exhibit
025062
DOD-050612
'1,0-0Y-cA0377 A641
Cgmt-o-et

FILE ginsvg., :211-ifst MI • ZawiejfiC) MI"
air
CONTINUsTATEMENT OF TAKEN AT DATED
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FOR OFFICUL USE ONLY

INITIALS OF PERSON MAKING STATEMENT: Allit_COL4-7-___
tbA tc\-1
025063 000d33
DOD-050613
/14-c/ - - 1)38r7 - 6??
US T1711 PAGE IF NEEDED. It..-.11$ PAGE IS NOT NEEDED. PLEASE, pRoctEb TD1-redAL PAGE bF Tkp
.
STATEMENT OF
9. STATEMENT (Conti-M*1,

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'INITIALS OF PERSON MAKING STATEMENT
PAGE 2, DA FORM 26'23, DEC 19.98
UrricAl, USf DiJ1.1 .i(thor-r?
025064 000061
usE 71-4s PAGa Ngp07,i, pvGE Nct NtOripo, PFlOpEED.176,,-.44 pAP.E oF THip FoRm:
TAKEN AT "44 DATED 266 OM
STATEMENT OF
k,L7)(3)( LI;),
9. STATEMENT leonthwed1 ,
put 1.),' 77/pee) ,) 6 t+
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T:e4/6 a3-te/eens'io-lis';.9714a 771-7 lace-6-4.01:s;•
INITIALS OF PERSON MAKINOST
PAOE
411111kallif
FOR OFFICIAL USE ONLY
Exhibit
711SAPI1 VI 00
PAGE 2, DA FORM 2B23, DEC 1G98 . .,
-
tC)(40-7
•
025065
000062
(0, -0V-co3 ar? -106, 99
--446-04-0D3 9-80649
.04e) us I./ c.... FILE NUMBE
DATED Zobgele7 ONTINUED:
STATEMENT OF , TAKEWAT ' . STATEMENT Corfee• ' '

__LIDE,„
h --..1 1 -¦ —I
Q:54 ( i -, vol-- 1' (411.(,)°-- 1
A: finicS111111111111., eilt...)-Z-,-k'-')()(%)= -2-
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,.../
•
(1;15)e.•
AFFIDAVIT • HAVE FtEAD 0 VE HAD READ TO ME THIS STATEMENT
,..1,
I FULLY UNDERSTAND THE CONTENTS THE EN11RE STATEMENT MADE BY MEVVHICH BEGINS. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INMALED THE
TTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REW
, WITHOUT THREAT OF PUNISHMENT', AND wrniouT COERCION, UNLAVVFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
rrg Statement)
WITNESSES: to at Subscribed and sw to before me, a person authorized by Iaw Of AP/Di— , 20 P)4/ -0 5 VI- rj g-61
ORGANIZAT/ON OR ADDFtESS
k;-)(.-4)6.\-‘ ,,.•41- •. • ;

ORGANIZATION OR ADDRESS:
CL,)())(1)--L_
(Authority To Administer OaMs)
STATEMENT
FOR OFFIC P.F
hxrubit
02.5Q66 000063:' DOD-050616
FtIPHI:. ARM*** PROC4DURPAINIVFR
For use Oj this torn), SOe AR 190-30; the proponent agency is ODCSCPS
AUTHORITY: Titl 10, United States Code, Section 80i2(e)
pFuNcw41, puRpOpE To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES: Your Social Security Number is itied aS en additionallaitginate tTlearIS tO facilitate filing end retrieval.

, -
DISOL.OSUOIE:. Disclosure of your Social Secbrity Nunter IS voluntary.
.Z DATE(07.
4 5'.eeo
OR6ANIZATION0Fi ADDRESS"
-GRADEJSTATUS
cc,,4"./
-4.
PART I - RIGHTS WAIVER/NON-WAIVER CERTfFICATt
SeCtiOn Right.S
The inVesiigatOr whoSe hems appears below told Me that he/she is with the United States Army 6.7,4",""ti,./*V "94 27071 zi.e-rd"-, 4017¦•147."4-1
40/k/17444/ and wanted to questien me about the following Offense(s) of which I am
sUspectedlaccused: /(014e/e.6.e..e

. .
fore he/she askee me any questions the olfense(s), howevei, he/she made it clear to me that I haye the following right&,
.
I de not have to answer any oris ot Say anything.
Anything I say or do c.a used a,s eviclenCe against me in a criniinal
(For peter:01nel S ct to the 1JCMj) I have the right to talk privately to a lawYer belore, during, end after questioning and to have a lawyer present with me
during que ning. This lawyer can be a civilian lawyer I arrange for at no expense to the Government Or a Military lawyer detailed for me at no expense•to me,

- Or -
17b r civilians not subject to the UCMJ) I have the right to talk priVately to a lawyer belore, during, and after questioning and to hove a laWyer Present ,with me during qUestioning. l'understand that this lawyer can be one that I arrange for at my Own expense, or if I Cannot afford a .1aWyer aria want one, a lawyet will be apt:feinted for Me before any'questioning begins.
)6.Y
.
If I pal now willing to discuss the plierise(s) under investigation, with Or without a lawyer present, I have hght to stop answering 'questions at any tinie, or speak
privately with e lawyer before ariSwering further..even if I sign the waiver below.

COMMENTS (Continue on reverse side)
Section B. WaiVer
I understand my rights‘ stated above. I am now willing -to discuss the offense(s) under investigation and make a statement without talking to a !airier first and withol,it having o lawyer present with me.
WITNESSES (11 aYailable,
mo-L (bV))4) -7
la. NAME (TYpe Or print)
. ORGANIZATION OR ADDRESS AND PHONE NATURE OF INVESTIGATO
01111111111111111, 0,-;) (1.3)(e)
2a. NAME (type or Print) TYP
. ORGANIZATION OR ADDRESS AND PHONE
Section C. Non-waiver
I do not Want gk;e tip My rights:
•
1:1 I want a lawyet.. 1:1 tio not Want to be qdestioned or say anything.
. SIGNATURE'OF INTERVIEWEE
ATTACH THIS WAIVER CERTiPIOATE TO ANY SWORN STATEMENT (DA FORM 2823) SUBSEQUE4nY EXE-PUTED BY THE SUSpECT/ACCIJSED. OA FORM 3881, NOV 89 . EDITION OF NOV 84 IS OBSOLETE
orricIAL VS'e Viot4
61(813,1"2. 06 7 000064

DOD-050617

-
(•1`11(47 -0 C/P317 dobc1 7
.

SWORN SINkInEbEEIErh

.
For use of this form

see AE 190,-44: The proponent agency of:the Dep#ty Chief ok tiatf fer ,Personhel:
DATE

FILE NUMBER

TIO$

GRADE/sTATus

.

LABT.EAMEI.,_SPET NAM.

111111111111r &`Th1(0.171-U E-6

ORGANIZATION-0A, *MBES
San Diego, c4.

(Ant'-U'

. . want to make the followin Pat4t.

ii-1-31V.171127sometim! during the early morning ho rs,. Tofwas assigned to ,--,
(1)(67(...
. ' . ,
' d was involved in a mission to Palo .14e a bOmbmaker
aisignment was to(.. 1.14,71.....
.60MeWhere in the\northeast portiOn pf MOSul -
. M1
navigate to-the target location and back .to was driVing our vehicle (Humvee).and I was navigating om the fron: We drove to the Pre-designated set .c, ht and stopped. AMI,
PaSS.Prige;:seat.
continued tO the
and I.staYed With our vehicle while the .
arget. otation.on fOo.t. Wfien we heard the explosion from the breaching .
,h
-

,h,h. .h.h
.

charge, we drove tc(the front of the target location and waited 30-60
.h-,h
._

. h

minUte$,until everYone was ready to leave. I neVer saw any of the detal,nees that_were caPttred at.the target locatiOn. We then navigatedMI--back tOAUIIIIIIIIIIIV• AI:Pout two daYa later, at_1500 hrs,. I was Ptacad on watch. gY du:ties were t0 guard the twO detainees who had been captured
04. MR and liMi were also assigned this duty.
on.2 APr
ok the detain es were b g interrogated during our watch. I '
Neither ,
ended the wa 318 0 hr .)/(..1-2
Q-: GM1 L-\--1,

A. SA
' 4: pid YQU see anYonePsc ybuse either of the detainees during your watch? .
-. ' ' ' (bliC° 4(in0q

A: No. --
Q: bo you have any knowledge of anyone abusing the detainees?
A: No. '
Q: Did you murder the detainee?
A: No.
Q:. Do you have anythihg you would like to ,dt.d to this statement?
11A: NO.MEnd of statenten-E/1/

;

(6.)(116-)"?
(OP -7-
INITIALS OF PERSON MAKING STATEMENT
PAGE OP
--711111,-
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF TAKEN AT DATED CONTINUED.' THE BOTTOM OF EACH
ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKTNG THE STATEMENT AND BE INITIALED AS "PAGE OF
PAGES." WHEN ADDITIONAL PAGES ARE UTILIZED, THE BACK OF PAGE I WILL BE LINED OUT, AND THE STATEMENT WILL BE
CONCLUDED ON THE REVERSE OF ANOTHER COPY OF THIS FORM.

FOA ()MC-Olt IJ5t-onn--/ r

025068 000065
DOD-050618

NUMBER:
STATEMENT OF.
DATED 7,4-PTZ YCONTINUED:..
STATEMENT (Continued)
C.)(-1)( t)--L
AFFIDAVIT
1,
HAVE READ OR HAVE HAD READ TO ME THIS STATEMENTWHICH BEGINS QN P I FULLY UNDERS THE CONTENTS OF THE ENTIRE STATF-MENT MADE BY ME.
THE STATEMENT IS TRUE. I HAVE INMALED ALCoORRECTIONS AND HA ITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. HAVE MADE THIS STATF-MENT FREELY WITHOUT HOPE OF BE IT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION; UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
Statement)
WITNESSES:
-C/11)--"St7iSsorIbed and swam to before me, a person authorfzed by law 3Y of "'PAW-, 20 0 y
. at A-priget. /174-42
ORGANIZATION OR ADDRESS
10111111111111111111 (6), (D)—' 1 (b)(;)Y(
(Signature of Person Admihistering Oath)
(TYPe-ettl)
ORGANIZATION OR ADDRESS
X-2 7 /f6" ere/ter
(Authority To Administer Oaths)
DF6ciitii_ 056 DNI-y
Ci-rt
0 506
000066._
DOD-050619

-0(/ C403 7V- Pa V?
SWORN STATEMENT
M2)
File Number: 046-04-0D389-80649
lineation: Mosul Airfield, Iraq
Date: 08 pn 04 Time: 1
Statement of:
SSN: (Plco\VZ 1-1(0-7. Grade/Status: 0-5/AD
Org/Address: 10 SF o Mos aq (Foil Carson, CO) -

„.
_ ant to make the following statement under oath: .5, It) --`7 On 2 April 2004 I Was asked to review the initial physical f'or Mr ortly After being taken hi custody pet SOP. See "Detainee Medical Scrt3ening Sheet" for detaila. Of note, /qr.
at described as aggressive and hostile during his detention ancl consequently
.
steam minor Mid-face and extremity trainna consistent with the described altercation.
-.
Approkimately 0130 On 5 April 2004, I was c,ontacted hi order to assess two detain.ees prior to being delivered to detention center on MAF. Upon initial entry into detention center, Mr: observed lying beside the fire in no obvious distress. e assessing "detainee yAN-, I was called urgently to a.ssess patient who was discovered unresponsive. Mr. hart is.well-documented and revealed normal mental status and normal vital 'signs mg temperature of 97.5 one hour prior to being found unresponsive. as treated per standard Basic Life Savhigs (BLS) and Advanced Cardiac Life Saying protocols, initially on scene at the detention center, during transport, and while at
CSH. See SF600 (outpatient progress nee) or MFR deed 05 April 2004 and SF558 (ER progress note) fer details. Overall, treatment course was well coordineed. Of note there W a S initial equipment problems with the bag-valve-niask (appara.tus used to deliver air and oxygen to the patient) requiting that this equipment plus the clefibrilla.tOr be obtained from the Aid Station whiCh resulted in a brief delaY iii advanced cpg ancl AC1,8 treatment. • Treatment teen con.sisting of 18D
andallir orpsmen involved in treatment oil scene and continued throughout
• treat:nen w e at the 671 CSH. Mr. as pronounced dead at 0250.
Cause of de arclionuhnon an-est. xact etiology of which is undetennined.

Q: SA -11t4))--)
)k,(0\ ((;)t)(04)
A.: I,TC
Q: \Vas Mr. (ill! any thne during the treement.period?
A: No.
•
Q: Did Mr. ce e any ou observed while in custody at the SOF compo n
A: I observed no si cant injuries on Mr.
Q: in your opinion, would any of the injuries suffered by Mr. have the capability of causing cardiac arrest.
A: No.
Q: Have you had direct knowledge of any detainees being physicely abused while in custody at the SOF compound?
A: No.
1NITIA.L (C/C17-11 7r: I Page 1 of 2 (91
-04LY:OR OFFICIAL USE ONLY EXHIBIT /9
„: .
025070 nods'?
(q)(ort
STAT'EMENT OF: DATED: 08 Apr 04 CA,SE #: 0046-04-M389-80649
Q: Would any of the interrogatpri techniques tilized Mrallinlikve the capability of causing cardiac an-est? -
A: Not that I arn aVvare ot ,mtto'cl
Q: Do,,you have anything to add to thiir state
(9hyty-ti
A: No. ///END OF STATEMENT///
,?1

AFFIDAVIT
•
, HAVE READ OR HAVE HAD READ TO MEE MIS STATEMENT WHICH BEGINS ON PAGE 1. AND ENDS ON PAGE 2. I FULLY UNDERSTAND THE COisITENTS OF THE ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE I HAVE INITIALED ALL cowenoNs AND ' H.AVE INITIALED THE BOTTOM OF EACH PAGE CONTAIN:N
. G TFIE STATEM:ENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT ;THREAT OP P SHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.
of Person Wang
ubsenled'and sworn to before Me, a person authorized by law to administer oaths, this 8 day of' April 2004 at
-Mosul, Irk. / ¦
C6)( X 0-1 '1(1V I
...,;: ...) -.
..,:.'
Special Agen1.111.1111
(Typed Name o erson m e g Oath)

le 136, UCMJ
(Autho to Administer Oath)

INITIALISE (610-1---Page 2 of 2 FOR OFFICIAL USE ONLY
(9 (7)(0-7-EXHB3IT / 0
n 2 5 rYT1-
000068
Rough Death Scene Sketch.
.

•
:\\

ow -if I-0P-f -
LEGEND
(A) Loeatjon where 1111111111111. went into eardkc arrest, -----"mm"I'mmlaw
TITLE BLOCK (6)..z. OFFENSE: Undetermined Death SCENE PORTRAYED: 1nterro 'on Area LAt4Pi-31 LOCATION: osul, Iraq VICTIM; Mr. (4141TIME/DATE BEGAN: 1400, 08 Apr 04 SKETCHED I3Y: SA
30- \
RE'VIEWED BY: SA

VA M.64
NOT TO SCALE
FOR. OFFICIAL USE ONLY EXHIBIT
025072 000069
0046-04-C113389-80649

PHOTOGRAPHIC PACKET

NUMBER. DESCRIPTION OF PHOTOGRAPHS , Photograph depicting fire pit and bench inside detainee facility.
2.
Photograph depicting fire pit and plywood sheet.

3.
Photograph depicting left side of fire pit.

4.
Photograph depicting right side of detainee cubicles.
5., Photograph depicting left side of detainee cubicles.

,
6.
Photograph depicting entrance to facility.

7.
Photograph depicting ftre pit and sitting area.

8.
Photograph depicting left side of sitting area.

9.
Photograph depicting left side of interrogation room.

10.
Photograph depicting center of interrogation mom. Photograph depicting right side of interrogation room.

FOR OFFICIAL ExmBrr USE ONLY
025073 000070
DOD-050623
„
DSC0.605. -FOR OFFICIAL USE ONLY
61.1ifsf r
0 titai 17 4

oa46-p4-ciP389-80649
DSC0010

FOR OFFICIAL USE ONLY
2

025075

y.ftiBcr-
010072

•

ROlorrOd:t9t:
U.S. ARMY MEDICAL COMMAND FREEDOM OF INFORMATION/'
PRIVACY ACT OFFICE ATTENTION: MCFP 2050 WORTH ROAD, SUITE 13 FORT SAN1 HOUSTON, TEXAS
-78234-6013
MR. JOHN PETERSON John.Petersonl@cen amedd.army.mil
(210) 221 7826
025076
• '•• uN.ci.,A$swm.p-ppit. ouicIAL USE oN4y',
•„ • • . . ,
DATE:„ 07 Apg.0.4.1.:,' • .. • • , • •
FRon 7571 m-p• T;.IFT Op 10S•tx, IRAQ • .

-Tc-:k • p1R,.•ij.Acge.',. FoR,T vA 2,06(.). •
ATT,1* usAcipc, Fon. BELVOTR,, VA 22060 '.07)(01 cr,gz, 7571414 pg.T.cm (Fiivp), BALAD.,. IRAQ • ,
cpgi.221.1.) (cipxF•wp),.:13AQI-ipAA. IRAQ 315N.u, GRP: (CID), or.u„w, 'GA 1NO,1„///,1., • .: •
.sbk,
Of STAF4110,' .
/600, ATTN: gocKy-.41,.mo
sAc, Ncis13.,m7TRA.114-,
SUBJE.CT: CID REPORT Of INVESTIGATION - INITIAL/SSI/J01NI. -0046-04-CID389-
80049,5x9Ef, : • ..„ : (AA ,,,,) - •

, • -_ •
1. DATES/TEvIES/LOCATIONS OF OCCURRENCES:
1._ 2 APRLL 2004/1733-5 APR 2004/0250; UNICNOWN L,OCA ION, LSA

MOSUL, IRAQ 02)2
2. DATE/TINIE REPORTED: 5 APRIL 2004, 1700
(...)-1 OCD-
3: liNVESTIGATED.BY $
• SA
4. SUBJECT: 1. NONE. ['UNDETERMINED DEATH]
‘0114(-1.1

5. VICTIM: (DE S ); C ; IRAQI; XZ; (NFI)
[UNDETERMINED DEATH]
6. INVESTIGATIVE SUMMARY: THE INFORMATION IN THIS REPORT IS I3ASED
LJPON AN ALLEGATION OR PRELIMINARY INVESTIGATION AND MAY CHANGE
PRIOR TO THE COIMPLETION OF THE INVESTIGATION.

"THIS IS AN OPERATION IRAQI FREEDOM INVESTIGATION"
THIS OFFICE WAS NOTIFIED BY MOR.TUARY A.FFAIRS, MOSUL, THAT THE
REMAINS QF AN IRAQI DETAINEE HAD BEEN DELIVERED BY 67TH COMBAT
SUPPORT HOSPITAL (CSH) PERSONNEL. .

PRELIMINARY INVESTIGATION REVEAL,ED TIIAT ON THE MORNING OF 2 APR 0
MR AS DETAINED BY
PERSO AFTER A STRUGGLE. MR
INTERROGA D BY, THE NSWT. ;AFTER. INT RROGATION,
WAS ALLOWED 0 SLEEP. ABOpT 0137, 5 PR 04,111411111.111111FA CHEC10ED

LASSETED-FOR 0 ICIAL USE ONLY
()((z)-Lk, 025077
(#1,),b)(rr-si
DOD-050627
it.,-)(q 6)1 IJNCLASSIFIED-FOR OFFICIAI, USE ONLY oil
CORpSMAN AND FOUND l'O BE UNRES IVE. AS T PORTED BY NSWT PERSONNEL TO CSH, MOSUL RE HE SUBSEQUENTLY RECEIVED EMERGEN DICAL CARE FOR ABOUT AN HOUR.
ABOUT 0250;5 APR 04, MR WAS PRONOUNCED DEAD OF, APPARENT CARDIAC ARR.EST BY DR (CPT) , 67TH CSH, MOSUL.
_tib)(0r7L---
AUTOPS.Y 1$ PENDING AT A LOLATION1 TO BE ETERM1NED (MOSLTL OR. BALA.D) IN IRAQ BY A FORENSIC PATHOLOGIST OF ME OFFICE OF THE ARMED FORCES • MEDICAL EXAMINER (0AFIvIE).
.
09)b) THE CID CASUALTY LIAISON OFFICER (CLO) IS SA AT DNVT 302-581-3100.
JOINT INVESTIGATION CONTINUES BY CID AND NCIS, WITH CID AS THE LEAD AGE,NCY.
7. CID REPORIt ARE EXEMPT FROM AUTOMATIC TERMINATION OF PROTECTIVE MARKINGS LN ACCORDANCE 'WITH CHAPTER 3, AR 25-55..
UNCLASSIFIED-FOR OFFICIAL, USE ONLY
2 025078
11111_51
tg „511ftran6Asigealiaglir:
0250$0,
f'or OffiOial -IJ$• -Ord -
AGENT ACTIVITY SUMMARY CONTROL NUMBER
(CID REGIRATION 195-1) '
,
0046-04-CID389-8064§
Time, Date and Agent Suinmary Of InN.iestigatiNie Actiyity- .

1700, 05' Apr 04 Notified by 1vIortuary Affairg of the death of an 'Iraqi iniscHleraf-virar. (Seo
AIR) '
19 0 05A r 0 Examination of remairth and re,ceii)t of death certificate. (See AIR

2030, 05 A r 04 Interview of SP
2200, 05 A r 04 Coordination with LT MO (See AIR.) •
1330, 07A r 04 Coordination with LT See AIR)
143104 Coordination with .L (See AIR
1716, 67 Apr 04 Interview of I-1M orpsinan. (See Sworn Statenaent)

SIMONI
6 07 A r 04
173_ , nIntervieW Of HM1111111Worpsman. (See Sworn Statement) •
sAIMIN
—) 175 07 A r 04 • Interview of HMCSOIMilitorpsman. (See Sworn Statement)
1615, 07 Apr 04 Interview of Ilk/12 111111111111See Waiver Certificate and Sworn
SAM= Staterhent)
1900, 07 A r 04 Coordination with LCIANIMIllornmandergEmimwSee
AIR)
2s0A011.1 Interview of GM1
Statement)
2100, 07 Apr 04 Coordination -with SAINNOCIS. (See AIR)

SAINIER
(5)(Qtrl (C)(1)(th
1206, 08 A r 04 Interview of LAMM(See Sworn Staternent)

(rviSA-1- (1'54)())(0.-2-
t
CID fORM 28-E TI1VEE; TVL: ADM: .
pAGE;
For Official IJ§e Only
025081 0.000d3
Time, Date and Agent
Ti-930, OS Apr 042
pk
Q9 Apr 05
CONTROL NUMBER
.0046-04-CID389780649I Summary of Investigative Activity
Interview of SPC See AIR)
Conducted death scene ex n. (See AIR)
(1.)(61 Interview of SOTO". Medie: (See AIR)
-
To SAC.
I. Polish guards in Baghdad for ten da.ys, will interview upon retarn.
2. Working on RFIA to I\ICISIo conduct interviews o
• .
members. Pending airtoPsy of M d receipt of report..
(APNLVAI
1:43 .g°\.:4")4'eldi
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ALL,1,
5 -7 . - D 1-16
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FORIA 287E TIME: : TVL: : ADM: : PAGE: 2,_
For Official Use Only
025082
0 0 0 0 4

AGENT'S ACTIVITY StliVilVIARY
'ontrol Number
IC:ID Re ulation 195-1 .7. 0046-04 -CID389- 80649
TIME, DATE, AND AGENT
MARV OF INVESTIGATIVE ACTIVITY
'(OP1-- • •
(9.0)(01'
ce,Je.k
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cn
O.71-FA4Cacp-J)sj'h.
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A (i)cc7
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ifte­
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7 ,
CID FORM 28
FOR OFFICIAL USE ONLY
I OCT 80 PAGE '...*
9
025083

U00005

DOD-050633

'
For Official Use Onl
AGENT ACTIVITY SUMMAR:Y .
COKtito I lvUmB ER.
'(elp fil:i;(11L.411(M i'l5-.1)"' .
0046-04-CID389-80649
‘ tinte, 1)ate. and.. Agent_ Suininary 'of Investigative Actiliity
In tervi.ewed CPT , confirmed death pronunciatidn. (See AIR)
0)(.-C)
To SAC, pending Info Repo tetviews of Polish personnel, and autopsy.
(L...„r. 14C:
0
--tA-4 C4-.

CA-1 lq A T r
A
4, 5 V.
CID FORM 28-E TIME: TVI,: ADM: PAGE; 14_
For Official Use Only 9
025084
0000o6

.
For Official Use only
CONTROL NUMBER
0046-04-C11)389-80049
Time, Date and Agent SIM Mary of Investigative Activity
1610;.21 Apr 04 Interview of splialre
411111111
16,611114 Interview of SG
(see AIR) \:..;1(7)k,v,
0900 22 A r 0
case, to 5.41111111111rending Info Report from NCIS and aiitopsy of IVir, 1111111111111"
(1,911"(44 (-1)(,)(1)7*,
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, , ""b„ MEV

finiarim„
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ALL.,
/Ye-(.4`SAJ p4Kr6„
cp 'FORM 287E, TIME: : : AbM:

PAGE:
t7;-'1"" -s • 4-ro
For OfficiallThe OnlY '
0 2 5 0 8 5
1 0 OU '7
A
INVESTIGATIVE WORKSHEET
AD-MOM-TY: DATA TCPJ,2111RED BY ITTEPRIVACY ACT Tide 10. United Stales Code. Secrion 301.210. ROTTINE USES: Your
social security numb& and other Ferrara)
filfOrE0263,1 Zre
used-se
addidociaValternate ro..ins provide Commamden aid law eniorcemeat officials identifiason D3 facilare Sing and retrieval.
with means by which inixannkin may be aamarely ideurified; DISCLOsuRE Disclosure of your axial neanity number ia wiluntara
PRINCIPAL PURPOSE.: To
1 REC MIX 2 ACRON OXE
11111111 L.A.ST, t;LA E A 4 2­1 3 LATE SUBMFTED 1Mikeigli— 4 SE0 NuMBER 4 5 YEAR 6 UNIT • . 3 7 RtY NUMBER 5 1 8 REL TO CASE 9
12 mr
13. GRAFX
1 OTHER IB NUMBER
5-•
23 HEIGHT . ooe-sy 19 .:-.)B-c.:71
1
31 moS. 32 MCAC,, 33.POSITION 34 INDUSTRY 35 5ECURIYY 29 PRIOR R -84 •Io MAP!tk.

2 2
38 ALiAS-NicKNAME 39 ALIAS-NICKNAME 40 ORGAN TION
41 IF CONTRACTOR, CONTRACT / i'':
NIT
44: FORT/CITY
45 STATE
4,5 CoUNTRy 1
47 ZIP COOPAPt
48 ADDRESS
I
2 50 STATE
51 COUNTRY
I _ 52 ZIP 18 54 EAMiLy REL Z 2
55 SPONSOR LAST NAME 55 SPONSOR FIRST NAME2
57 SPONSOR MIDDLE +..m+ 58 SOCIAL SECURITY NUMBER
59 SPON GRADE BO SPON MCAC-15
81 SPONSOR:UNIT ADDRESS
• 2 SFON ST
SPON,CTY 65 SPQR ZIP CODE/AFO
2
E6 OFFENSE CODE OFFENSE-
. 57 UFC
88 OFFENSE CODE EG UPC,
70 OFFENSE C006 1
. TELEPHONE /
ADMINISTRATIVE DATA
ETS pcs/DER05
BAIT INTERV
TIME INIEFry START
STA.FIT
TIME INTERV PLACE OF INTERVIEW F INGERPRINTVE.HICLE DATA END END DISPOSITION-
74 CONTRACTOR NUMBER CORPORATION DATA
75 FEc sERv/pRoo
76 CoRPORATiON NAME 77 CORP ADDRESS 4 78 CORP CITY 82 CONTRACT NUMBER
CIO FORM. 44-11
EDIDON OF 1 AUG
DEC 87 BE
USED UNTIL. EXHAUSTED
025086
11

DOD-050636

025087 12 tw0009
DOD-050637
_._
INVES7'/GAITVE WORKSHEET .
• -
AUTHORITY;
DAT A REQOIRED BY THE 'PRIVACY ACT , _ _. 7._____
_ Tide 10, United &ante CDde. Section 301.2ig.l. ROUTim USES: ' .. . Your social Beau*); number and ccrIc peruor.1
PRINGEF:Al...PuRposz . inizmition are hoed as an ariclinomayannroare .
snr_a.o, of
Tettrae, .
°.T7'1'54'7 a'"d 17.„
...
be
r ciathisidearrard.
1 -
REC COOE 1329CLoit
2 ACIION COCE . Dedom.... ct .
nodal
'
A 4 4 SO Ntrh1883 I 5 YEAR 5 LINIF..numb= is van:mare
7 gtiSat(diTTQ 6 7 ROI NUMBER
a Fe. TD CASE
1,11111P
2 -, 3 1 9 fivrit)! e'
irtiteiMar. • 5
DIVIDUAL D 1
' , ii FiRsr RALE .
12 M!
'14 SLICIAL SECURITY NUMBER WA14 13 GRADE
15
IO NLIMBE6 15
16
15
21 RACE .22 ETHNIC
ffErslit
24 WBGHT • .25 HAIR
fry/ .25 EY1 COLOR
7.2/' 2 ite) ZT.PrroiN. 28 Eouq:
MaS 3 t7R,,L) mai • :4,14
/e. 32 mc.Ac 5 5 30 HATA.
fosmoti (./.f '2
34 INDUS-MY
//it/ 5 •2
as sacvRav f 36 Priysic..a. movEs /1--7
37 ALI&S-NiCKNAME(SI
30 AUAS-NICKNA ME - 21 7-A7/F.eit­
2,1ze,e .
39 ALIAS-NICKNAME o •T
40 ORGANIZA
it I 42 MRJTARY SVC: .
41 IF CONTRAcTOR. CONTRAcT
. 43 SUNUNU'
eL—
45 STATE
2-2 46 COUNTRY I
47 ZIP C.40F.,•AF!' 49 CrTy 2
50 STAT5
.51 COUNTRY
52 ZIP COOF.".4,--•. 55 sPonsp0 LAST NAME FAMILY MEMBER DATA 14 2 .91/ I
55 SPoNSOR Fin; NAmE
. .
57 SPONSOR Mak t
Ea SPON HCAC
• 15
spONsOR uNIT ADDRESS
64 SPON CTY
65 !PON ZIF C00E/APO
2

OFFENSE
uFe n.aFFfNsa CODE 1
ADMINISTRATIVE DATA _ _ .
TIME arTERv ,
DATE t&Ttilv.
TIME ItrrEERI START
PLACE OF INTER0Fw
vF_HicLE DATA •

ENO.
END FINGERPRINT
END DISPosmoN
•
CORPORATION DATA
76-CORPORAT1ON NAmE
78 CORP CITY
80 CORP erri •
:
NOTES .•
CID FORM 44-R
i DEC ST Eor7Kw OF
Ape at MIL BE USE° tNrcIL ep,sAus-rEe
025088
1 3

00 01 0

DOD-050638

DIVESTIGATTVE TVORKSI
DATA REQUIRED /TY THE PRIVACY ACT
ALITI-10123Ti: Tide 10. Uhited Soma Co5e. Sethan 301.2l0. 1401-713,TE USE% aceial security ritunber and other pereur.4
•• . .
infoanabco axe wed an
an acktnicaLallaheenate innani ot idnitific.to facilitate Bling:and
PiuNciPia. Pv-R.PosE; TO.' cocomanatri and Iaiii enforsecnent official '
,
'
' mams by Mach information naiY be accierzady icienfifiod. PI.ECt.DSURE:r DiectOmiie cif r.iir.ziocW sectirity 'number is..v..
, -,itter.try 1 REC COX 2 /,CtiON CODE 4 SEC! NUMBER . 1 5 YEAR 6 UM!'.
7 poi NUMBER,.8 RE TO CASE 9 crurc.r1 I.
A4
2'.033 3 •
-3
INDIVIDUAL DATA
10 LkST.
1,3 fl
13 GRADE.
.,•=a4Milaw
TallittiteSKM1"-1
•
ER -ID NUM1461.1
R8 'OEI-ST ig sna .15 23 HEIGHT •24 WEIGHT 25 NAIR.COLDf
YAW.;
20 PRIOR
MA R! 1 A 2. 5
" 3
33 POSITION 31 INDUSTRY 35 SECURITY

ICKNA
DROANIZATID
44 FORT/CITY ''
4E. STATE.
46 COUN7RY I 47 2IF C.0a5,IAP! 18 2
2 j.
50 TA 51 COUNTRY I 52 ZIP COD', Ar.
cAA)/9-0 8
21 2 I
FAMILY MEMBER
53 JUV 54 FAMILY REL 65-SPONSOR LAST NAM E, „
5FONSOR IXX t '
15 ?.1
59 SFON GRADE spoN mcac i
sPoNsoN UNIT ADDRESS
: I
62 SPON CITY.
SFON ST
61 SPONFY 65 spoN zip CODE/AFO, 2 2
71 UFC 72 OFFENSE CODE
TELEPHONE /
FCS/13ERDS'
DATE INTERV I TIME MIER)/ spiPT I START DATE INTERV TIME •INTERV PIACE OF. INT-4140N/ •
FINGERPRINT
END ENO
END
CORPORATION DATA
74 CONTRACTOR NUMBER
.75 FED SERV/PROD / 7E CARPOMTION NAME .
12 4

77 CARP ADDRESS 78 CORP CITY .
[,OPP -. . 7 •
NOTE
LIT o/--
C-n-L
covm7aY
TA/ ? o
)( (c.)z_ Alp/
CID FORM 44-FI
ED1110/1 Of 1 AUG 87 WILL BE LI5E0 UNTIL EXT'AUSTE0
DEC 87
025089 mon
DOD-050639

INVESTIG.A.TiVE WORKSHEET
'
..
DATA FCBQI.TIRliD BY TEIEPRIVACY ACT 7Bie 10, Uraixd §mats tecle. Section kli.2(!):. yibiTTINE USES: Your szdal securicy numb=
AUTHORITY;
pear...
_:__ and ccbor ..... rrq.1 •
fatioresadsoo are used as an alditiocali ..­PRINCIPAL-PURPOSE TO
alamm2s= reeane of ' gee:m=3d= mad la.ss-klentifimcleil so tazBitkEr Blixig sacl retriewl.
, ,. : Miorameut officials
' IIIGMB , by wiii± informition may be aommtcly identified.. Dlfia.CarRE Disclosure of your social asauty number is volun&
Fec OWE 2 ACDON coee
3 to.y.it(su
lar .....4. 4 5E0 NUMBER. I
5 YEAR
6 UNIT
A 4-7 RO/ NUMBER .
8 REL rcr CASE
I 9 Cl/NiO e
AM
13 GRADE

E_
a
2 P1R. C71
18
2 1
29 PRIOR
30 MAPC4,...—
as seiiRrrv
35 PHYSICAL MARKs .
2 38 ALJAS-NICKNAME 39 ALieis,NicpuimE
20
41 -1F CONTRACTOR. gavrpAer
S NIT
4:4 FORT/CITY 45 STATE -
46 COUNTRY
2 I 47 ZIP CODEILT,
8
2
49 CTT' 2
50 STATE
51.GOON1111.
(-eV( 0 52 ZIP CO%
113
FAMILY MEMBER DATA 2
5.5 SPONSOR
LAST NAME SPONSOR FIRST NAME " z7 SPONSOR 1.41I-)0(t
2058 50CIAL SECURITY NUMBER
59 SFOH GRADE 1 5
60 GPI)+, maac
sPavsati uNrr.ADORESS
2
64 SPON, CTY 65 SPON ZIP CODEMPO
OFFENSE
67 UFC 68 OFFSISE CODE
-
1 71 UPC 72 OFFENSE COOE
Es ADMINISTRATIVE 1
DATA
FCS/DEROS
1:14TE INTESV
TIME INTERV
PLACE OF INTERVIEW

STAP.T
DATE 'MIRY, START
TimE INTERv
START PLACE OF INIEFNIEW
END FINGERPRINT

VF1-11CI,E DATA, ENO END DiSPOSrTION
CORPORATION DATA 76 CORPORATION NAME
78 CORP CITY 79 CORP ST
80 CAR?
-
1B
2
NOTES
MO-7-
CID FORM 44-R
EDITION OF 1 AUG 87 \Nu BE UsED urrnt, FP',AUSTED
DEC R7
025090
15

000012 DOD-050640
JATTI:(ESTIGATIVE WaRic,'SHEET .
.1.14-1-80R1TY; , -, , DATA FCECArIViD AT r112.1.-R"74-CY-=.•=:.•,,--,---,,
Tilie 10, United 5#/tee code. SeCiitil 3013lti, , , , ' ' : AF
. .. ' ; , ,
.potrrpsrE usEp:
, Yout xcial Aettnity iliinibeT wid otoci' pan,
, :t -' - i;-.1 -
.. . kilareipscin. air. timed ie 4:n 4tErtit..a14.toeen4ie lee.,r1.4 o;
,
PRENCIPA.1., PURPOSE; To provid. idendiScadon tO. bate* /Ming F. ad retFieral,
. e comrazockei 4ild live cofcrerrierit otki2J4 '
•.
. with ei,c,,na by witizb bikirthetioi 04;ty be athr,-,;toy idcpria4 ixscwsu-RF4 , Digoaitut
.
. . .
.
•-
.1. REc . „. ,
:".:OLIf ' 2 AMON cow ,.. . , of, . J,044=1-kci..21actpriili
q aikrE SUEiMI . " .ni•umbtr: ii 1,•,,Itult...17:-
0.4 SEP ,N0M051 ..1 :5.YEAR
5 UNIT ' 7 ROI NUMBER
A 4:' t I . 1 I.. 18 REL TO CASE a crurrd" •
4 2 5.2.
001.
j 13 G9A0E
15 I ez-„..; • .
: 21-ap,c 22 ETNN 23 HEIGHT
24 WEJGHT 25 HAIR COLO 18
COLOR
29 PRIP8
Q_ Ip'ot. 21 20 0 3
C) 5 ; 5
.40S._
FOSMON.1
34 INOUSTRV
/11 35 sEcupm i 35 PI-PrsiCAL mAnKs
Fd
a, AL As:pacxhAMEtSi 00 2 I 9 9 2 110 2 I
36 ALAS ./ICYNAM.
' : 39 AL.A.4.,aCKNAME
4o pRGANIzAnott 20 I
20
Gactrrrnerit 4: :F 'CNTRAC.:IFL CONTRAC, /
m1LITARy svc

1 s
r.r,R7 7, 45
: . :OU/V-TY ZI°
1
48 ADDRESS
2 435'
2:
5¦3 :74TE 51 courmv
5,2 .%=
2
2
ivy • REL.FAMILY MEMBER DATA
55 SPONSOR- IAST
NAME
55 SPONSOR.F ¦
RS7 NAME,
:
SPONSOP
-
•sotiAi,
NUMBER
55 SPON GRACE I 60 SPON MCAC ;.-
I a- 3Pro,lsoR,:iNn-ADDREss
2 t
2 ,
I S3 5PON ST I 64 S?')11 :77:' I
as sFEIN ZIP CODE/APO
18
21 2
1
OFFENSE
67 UFC
68 OFFENSE CODE
I 69 UFC
I 213 OFFENSE CODE
1
TELERic.INE ADM INISTFiATIVE DATA

ETS
PCS/DEROS
CiAtE
RACE OF iNTF_FIVIEW SLOT
DATE INTERV rImE
pi.AcE OF Ara?v¦ Ew ST
:5-TApr: 'IMART
k J.Nr
it:VINGEP91147
END
VEHICLE OITA ENO
I END
OISMSITION
CORPORATION DATA
74 CON1RACTOR NUMBER 75 FEC SEPV. PROD /
I 'e :;ORPPL'ATION
12 I
CORP ADDRESS
76 COPP
corip sT
82 CONTRACT NUMBER
la
2 '
15
(1,40--L
,5)N 6 e-c-a,AL i 1 _5'
QID FORM 14-71i
ED1110N-I1
AUG R7 WILL BE
DEC. A3'
025091
16
000013
DOD-050641

DEPARTMENTOFT0EARNIY' •
. UNITED STATE ARMY CRIMINAL INVESTIGATION COMMAND , ,.6010 611 STREET
. FORT BELVOlki VIRGINIA 22060
28 March 2005

MEMORANDUM FOR Director, Crime Records Center, Fort Belvoir,
United States Army Criminal investigation

,h

Command, Fort Belvoir, VA 22060

SUBJECT: Transmittal of InfOrmation

1.:,--.The attached Final. Autopsy Report and CD containing-AutopSy
PhotegraphB- are fOrwarded for enclosure into.'.case file 0046-04-

-if . ,
CID389 -80649 -5H9B. This was a Final Referred to NCIS whO had

.h

already made Arrangement8 to obtain a Copy for, their case file, ThiSh
fOr documentatiOn purposeS

contact this itemorandum is SA
belvoir.army.mil Or the undersig

2. Point.-h

C6) (q(q)(c,)
2-encl
as CTAT2, MP
Special Agent

PRINTED ON RECYCLED PAPER
9 5 0 2 000d14
DOD-050A47
UWE e-st ., rar suittal (004-6-0;4-, 5 0649
. .
n 05 A r 04, this office initiate mvo vmg the death of

-.
an Ira i detainee in the c stody -as being held- 91141ibstl0ning4eth e4ng „ uni9ro
mprovis c tosrve devices and 0t11 -15910:litakirig rim. W:134'ilt be. iallOw.: 6'd to rest;
"
went into cardiac an-firim unkno . tcauses'.fife
g nlOsilie§ -*Pre -
,
utmediaterY adrathistired 01..1;dulY 0 ithell and 411` Y or, however,'' efforts
sutate Mt e res

cap:Oe:04:0, tb was
listed as cardiac West.
. ,

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Referred to:
DEPARMENT OF THE NAVY CHIEF OF NAVAL OPERATIONS ROOM DN536 2000 NAVY PENTAGON WASHINGTON, DC 20350-2000
MS. DORIS LAMA
navyfoia@hq.navy.mi

(202) 685-6544/5/6
025095

CID001 CRC(sc)-
From:: . rmy.smil.mill
Sent: - - - . 3 AM
To: Mail), .
Subject: 01A parts 3 and 4

PDF
0046-04-CID389-3.0046-04-CID389-4.
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046-04-CIDSSSL-S.pdf OD46-04-cib389-4.pdf

CW3-, MP'

SPECIAL AQENT

75TH MP DET (cIE.1}
MOsuAIRFILD
APO ik'09S34

DNVT:

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DEPARMENT OF THE NAVY CHIEF OF NAVAL OPERATIONS ROOM DN536 2000 NAVY PENTAGON WASHINGTON, DC 20350-2000
MS. DORIS LAMA navyfoia@hq.navy.mil
(202) 685-6544/5/6
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U.S. CENTRAL COMMAND
7115 SOUTH BOUNDARY BLVD
ATTN: CCJ6-DM
MACDILL AIR FORCE BASE
FLORIDA 33621 5101

Master Sergeant Pamela Andrews
andrewsp@centcom.smil.mil
(8T3T8'27-:534T/28 30— -

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DOD-050649
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DEPARMENT OF THE NAVY CHIEF OF NAVAL OPERATIONS ROOM DN536 2000 NAVY PENTAGON WASHINGTON DC 20350-2000
MS, DORIS LAMA • nayyfoia@lioiavy.mil (2(?2) 68.-5-6544/5./6
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