Documents relating to CID Report: 0147-04-CID259-80210

First 18 pages of CID Report are missing; details are indiscernible. This document contains hand-written confessions, written in English, regarding IED attacks against U.S. soldiers, and one page out of a three page statement by a U.S. officer, noting that detainee's injuries were self-inflicted.

Doc_type: 
Investigative File
Doc_rel_date: 
Wednesday, December 29, 2004
Doc_text: 

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U.S.
CENTRAL C MMAND 7115 SOUTH B UNDARY BLVD ATTN: CCJ6- M M CDILL AIR F CE BASE FL RID 33621-5101 -

S.
JAC UM-NE SCOTT scoff axentcom.sra.mil

(813) 827-5341/2830
!DATE
CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD
.g! use of Inci 'atm. see AR 380•E. tne proponent agency's the Of lice. Assistant Chief of Staff for Intelligence
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SECTION A - GENERAL
TO. SAS-/ r144 rip DIA.(CC. ID )tri....4 ),, AA, ii.A./.4 t FROM: SAL , Lii. "1"1 pieoN.:1-Cc.( 19 ,oF;,...f.oCh ip/ A., 1
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DATE RECEIVED ACTION OFFICE(S) SUSPENSE DATES) REGISTER OR CONTROL NO. I
CONTROL LOG CLASSIFI-NUMBER DESCRIPTION (Type, File Ref, Unclassified Subject DATE OF
ORIGINATOR

OR FILE NO. CATION OF COPIES or Short Title and. Nimiber of Indorsemenrs/Incls) DOCUMENT
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SECTION B - ROUTING I ACKNOWLEDGE RECEIPT OF THE MATERIAL DESCRIBED HEREON
TO COPY NO. DATE
PRINTED NAME SIGNATURE
1.

4.

5.

SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) MATERIAL DESCRIBED HEREON HAS BEEN: PAGE OR COPY NO
. DESTROYEDo. TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-5) OFFICE SYMBOL DATE PRINTED NAME OF CUSTODIAN OR REP SIGNATURE
_
DESTRUCTION RECORD NO. DATE PRINTED NAME OF CERTIFYING(DESTR. OFF. SIGNATURE

PAGE OR COPY NUMBER DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE
SECTION D - REPRODUCTION AUTHORITY NUMBER OR COPIES TO BE REPRODUCED I AUTHORIZED BY DATE
. SECTION E -RECEIPT/TRACER ACTION (Check appropriate block)
no
F..; RECEIPT OF DOC!.'MENTIS) ACKNOWLEDGED DOCUMENT(S) HAVE NOT BE=M PECEIVc0
L j TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED. DATE PRI NAME, GRADE OR TITLE 1 SIGNATURE !
-

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0147-04-C1D259-80210
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INTERVIEW WORKSHEE
Name
1.1111 "46' SSN 01111 .(DOS
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Rank MACOM Sp Place of Birth 11.11111 _ 11.1r 76 United States Country Home Tele. Work Tele.
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Unit Address ODA 085. C Co. 2nd Bn. 10th SFG Street
Fort Carson Colorado United States City State Country
Resident 7614'(
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Sponsor Last First Middle
Sponsor SSN Sponsor Rank
Sponsor Unit Address Street
City State Country
Sex M - Male Citizenship US - United States Height 6' 2" Education ED - Baccalaureate Degree Weight Fingerprints
185 lbs Eye Color GRN Home Tele MOS
Build THN - Thin Dress/Disguise _
Complexion LIT - Light Martial Status M - Married SE1 - Secret
Clearance
N Nn

Photographed
Age 41 - 41 ETS Date
Ethnicity E2 - Not Hispanic Fugitive
Hair Style LS - Length - Short
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Hair Color BRN - Brown
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Facial Hair CS - Clean Shaven _9/_1.Pnn
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E2 - Not Hispanic
LS - Length - Short BRN - Brown CS - Clean Shaven NG - Does Not Wear Glasses N - No Citizenship
Education
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U.S. CENTRAL COMMAND

7115 S UTH tOUNoBLV ATTN: CCJ6-AC ILLoF RCE :ASE FLS" A 33621-5101 -
MS. JACQUELINE SCOTT scotti@centcom.smil.mil
(813) 827-5341/2830
DODDOACID-004879

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U.S. ARMY MEDICAL COMMA
FREEDOM OF INFORMATION/

PRIVACY ACT OFFICE ATTENTION: MCFP 2050 WORTH RO , SUITE 13 F RT SAM OUSTON, TEXAS 78234-6013
J HN PETE!'' SON John.Peterson1@cenoamedd.army.mil
(210) 221-7826

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CENTRAL COMMAND 7115 SOUTH D OUN YA Y BLV ATTN: CO-6-. M MAC . ILL AIR FORCE BASE FLO DA 33621-5101 -

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(813) 827-5341/2830
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U.S. CENTRAL COMMAN 7115 SOUTH BOUNDARY BLVD ATTN: CCJ6-DM MACDILL AIR F CE ASE FL RIDA 33621-5101 -
MS. JACQUELINE SCOTT scotti@centcom.smil.mil
(813) 827-5341/2830
Page(s)

7
Referred to:
U.S. CENT L COMMAND 7115 SOUTH BOUN ARY BLVD ATTN: CCJ6-DM
CDILL AIR F RCE ASE FLORIDA 33621-5101 -
MS. JAC UELINE SCOTT scotti@centcom.smil.mil
(813) 827-5341/2830
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Referred to:
U.S. CENTRAL C MMAN 7115 SOUTH B UNDARY BLVD ATTN: CCM- M MACDILL AIR F CE BASE FL RIDA 33621-5101 -
MS. JACQUELINE SCOTT scotti@centcom.smil.mil
(813) 827-5341/2830

Doc_nid: 
2381
Doc_type_num: 
66