Marine Corps Memo re: Inquiry into Alleged Detainee Abuse at the Marine Corps 2nd Marine Regiment (2/2) Division Interrogation Facility (DIF), Iraq

On April 16, 2004, members of Marine Corps stopped and detained three (3) men who were transferred to the Division Interrogation Facility (DIF). On April 26, 2004 the DIF released the trio to the custody of Task Force 6-26. They were then transferred to the custody of "OGA" [common pseudonym for the CIA]. While with the OGA, two of the trio claim they were struck with a rifle on and one alleges he was sodomized with the butt of a rifle while in custody. Medical reports and detainee statements indicate that abuse did not occur while in custody at the DIF or with the Marines who initially stopped them. The report stated "In my opinion, based on the facts and circumstances articulated above, the two detainees in question were not abused at any point while in the custody of the (sic) Marine Division personnel." It was recommended that "No further investigation is warranted".

Doc_type: 
Investigative File
Doc_date: 
Thursday, June 3, 2004
Doc_rel_date: 
Tuesday, June 27, 2006
Doc_text: 

UNITED STATES WAKENS CORPS
1st Marine Division (Rein)
UIC 40120
FPO AP 96426-0120

INAMPO'REATRTM

SJA5831111111

JUN 0 3 2004
FIRST ENDORSEMENT on jA(7 )(C ). PI of 30 May 2004
From: Commanding General, 1" Marine Division (Rein)
To:.

File

Subj.: RESULTS or PRELIMINARY INQUIRY INTO ALLEGATIONS OF ABUSE AT TRE
DIVISION INTERROGATION FACILITY

1.
Readdressed and forwarded. The findings of the Investigating Officer are
approved.

2.
This investigation was prompted by a report that 1"Marine Division

personnel had been accused of abusing detainees at the Division Interrogation
Facility 4DIF).

3.
On or about 16 April 77104, members of 2" Battalion, 2"° marAne Regiment, 1" Marine Division (2/2) detained three men with weapons, communications equipment and 5500,000.00 in their vehicle. They identified themselves as members of the Supreme Council for the islamie Revolution in Iraq (SCIRI). They were quickly transferred from the custody of 2/2 to the Division Interrogation Facility (DIF). The DIF released them to the custody of Task Force 626 on 26 April 2004. From there, the trio was transported to the custody of an unknown U.S. Governmental agency {OGA) on an unknown date. The allegations of abuse made by two of the three individuals were made while in the bnstody of OGA. The allegations clearly indicated that that abuse was alleged to have taken place at one of the intermediate holding fecilities; either the DIF or in the custody of TF 62.6.

4.
The investigation revealed that neither of the two detainees making
accusations of abuse were mistreated while in Marine custody. First, a
medical doctor examined all of the detainees prior to their transfer to TF

626. The doctor noticed no physical sign of abuse on the detainees, and noted nothing else about them to indicate that they had been abused at the DIF. Second, based on review and enforcement of the DIF's weapons handling and custody SOP, and interviews with DIF personnel who had contact with the detainees, there is no evidence to indicate that any abuse occurred.
5.
I find that the abuse allegations are not supported by the evidence. The Marine Corps did have custody of these individuals from approximately 16 April until 26 April, however, as revealed in the investigation, these men were not mistreated in our custody.

6.
No further investigation is warranted.

J. N. MATTIS

Copy to:
RCT -1

H.. )1, 7 1 C
[ USMC 1ST MARDIV (20) j
UNYTID STATES MIMS CORPS
1ST MARINE DIVISION (REIN)
um 40120
FPO AP 96426-0120

IN REPLY REFER TO:

SJA

5831111111

MAT 3 0 2004
From: Staff Judge Advocate

To: Marine Division (Rein)

Commanding General,
Via:

Chief of Staff, l't Marine Division (Rein)

Sub): RESULTS OF PRELIMINARY INQUIRY INTO THE CIRCUMSTANCES SURROUNDING
ACCUSATIONS OF DETAINEE ABUSE AT THE DIVISION INTERROGATION FACILITY

1. Executive Summary. On or about 25 May 2004, the lat Marine Division was
made aware of allegations of abuse, made by two detainees in the custody of
members of a non-Department of Defense gave

etainees identified themselves as
The two detainees alleged that en a ru

a a

n the hands, wrists and backs of their legs while in U.S custody.

further alleged that he was also sodomized with the muzzle of a rifle.

e detainees indicated that they had been held in several facilities prior
to being transferred to the custody of OGA. Both detainees indicated that
they were certain that they had not been abused at the first facility where
held, and they had not been abused at the facility in which OGA was holding
the detainees. They claimed the abuse took place at one of the intermediate
facilities in which they were housed and interrogated prior to being
transferred to the custody of OGA. The investigation revealed that the
detainees were not mistreated in any way by either the capturing unit, (2"
Battalion, 2" Marine Regiment) or at the Division Interrogation Facility

(DIF). There is no evidence to indicate that these individuals were abused
while they were In Marine custody. The facts developed during the
investigation follow.

2. on 15 April, a vehicle checkpoint (VCP) established by G Company, 2"
Battalion, rd Marine Regiment (2/2) stopped a Toyota Land Cruiser with three
occupants, approximately 1.6KM south-southwest of Al Mahmudiyah, at the Jair
Sukhax bridge in Lutafiyah. When the vehicle was searched, the Marines
discovered three weapons and a briefcase containing approximately
000,000.00. Some electronic communications equipment was also discovered.
The Marines on the scene confiscated the weapons, cash and communications
equipment. The three occupants of the vehicle were then dotal

f 2 ust selves as

• c in U. th= t

All threeindicated
t at ey were m upreme ounce or a Islamic Revolution in
Iraq (SCIRI).

3. The SCIRI affiliation, coupled with the fact that the trio was in
possession of a significant amount of cash, impressed upon the members of 2/2
that the detention of these individuals would probably generate interest
within the intelligence community and with higher authority, as such,
Division was notified immediately. Higher authority indicated to members of
2/2 that they should cause the three detainees to be transported to the
Division Interrogation Facility as soon as possible. To facilitate the rapid
transfer of the detainees to the DIF, 2/2 arranged for a convoy to move to G
Company's position on 15 April and transport the detainees back to the 2/2

Subj: RESULTS OF PRELIMINARY INQUIRY INTO THE CIRCUMSTANCES SURROUNDING
ACCUSATIONS oe DETAINEE ABUSE AT THE DIVISION INTERROGATION FACILITY

FOB. However, the 15 April convoy was ambushed in route to G Company's

position and was forced to return to 2/2's FOB without picking up the

detainees. Consequently, the three $CIRI detainees spent the night of 15

April in the field with C Company at the point of capture.

4.
On 16 April a convoy was again dispatched to the G Company position.
They were able to take custody of the three detainees and transport them to
2/2's FOB. Once the detainees arrived at the 2/2 position, they were
processed into the 2/2 holding facility in accordance with all governing
directives. Or. 10 April the detainees were transferred to the DIF without
incident.'

5.
On 18 April 2004, the three detainees arrived at the DIP. They were in­processed in accordance with the DIF's standard operating procedures, which
included a medical assessment. Nothing unusual was discovered during the
medical screening. The DIF held the three detainees until April 26 14. During
their time at the DIF the three detainees were each interrogated one time on
or about the 22'd of April. Each interview lasted approximately one hour.
Due to the fact that the importance of these detainees was communicated to
DIP personnel, the "interrogation' was characterized by the DIF facility
staff as n to an interview. On or about the 23"' of April, one of the
detainees as asked ten questions in addition to the first
interview. No pre-interrogation preparation strategies were used en any of
the three detainee,. At no time while the three were held at the DIF were
any of the detainees sleep deprived, nor were any dietary manipulation
techniques employed. The "fear up" process was omitted entirely. Part of
the rational for not applying any interrogation preparation techniques was
due to the understanding by the DIF personnel that the three detainees would
be interviewed by higher authority, and as such, the DIP personnel did net
want to "spoil" the potential for successful exploitation by future
interrogators. Effectively, the personnel at the DIP were cognizant of the
potential value of the three detainees, and as such they conducted only
rudimentary fact gathering interviews, as instructed by higher.

6.
On 26 April 2004, the detainees were transferred into the custody of Task
Force 626. Task Force 626 is a special operations, theatre level asset,
operating in the 1" Marine Division area of operations CAO) that is neither
TACOS or OPCON to the Division. The members of Task Force 626 transported
the three detainees to an undisclosed location. It is not known how long the
detainees were in the custody of Task Force 626. It is similarly unknown
under what conditions the three detainees were held, or whether they were
interrogated by members of Task Force 626.

7.
Analysis and Conclusions. There is no evidence that the detainees were
abused at the DIF.

a. First, all three detainees were medically screened upon their arrival at the DIF. This initial medical screening set a base line of fitness that would reveal any injuries that were suffered at the DIP. Upon
n custody to members of Task Force 626 on 26 April,

, USN, personally examined the three detainees in MCCOY nee w t . procedure which requires a medical evaluation -by either a certified medical doctor, or an independent duty corpsman upon transfer or
a it is important to note that the detainees did not allege, nor was there any evidence to
indicate that the detainees were abused or maltreated while in the field with 2/2 on 25 Apr. or
while held at the 2/2 detention facility.

'2
.

Subj: RESULTS OF PRELIM/NARY INQUIRY INTO'THE CIRCUMSTANCES SURROUNDING
ACCUSATIONS OF DETAINEE ABUSE AT THE DIVISION INTERROGATION FACILITY

id not discover any sign that would be

release of a detainee.

consistent with abuse of any sort, and specifically did not detect any

symptoms that would lead him to suspect that any of the three detainees were

beaten or had been struck with a rifle on the hands, w backs of

their legs as was alleged to OGA. During an interview (I)i;71{.ndicated

that the type of symptoms that would result from being -ea en w a rifle or
any other blunt object would become manifest and noticeable a

immediately, and therefore, there was little possibility that (L: 7)C)
conducted his examination and failed to notice the symptoms be a ey ad

not yet emerged. . highly unlikely that any sign of abuse would

have healed before 0:7W.7.;) examined the three detainees. This is

especially true gi'en e t that bruising was noticed by members of OGA

when they conducted their debrief of the detainees on or about 2 May 2004.
Furthermore, all detainees are given medical exams by the duty Corpsman prior

to and immediately after any interview interrogation is conducted. Nothing

was noted with respect to any of the three detainees. Lastly, the detainees
did not claim to any of the medical personnel that they were abused or

mistreated in any way while at the DIF.

b.
Second, the victims of the alleged abuse complained of being struck with rifles. It is extremely unlikely that any mistreatment involving a rifle took place at the DIE. Weapons are not allowed into the interrogation area at the DIF. There is only one entrance/exit to the DIF. One enters the DIF and must pass an entry control point called "Checkpoint before one can proceed into the facility. Checkpoint 1 is continually staffed with at least two corrections personnel. The DIF has a strict policy of not allowing weapons past Checkpoint 1. Staff and visitors alike are required to check their weapons at Checkpoint. 1, where they are kept, and then returned to the staff member or visitor upon their departure from the DIV. Corrections and HET personnel indicated during interviews that there were times when this rule was violated with pistols, but all interviewees indicated that the rule was not violated with respect to long arms. 2 In the present case, since the allegations indicated that the abuse was done with a, rifle, it would have required that a rifle be brought past Checkpoint 1, past the guards manning the checkpoint, and into one of the two interview rooms. It would then have to be used to beat and mistreat a detainee and then, taken out of the facility without any of the guards noticing the weapon being carried out. None of the corrections personnel at the DIF saw a rifle being carried into or out of the DIF past Checkpoint 1.

c.
Finally, all three detainees were interviewed by the same HET member. He indicated that he was aware of the high profile nature of these detainees and was certain that there would be higher-level agencies with an interest in interviewing them. Because of attention being paid to the detainees, and the potential intelligence value of these indiviguals, the decision was made to simply "hold" the detainees until higher agencies had a chance to interrogate them. As such, the HET interrogator did not wart to reveal any interrogation preparation techniques to the detainees before they were transported to higher agencies for interview, As such, none of the detainees were 'interrogated" by HET at the DIF, they were interviewed for approximately one hour each. Additionally, the door on the interrogation room was left ajar and a HET supervisor was at the DIF when the detainees were interviewed. He periodically and irregularly supervised all ongoing

;Sidearms have gotten past the checkpoint due to either; (11 someone forgetting the pistol and
the corrections personnel manning checkpoint one foiled to notice the pistol, or (2) because HET
Members did an occasion lock their pistols up in their private ready room.

Subj: RESULTS OF PRELIMINARY INQUIRY INTO THE CIRCUMSTANCES SURROUNDING
ACCUSATIONS OF DETAINEE ABUSE AT THE DIVISION INTERROGATION FACILITY

interviews/interrogations from just outside the interrogation room; he
witnessed no abuse of amy detainee at any time.

8. In my opinion, based on the facts and circumstances articulated above,
the two detainees in question were not abused at any point while in the
custody of 1" Marin rsonnel. It is clear, based on the first-
hand recollection Of1:))7.)0.7,; that immediately prior to the transfer of the
detainees to Task Fo medical examination indicated no sign
whatsoever that any of the three had been abuse• or mistreated.

(b)(7)(C)
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THREE CLASSIFIED PAGES
REMOVED FROM
PRELIMINARY INQUIRY REPORT.

REVIEW REVEALS THESE PAGES
TO BE CURRENTLY AND PROPERLY
CLASSIFIED PURSUANT TO
PROVISIONS ESTABLISHED IN
EXECUTIVE ORDER 12958.

THESE THREE CLASSIFIED PAGES
ARE DENIED PURSUANT TO
EXEMPTION (b)(1) OF THE FOIA.

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(b)(7)(C
b)(7)(C
ARTICLE 31 RIGHTS
Name: (b)(7)(C) Rank/Rate: (b)(7)(C)
Activity: 0.=.. Unit l s4- Te4
Telephone number:

1 have been advised that I may be suspected of the offense(s) of ott*T-Ner-and that:
have the right to remain silent.
y statements I do make may be used as evidence against me in trial by ourt-martial. have the right to consult with lawyer counsel prior to any questioning: This wyer counsel may be a civilian lawyer retained by me at my own expense, military lawyer appointed to act as my counsel without cost to me, or both.
have the right to have such retained civilian lawyer and/or appointed ' 'tary lawyer present during this interview. have the right to terminate this interview at any time.
WAIVER OF RIGHTS
III" further certify and acknowledge that I have read the above statement of my s and fully understand them, and that I expressly desire to waive my right to remain silent. expressly desire to make a statement expressly do not desire to consult with either a civilian lawyer by me or a military lawyer appointed as my counsel without to me prior to questioning. expressly do not desire to have such a lawyer present with me ming this interview. s acknowledgment and waiver of rights is made freely and
oluntarily by me, and without any promises or threats having been made to me or pressure or coercion of any kind having been. used against me.
(b)(7)(C) PRo
(b)(7)(C). I C;
(Witness signature/date) (Member signs 0/date)
Understanding my rights under U.C.M.J. Article 31, 1 wish to make the following statement
PRIVACY ACT !MAT/MOTT
Name: (b )(7)(C )
Rank/Rate:
Activity: afb„Na Pell70144on Her I

.. ' Unit:
Telephone number:

20.124, 1 acknowledge that I have
received the following advisement under the guidelines of the Privacy
Act.

Today, 7740.03e6LV Aeol.14511.:. .

This statement is provided in compliance with the provisions of the
Privacy Act of 1974 (Public Law 93-579) which requires that Federal
agencies must inform individuals who are requested to furnish personal
information about themselves as to certain facts regarding the
information requested below.

1. AUTHORITY: 5 U.S.C. 301; IC U.S.C. 972, 1201-1221, 2733, 2734-
2734b., 2737, 5013, 5031-5036, 5131-5150, 5947, 614e, 7205, 7622-7623; 28

U.S.C. 1346, 2671-2680; 31 D.E.C. 240-243, 3521-3531, 3701-3702, 3717­3718; 37 U.S.C. 802; 38 U.S.C. 105; 42 U.S.C. 2651-2653; 44 U.S.C. 3101;
49 U S.C. 1901.

.
2. PRINCIPAL PURPOSES. The information which will be solicited is
intended principally and may be used for the following purposes:

a. Determinations on the status of personnel regarding

entitlements to pay during disability, disability benefits, severance
pay, retirement pay, increases of pay for longevity, survivor's benefits.
involuntary extensions of enlistments, date of expiration of active
Obligated service, and accrual ot annual leave.

b. Determinations on disciplinary or punitive action.

c.
Determinations on A.ability of personnel for losses of, or
damage to, public funds or property.

d. Evaluation of petitions, grievances, and complaints.

e.
Adjudication, pursuit, or defense of claims for or against
the Government or among private parties.

f.
Other determinations, as required, in the course of naval
administration.

g. Public information releases.

h.
Evaluation of procedures. operations, material. and designs
by the Navy and contractors, with a view to improving the efficiency and
safety of the Department of the Navy.

3. ROUTINE USS; In addition to being used within the Department of
the Navy and Defense for the purposes) indicated above, records of
investigations are routinely furnished, as appropriate, to the Department
Of Veterans Affairs for use in determinations concerning entitlement to

veterans' and survivors' benefits; to Servicemen's Group Life Insurance administrators for determinations concerning payment of life insurance proceeds; to the U.S. General Atcounting Office for purposes of determinations concerning relief of accountable personnel from liability for losses of .public funds and related fiscal matters; and to the Department of justice for use in litigation involving the Government. Additionally, such investigations are sometimes furnished to agencies of the Department of Justice and to State or local law enforcement and court authorities for use in connection with civilian criminal and civil court proceedings. The .record4 of investigations are provided to agents and authorized representatives of persons involved in the incident, for use in legal or adMinistrative matters. The records are provided to contractors for use in connection with settlements, adjudication, or defense of claims by or against the Government, and for use in design and evaluation of products, services, and systems. The records are also furnished to agencies of the Federal, State, or local law enforcement authorities, and regulatory authorities, for use in connection with civilian and military criminal, civil, administrative, and regulatory proceedings and actions.
4. MANDATORY/VOLUNTARY DISCLOSURE, CONSEQUENCES OF REFUSING TO
DISCLOSE:

a.
Where an individual is a subject of an investigation for purpose 2a or 2b, above: Disclosure is voluntary. You are advised that you are initially presumed to be entitled to have the (personnel determination] (disciplinary determinations) in paragraph 2, above, resolved in your favor, but the final determination will be based on all the evidence in the investigative record. If you do not provide the requested information, you will be entitled to a favorable determination if the record does not contain sufficient evidence to overcome the presumption in your favor. If the completed record does contain sufficient evidence to overcome the presumption in your favor, however, your election not to provide the requested information possible could prevent the investigation trom obtaining evidence which may be needed to support a favorable determination.

b.
Where an individual is a subject of an investigation for purpose 2c, above: Disclosure is voluntary, and if you do not provide the requested information, any determination as to whether you should be held pecuniarily liable for repayment of the Government's loss would be based on the other evidence in the investigative record, which possibly might not support a favorable determination.

c.
Where the individual is a claimant or potential claimant in
an investigation for purpose 2e, above: Disclosure is voluntary, but
refusal to disclose the requested information could prevent the
investigation from obtaining sufficient information to substantiate any
claim which you have made or may make against the Government as a result
of the incident under investigation.

d.
Where the individual was treated at Government expense for
injuries caused by third parties in connection with a matter being
investigated for purpose 2e, above: Disclosure is voluntary, but refusal
to disclose the requested information could result in a requirement for

you to assign to the Government your medical care claims against third
parties in connection with the incident, or authorize withholding of the
records of your treatment in naval medical facilities.

e. In any other case: Disclosure is voluntary, and if you do
not provide the requested information, and determinations or evaluations
made as a result of the investigation will be made on the basis of the
evidence that is contained in the investigative record.

PRIVACY ACT STATEMENT

Name: (b)(7)(C) SW! (b)(6) - SSN
Rank/Rate:

(c)ip)
Activity: It uni t : 64-.
Telephone number:

Today, ite1 15— , 2001, I acknowledge that I have received t.e following advisement under the guidelines of the Privacy Act.
This statement is provided in compliance with the provisions of the
Privacy Act of 1974 !Public Law 93-579) which requires that Federal
agencies must inform individuals who are requested to furnish personal
information about themselves as to certain facts regarding the
information requested below.

1. AUTHORITY: 5 U.S.C. 301; 10 U.S.C. 972, 1203-1221, 2733, 2734-
2734b., 2737, 5013, 5031-5036, 5131-5150, 5947, 6148, 7205, 7622-7623; 28

U.S.C. 1346, 2671-2680; 31 U.S.C. 240-243, 3521-3531, 3701-3702, 3717-
3718; 37 U.S.C. 802; 38 U.S.C. 205; 42 U.S.C. 2651-2653; 44 U.S.C. 3101;
49 U.S.C. 1901.

2. PRINCIPAL PURPOSES. The information which will be solicited is
intended principally and may be used for the following purposes:

a.
Determinations on the .status of personnel regarding
entitlements to pay during disability, disability benefits, severance
pay, retirement pay, Increases of pay for longevity, survivor's benefits,
involuntary extensions of enlistments, date of expiration of active
obligated service, and accrual of annual leave.

b. Determinations on disciplinary or punitive action.

c.
Determinations on liability of personnel for losses of, or
damage to, public fonds or property.

d. Evaluation of petitions, grievances, and complaints.

e_ Adjudication, pursuit, or defense of claims for or against
the Government or among private parties.

f.
Other determinations, as required, in the course of naval
administration.

g. Public information releases.

h.
Evaluation of procedures, operations, material, and designs
by the Navy and contractors, with a view to improving the efficiency and
safety of the Department of the Navy.

3. ROUTINE USES: In addition to being used within the Department of
the Navy and Defense for the purpose(s) indicated above, records of
investigations are routinely furnished, as appropriate, to the Department
of Veterans Affairs for use in determinations concerning entitlement to

veterans' and survivors' benefits; to Servicemen's Group Life Insurance administrators for determinations concerning payment of life insurance proceeds; to the U.S. General Accounting Office for purposes of determinations concerning relief of accountable personnel from liability for losses of public funds and related fiscal matters; and to the Department of Justice for use in litigation involving the Government. Additionally, such investigations are sometimes furnished to agencies of the Department of Justice and to State or local law enforcement and court authorities for use in connection with civilian criminal and civil court proceedings. The records of investigations are provided to agents and authorized representatives of persons involved in the incident, for use in legal or administrative matters. The records are provided to contractors for use in connection with settlements, adjudication, or defense of claims by or against the Government, and for use in design and evaluation of products, services, and systems. The records are also furnished to agencies of the Federal, State, or local law enforcement authorities, and regulatory authorities, for use in connection with civilian and military criminal, civil, administrative, and regulatory proceedings and actions.
4. MANDATORY/VOLUNTARY DISCLOSURE, CONSEQUENCES OF REFUSING TO
DISCLOSE:

a.
Where an individual is a subject of an investigation for purpose 2a or 2b, above: Disclosure is voluntary. You are advised that you are initially presumed to be entitled to have the (personnel determination] (disciplinary determinations] in paragraph 2, above, resolved in your favor, but the final determination will be based on all the evidence in the investigative record. If you do not 'provide the requested information, you will he entitled to a favorable determination if the record does not contain sufficient evidence to overcome the presumption in your favor. If the completed record does contain sufficient evidence to overcome the presumption in your favor, however, your election not to provide the requested information possible could prevent the investigation from obtaining evidence which may be needed to support a favorable determination.

b.
Where an individual is a subject of an investigation for purpose 2c, above: Disclosure is voluntary, and if you do not provide the requested information, any determination as to whether you should be held pecuniarily liable for repayment of the Government's. loss would be based on the other evidence in the investigative record, which possibly might not support a favorable determination,

c.
Where the individual is a claimant or potential claimant in an investigation for purpose 2e, above: Disclosure is voluntary, but refusal to disclose the requested information could prevent the investigation from obtaining sufficient information to substantiate any claim which you have made or may make against the Government as a result

of the incident under investigation.

d. Where the individual was treated at Government expense for
injuries caused by third parties in connection with a matter being
investigated for purpose 2e, above: Disclosure is voluntary, but refusal
to disclose the requested information could result in .a requirement for

you to assign to the Government your medical care claims against third
parties in connection with the incident, or authorize withholding of the
records of your treatment in naval medical facilities.

e. In any other case: Disclosure is voluntary, and if you do
not provide the requested information, and determinations or evaluations
made es a result of the investigation will be made on the basis of the
evidence that is contained in the investigative record.

PRIV= ACT SITATLIMWf

Namaffi
Rank/Rate:
Activity: 1 Unit: X$%E Me-r
Telephone number:

Today, 01,12A37t. IIT , 2021, I acknowledge that I have
received the fcllowing advisement under the guidelines of the .Privacy
Act.

This statement is provided in compliance with the provisions of the
Privacy Act of 1914 (Public Law 93-579) which requires that Federal
agencies must inform individuals who are requested to furnish personal
information about themselves as to certain facts regarding the
information requested below.

1. AUTHORITY: 5 U.S.C. 301; 10 U.S.C. 972, 1201-1221, 2733, 2134-
2734b., 2737, 5013, 5031-5036, 5131-5150, 5547, 6149, 7205, 1622-7623; 28

U.S.C. 1346, 2611-2680; 31 U.S.C. !,:40-243, 3521-3531, 3101-3102, 3117­3718; 37 U.S.C. 80i; 38 U.S.C. 105; 42 U.S.C. 2651-2653; 44 U.S.C. 3101;
49 U.S.C. 1901.

2. PRINCIPAL PURPOSES. The information which will be solicited is
intended principally and may be used for the following purposes:

a.
Determinations on the status of personnel regarding
entitlements to pay durinc disability, disability benefits, severance
pay, retirement pay, increases of pay for longevity, survivor's benefits,
involuntary extensions of enlistments, date of expiration of active
obligated service, and accrual of annual leave.

b. Determinations on disciplinary or punitive action.

c.
Determinations on liability of personnel for losses of, or
damage to, public funds or property.

d. Evaluation of petitions, grievances, and complaints.

e.
Adjudication, -pursuit. or defense of claims for or against
the Government or among private parties.

f.
Other determinations, as required, in the course of naval
administration.

Public information releases.

h. Evaluation of procedures, operations, material, and designs
by the Navy and contractors, with a view to improving the efficiency and
safety of the Department of the Navy.

3. ROUTINE USES; In addition to being used within the Department of
the Navy and Defense for the purpose(s) indicated above, records of
investigations are routinely furnished, as appropriate, to the Department
of Veterans Affairs for use in determinations concerning entitlement to

veterans' and survivors' benefits; to Servicemen's Group Life Insurance
administrators for determinations concerning payment of life insurance
proceeds; to the U.S. General Accounting Office for purposes of
determinations concerning relief of accountable personnel from liability
for Losses of public funds and related fiscal matters; and to the
Department of Justice for use in litigation involving the Government.
Additionally, such investigations are scmetimes• furnished to agencies of
the Department of Justice and to State or local law enforcement and court
authorities for use in connection with civilian criminal and civil court
proceedings. The records of investigations are provided to agents and
authorized representatives of persons involved in the incident, for use
in legal or administrative matters. The records are provided to
contractors for use in connection with settlements, adjudication, or
defense of claims by or against the Government, and for use in design and
evaluation of products, services, and systems. The records are also
furnished to agencies of the Federal, State, or local law enforcement
authorities, and regulatory authorities, for use in connection with
civilian and military criminal, civil, administrative, and regulatory
proceedings and actions.

4. MANDATORY/VOLUNTARY DISCLOSURE, CONSEQUENCES OF REFUSING TO
DISCLOSE:

4, Where an individual io a subject of an investigation for purpose 2a or 2b. above: Disclosure is voluntary. You are advised that you are initially presumed to be entitled to have the [personnel determination) (disciplinary determinations) in paragraph 2, above, resolved in your favor, but the final determination will be based on all the evidence in the investigative record. If you do not provide the requested information, you will be entitled to a favorable determination if the record does not contain sufficient evidence to overcome the presumption in your favor. If the completed record does contain sofficient evidence to overcome the presumption in your favor, however, your election not to provide the requested information possible could prevent the investigation from obtaining evidence which may be needed to support a favorable determination.
b. Where an individual is a subject of an investigation for purpose 2c, above: Disclosure is voluntary, and if you do not provide the requested information, any determination. as to whether you should be
held pecuniarily liable fox repayment of the Government's loss would be
based on the other evidence in the investigative record, which possibly
might not support a favorable determination.

c. Where the individual is a claimant or potential claimant in an investigation for purpose 2e, above: Disclosure is voluntary, but refusal to disclose the requested information could prevent the investigation from obtaining sufficient information to substantiate any claim which you have made or may make against the Government as a result of the incident under. investigation.
d, Where the individual was treated at Government expense for injuries caused by third parties in connection with a matter being investigated for purpose 2e, above: Disclosure•is voluntary, but refusal tO disclose the requested information could result in a requirement for.
you to assign to the Government your, medical care claims against third
parties in connection with the incident, or authorize withholding of the
records of your treatment in naval medical facilities.

e. In any other case: Disclosure is voluntary, and if you do
not provide the requested information, and determinations or evaluations
made as a result of the investigation will be made on the basis of the
evidence that is contained in the investigative record.

(b)(7)(C) (b)(6) - SSN
Name:
Rank/Rate: 7 , C ,
Activity: 47/47 Unit: /SFr"//
Telephone number:

/

Today, t`edia, I I., 200'f, 1 acknowledge that I have

/

received the following advisement under the guidelines of the Privacy
Act.

This statement is provided in compliance with the provisions of the
Privacy Act of 1974 (Public Law 93-579) which requires that Federal
agencies must inform individuals who are requested to furnish personal
information about themselves as to certain facts regarding the
information requested below.

1. AUTHORITY: 5 U.S.C. 301; 10 U.S.C. 972, :201-1221, 2733, 2734-
2734b., 2737, 5013, 5031-5036, 5131-5150, 5947, 6148, 7205, 7622-7623; 28

U.S.C. 1346, 2671-2680; 31 U.S.C. 240-243, 3521-3531. 3701-3702, 3717­3718; 37 U.S.C. 802; 3a U.S.C. 205; 42 U.S.C. 2651-2653; 44 U.S.C. 3101;
49 U.S.C. 1901.

2. PRINCIPAL PURPOSES. The information whict will be solicited is intended principally and may be used for the following purposes:
a.
Determinations on the status of personnel regarding entitlements to pay during disability, disability benefits, severance pay, retirement pay, increases of pay for longevity, survivor's benefits, involuntary extensions of enlistments, date of expiration of active obligated service, and accrual of annual leave.

b. Determinations on disciplinary or punitive action.

c.
Determinations on liability of personnel for losses of, or
damage to, public funds or property.

d. Evaluation of petitions, grievances, and complaints.

e.
Adjudication, pursuit, or defense of claims for or against
the Government or among private parties.

t.
Other determinations, as required, in the course of naval administration.

g. Public information releases.

h.
Evaluation of procedures, operations, material, and designs by the Navy and contractors, with a view to improving the efficiency and safety of the Department of the Navy.

3. ROUTINE USES: In addition to being used within the Department of
the Navy and Defense for the purpose(s) indicated above, records of
investigations are routinely furnished, as appropriate, to the Department
of Veterans Affairs for use in determinations concerning entitlement to

veterans' and survivors' benefits; to Servicemen's Group Life Insurance

administrators for determinations concerning payment of life insurance

proceeds; to the U.S. General Accounting Office for purposes of

determinations concerning relief of accountable personnel from liability

for losses of public funds and related fiscal matters; and to the

Department of Justice for use in litigation Anvolving the Government.

Additionally, such investigations are sometimes furnished to agencies of

the Department of Justice and to State or local law enforcement and court

authorities for use in connection with civilian criminal and civil court

proceedings. The records of investigations are provided to agents and

authorized representatives of persons involved in the incident, for use

in legal or administrative matters. The records are provided to

contractors for use in connection with settlements, adjudication, or

defense of claims by or against the Government, and for use in design and

evaluation of products, services, and systems. The records are also

furnished to agencies of the Federal, State, or local law enforcement

authorities, and regulatory authorities, for use in connection with

civilian and military criminal, civil, administrative, and regulatory

proceedings and actions.

.. HANDATORY,VOLUNTARY DISCLOSURE, CONSEQUENCES OF REFUSING TO
DISCLOSE

a.
Where an individual is a subject of an investigation for
purpose 2a or 2b, above: Disclosure is voluntary. You are advised that
you are initially presumed to be entitled to have the (personnel
determination] [disciplinary determinations; in paragraph 2, above,
resolved in your favor, but the final determination will be based on all
the evidence in the investigative record. If you do not provide the
requested information, you will be entitled to a favorable determination
if the record does not contain sufficient evidence to overcome the
presumption in your favor. If the completed record does contain
sufficient evidence to overcome the presumption in your favor, however,
your election not to provide the requested information possible could
prevent the investigation from obtaining evidence which may be needed to
support a favorable determination.

b.
Where an individual is a subject of an investigation for
purpOse 2c, above: Disclosure is voluntary, and if you do not provide
the requested information, any determination as to whether you should be
held pecuniarily liable for repayment of the Government's loss would be
based on the other evidence in the investigative record, which possibly
might not support a favorable determination.

c.
Where the individual is a claimant or potential claimant in
an investigation for purpose 2e, above: Disclosure is voluntary, but
refusal to disclose the requested information could prevent the
investigation from obtaining sufficient information to ;substantiate any
claim which you have made or may make against the Government as a result
of the incident under investigation.

d.
Where the individual was treated at Government expense for
injuries caused by third parties in connection with a matter being
investigated for purpose 2e, above: Disclosure is voluntary, but refusal
to disclose the requested information could result in a requirement for

you to assign to the Government your medical care claims against third
parties in connection with the incident, or authorize withholding of the
records of your treatment in naval medical facilities.

e. In any other case: Disclosure is voluntary, and if you do

not provide the requested information, and determinations Or evaluations
made as a result of the investigation will be made on the basis of the
evidence that is contained in the investigative record.

PRIVACY Acr STATEMENT

Name:
Rank/Rat
Activity' Unit:
Telephone number:

Today, 11fte /5— Amy 200e, I acknowledge that I have
leceived the following advisement under the guidelines of the Privacy
Act.

This statement is provided in compliance with the provisions of the
Privacy Act of 1974 (Public Law 93-5791 which requires that Federal
agencies must inform individuals who are requested to furnish personal
information about themselves as to certain facts regarding the
information requested below.

1. AUTHORITY: 5 U.S.C. 301; 10 U.S.C. 972, 1201-1221, 2733, 2734-
2734b., 2737, 5013, 5031-5036, 5131-5150, 5947, 6148, 7205, 7622-7623: 28

U.S.C. 1346, 2671-2680; 31 U.S.C. 240-243, 3521-3531, 3701-3702, 3717­3718; 37 U.S.C. 802; 38 U.S.C. 105; 42 U.S.C. 2651-26531 44 U.S.C. 3101;
49 U.S.C. 1901.

2. PRINCIPAL PURPOSES. The information which will be solicited is
intended principally and may be used for he following purposes:

a.
Determinations on the status of personnel regarding
entitlements to Pay during disability, disability benefits, severance
pay, retirement pay, increases of pay for longevity, survivor's benefits,
involuntary extensions of enlistments, date of expiration of active
obligated service, and accrual of annual leave.

b. Determinations on disciplinary or punitive action.

c.
Determinations on liability of personnel for losses of, or
damage to, public funds or property.

d. Evaluation of petitions, grievances, and complaints.

e.
Adjudication, pursuit, or defense of claims for or against
the Government or among private parties.

f.
Other determinations, as required, in the course of naval
administration.

g. Public information releases.

h.
Evaluation of procedures, operations, material, and designs by the Navy and contractors, with a view to improving the efficiency and safety of the Department of the Navy.

3. ROUTINE USES; In addition to being used within the Department of the Navy and Defense for the purposeis) indicated above, records of investigations are routinely furnished, as appropriate, to the Department of Veterans Affairs for use in determinations concerning entitlement to
veterans' and survivors' benefits; to Servicemen's Group Life insurance administrators for determinations concerning payment of life insurance proceeds; to the U.S. General Accounting Office for purposes of determinations concerning relief of accountable personnel from liability for losses of public funds and related fiscal natters; and to the Department of Justice for use in litigation involving the Government. Additionally, such investigations are sometimes furnished to agencies of the Department of Justice and to State or local law enforcement and court authorities for use in connection with civilian criminal and civil court proceedings. The records of investigations are provided to agents and authorized representatives of persons involved in the incident, for use in legal or administrative matters. The records are provided to contractors far use in connection with settlements, adjudication, or defense of claims by or against the Government, and for use in design and evaluation of products, services, and systems. The records are also furnished to agencies of the Federal, State, or local law enforcement authorities, and regulatory authorities, for use in connection with civilian and military criminal, civil, administrative, and regulatory proceedings and actions.
4. MANDATORY/VOLUNTARY DISCLOSURE, CONSEQUENCES OF REFUSING TO
DISCLOSE:

a. Where en individual. is a subject of an 'investigation for

purpose 2a or 2b, above: Disclosure is voluntary. You are advised that you are initially presumed to be entitled to have the (personnel determination] [disciplinary determinations] in paragraph 2, above, resolved in your favor, but the final determination will be based on all the evidence in the investigative record. If you do not provide the requested information, you will be entitled to a favorable determination if the record does not contain sufficient evidence to overcome the presumption in your favor. If the completed record does contain sufficient evidence to overcome the presumption in your favor, however, your election not to provide the requested information possible could prevent the investigation from obtaining evidence which may be needed to support a favorable determination.
b. Where an individual is a subject of an investigation for purpose 2c, above: Disclosure is voluntary, and if you do not provide the requested information, any determination as to whether you should be held pecuniarily liable for repayment of the Government's loss would be based on the other evidence in the investigative record, which possibly micht not support a favorable determination.
c.
Where the individual is a claimant or potential claimant in an investigation for purpose 2e, above: Disclosure is voluntary, but refusal to disclose the requested information could prevent the investigation from obtaining sufficient information to substantiate any claim which you have made or may make against the Government as a result of the incident under investigation.

d.
Where the individual was treated at Government expense for injuries caused by third parties in connection with a matter being investigated for purpose 2e, above: Disclosure is voluntary, but refusal to disclose the requested information could result in a requirement for

you to assign to the Government your medical care claims against third
parties in connection with the incident, or authorize withholding of the
records of your treatment in naval medical facilities.

e. In any other case: Disclosure is voluntary, and if you do
not provide the requested information, and determinations or evaluations
made as a result of the investigation will be made on the basis of the
evidence that is contained in the. investigative record.

Doc_nid: 
2942
Doc_type_num: 
66