Unknown interviewee's sworn statement stating "On June 24, 2004, I identified [redacted] from a photo spread provided to me as being the unknown Captain described in my January 20, 2004 statement to CID Agent. This is the Captain that I witnessed beating a prisoner inside the Hard Site in late November 2003. IO have nothing further to add to this statement."
SWORN STATEMENT
for use of this form, see AR 190-45; the proponent agency is ODCSOPS
PRIVACY ACT STATEMENT AUTHORITY: Title 10 USC Section 301; Title 5 USC Section 2951; EA:J..9397 dated November 22, 1943 ISSN). To provide commanders and law enforcement officials with nieens by which information tray be accurately
PRINCIPAL PURPOSE: Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval
ROUTINE USES:
DISCLOSURE: Disclosure of your social security number is voluntary.
2. DATE IVYYYMMD E . FILE NUMBER
1. LOCATION r KIEWIR'sft klf.1.4S 4 \h'rek‘i Ala
2" 6 4-(6/0(7. 06 i 1 T GRADErsTATus
6. L. N N IDD E NAME
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. WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
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10. EXHIBIT 11 I ALS PERSON MAKING STATEMENT
i PAGE 1 OF
ADDITIONAL PAGES•MUST CONTAIN THE HEADING 'STATE AKEN AT DATED
THE BOTTOM OF EACH ADDITIONAL PA GF MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE BE INDICATED.
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STATEMENT OF1111111111 N AT ileuipAr+ N ATED 2-°° %4-454° .1" 111
9. STATEMENT (Continued)
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FFIDAVIT
I, , HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
WHICH BEGMTIMON PAGE 1, AND ENDS ON Y 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 fYt t E7NER--1-47:;(411). WITH
THREAT OF PUNISHMENT, AND WITHOUT COERCION, 'NI i41"
Signature of Person Making Stateme
Subscribed an• worn to before me, a person authorized by law to
WITNESSES: administer oaths, this 2.4T1/ day of ..7* If1P) 200V-
St
ORGANIZATION OR ADDRESS
(Typed Nome of Person ministering eat
5L-I3
ORGANIZATION OR ADDRESS (Authority To Administer Oaths)
INITIALS OF PE G STATEMENT
PAGE 1111.11/11
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