Military Police Report Death of Detainee in Custody (0114-02-CID369-23525)

MILITARY POLICE REPORT For use of this form, see AR 190-45; the proponent agency is ODCSOPS PRIVACY ACT STATEMENT /_AUTHORITY:_Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES:_Your Social Security Number is used as an additional/altemate means of identification to facilitate filing and retrieval. DISCLOSURE:_Disclosure of your Social Security Number is voluntary. MILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: ATTN: LT1111010 )314'3 Ith .3 ECHO DRIVE BAGRAM AF,AE AF 09354 BAGRAM AIRFIELD, AE AF 09354 Section I - Administration — — __ X — — 1. REPORT TYPE: Information Traffic Military Offense Criminal Complaint X _ _ 3. EVALUATION: FoundedF Unfounded 4a. COMPLAINT DATE:. (YYYY/MM/DD): 2003/05/25 X _ — 2. STATUS: Initial Supplemental Cdr's Action 4b. COMPLAINT TIME: (24hr.); 1416 4c. BY: _ _ — — — — COMPLAINT RECEIVED In person 911 CB Telephone Mail Radio Crime Stoppers Alarm Other (Specify): D/SG1111111111111110 (49C-.3 1 LO(49 "3 5a. _ — _ — — CLEARANCE REASON: ' C A Death of Offender B Prosecution Declined C Extradition Declined D Victim Refused To E Juvenile, No Custody U Unfounded X Apprehension 5b. EXCEPTIONAL CLEARANCE DATE: (YYYY/MM/DD): .— X 7. INVOLVEMENT: Hate Death . Trainee — — — Domestic Gang Extremist 6a. _ T MP ACTION: MPI CID Civil Authorities — Traffic Other (Specify) 6b. DATE REFERRED: (YYYY/MM/DD): 2002/09/25 X Section II - Offense la. OFFENSE NO. 1 lb. SUBJECT NO. INVOLVEMENT: 1-2-3-4 lc. VICTIM NO. INVOLVEMENT: 1 1d. NIBRS LOCATION CODE: 13 le. — x ' Attempted Completed if. SAME OFFENSE DATA FOR ALL OFFENSE CODES: Yes x_No (See 3975-1) 1g. OFFENSE lh. OFFENSE DESCRIPTION(s): 1i. OFFENSE LOCATION ADDRESS: CODE(s): MURDER - BY SHOOTING (ARTICLE #118, UCMJ) (OFF 5H1A POST) ROAD ADJACENT TO U.S. FIRE BASE, LWARA, AE AF 2a. BEGIN DATE: (YYYY/MM/DD): 3. TYPE OF CRIMINAL ACTIVITY 4. OFFENSE STATUTORY BASIS: 5. OFFENDER USED 2002/08/28 (Check Up To Three): (Check Up To Three) A UCMJ _ B Buying/Receiving B Non-Criminal Fatality A Alcohol _ 2b. BEGIN TIME (24hr.): C Cultivating/Manufacturing/Publishing —— C State _ C Computer Equipment 1500 — D Distributing/Selling D Local D Drugs/Narcotics _ E Exploiting Children _ E Foreign X N Not Applicable2c. END DATE: (YYYY/MM/DD): — _ 0 Operating/Promoting/Assisting F Federal, Non-UCMJ 2002/08/28 P Possessing/Concealing — T Transporting/Importing2d. END TIME: (24hr.): — U Using/Consuming 1800 — NATIONAL INCIDENT BASED REPORTING SYSTEM (NIBRS) LOCATION CODES 01 Air/Bus/Train Terminal 10'FielcWVoods/Training Area 19 Rental/Storage Facility 02 Bank/Credit Union 11 Government/Public Building 20 Residence/Quarters/Barracks/BEQ/BOQ 03 Bar/Officer/NCO Club 12 Grocery Store/Commissary 21 Restaurant/Dining Facility 04 Church/Synagogue/Temple 13 Highway/Road/Alley/Street 22 School/College 05 Commercial Office Building 14 Hotel/MoteINAQNEQ/TLQ 23 Service/Gas Station • 06 Construction Site 15 Jail/Prison/Corrections Facility 24 Specialty Store/Concessionare 07 Convenience Store/Shoppette 16 Lake/Waterway/Ocean 25 Child Care Facility/Home Day Care 0 iiiiii Qiii 1^4 08 Dept/Discount Store/Exchange 17 Liquor/Store/Class VI 26 Recreation Area/Park 09 Drug Stor/Hospital/Clinic 18 Motor PooVParking Lot/Garage 27 Training Center/Service School 28 Ontoard Ship DA FORM 3975, JUNE 2001 00134.2003-MPC259 DA FORM 3975, MAY 88, IS OBSOLETE Page 1 of 19 Pages 6. TYPE OF WEAPON/FORCE. Check up to hree and indicate in the second block next to the item whether: F - Fully Automatic S - Semi-Automatic M - Manual .U - Unknown 11 Firearm(Unk Type) 35 Motor Vehicle.I.I.I.90 Other(Specify) 12 Handgun 50 Poison X S 13 Rifle 60 Explosives. 99 None 14 Shotgun 65 Fire/Incendiary 7. NUMBER OF PREMISES ENTERED 40 Personal Weapons 70 Narcotics/Drugs (For Burglary/Housebreaking only) 20 Knife/Cutting Instrument 85 Asphyxiation 30 Blunt Object 95 Unknown 0.Forcible Entry.No Forcible Entry 8. AGGRAVATED ASSAULT/HOMICIDE CIRCUMSTANCES (Check up to two) 9. ADDITIONAL JUSTIFIABLE HOMICIDE CIRCUMSTANCES _ 1 Argument 20 Criminal Killed By Private Citizen A Criminal attacked police officer and that police officer 2 Assault on Law Officer 21 Criminal Killed By Law Enforcement killed the criminal 3 Drug Dealing 30 Child Playing With Weapon B Criminal attacked police officer and was killed by _ 4 Gangland 31 Gun Cleaning Accident another police officer _ - -5 Juvenile Gang 32 Hunting Accident C Criminal attacked civilian - 6 Domestic Quarrel 33 Other Negligent Wpn Handling D Criminal attempted flight from a crime _ 7 Mercy Killing 35 Other Negligent Killings E Criminal killed in comminsion of a crime _ _ - 8 Other Felony Involved F Criminal resisted arrest _ G Unable to determine 10. BIAS MOTIVATION (As applicable) Yes.No X_ Unknown Section III - Subject la. SUBJECT lb. NAME Last, First, Middle Name, JR., Sr., Ill):., lc. SSN/FNN/ALIEN REG NO: 1d. PROTECTED IDENTITY: NO: 1 (0q L' A"r, b 6-S SSN_111111111.111 1974 •Slinf,* t le. CATEGORY: 1f. DOB (YYYY/MM/DD): 1g. POB: City, State, Country: 1h. GRADE: 1i. HOME PHONE: X A ArmyArm 11111111111111110 674--51 k'_`S CPT 1111111111.0 C Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: -F Air Force _ IR.US. Country.(Specify): H Public Health Resident Alien: M Marine _ N Navy lm. COMPONENT 1n. DRIVER LICENSE 10. S LICENSE _ 0 NOAA G Nat'l Guard NO: FR Foreign.State (Specify): _ _ P Family Member X R Regular.V Reserves IT International -Q Civil Service _ R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: 2d. Zip/APO: -S Contractor ADDRESS: BAGRAM AF 09354 _ , ____ T Other Gov. Empl. 2c. STATE/COUNTRY: 2e. UNIT PHONE: ODA 343, 2/3RD SFG U Foreign Nat'l Empl. AE AF V Other Foreign Nat'l 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: 3d. ZIP/APO:W Retired Military _ 3c. STATE/COUNTRY: 4a. HAIR COLOR 4b. EYE COLOR 4c. COMPLEXION 4d. AGE 5. JUVENILE 7. RACE _ Brown Brown Albino - Medium RANGE _ _ -Blond Black -Black Medium Brown ( Specify ) Yes A Asian/Pac. Islander _ _ _ _ _ Black Gray Dark Ruddy 7-No B Black _ _ _ _ Gray Blue Dark Brown Yellow I American Indian/ - - 4e. HEIGHT 6. SEX -Red Green -Fair Sallow Alaskan Native X Male -White -Hazel -Light - Olive X W White - - Female - Other (Specify) Violet -Light Brown 4f. WEIGHT: - U Unknown Unknown . 8. ETHNICITY 9. IDENTIFYING MARKS AND LOCATION: 10. HOW DRESSED AT TIME OF INCIDENT (Clothing, Materials, Colors): -H Hispanic N Not of Hispanic Origin 11. OFFENDER'S DISPOSITION: U Unknown 12. SECURITY CLEARANCE 13. MARITAL STATUS 14. SUBJECT ARMED WITH ( Check up to 2 and indicate in 2nd box whether None Annulled F -Fully Automatic, M - Manual, S - Semi-Automatic, U - Unknown ) _ Confidential -Divorced 1 Unarmed 16 Lethal Cutting Instrument _ Secret Divorce Decree, Not Finalized 11 Firearm (Unk Type) 17 Club/Blackjack/Knuckles _ Top Secret Legally Separated 12 Handgun 15 Other (Specify) - Other (Specify) Married 13 Rifle. • - -Single 14 Shotgun ___ Widowed , Qiiif) 0 Cs 0 _ DA FORM 3975, JUN 2001 00134-2003-MPC259 DA FORM 3975, MAY 88, IS OBSOLETE Page 2 of 19 Pages 15a SUBJECT INVOLVEMENT 15b APPREHENSION TY PE 15c. APPREHENSION DATE 15d. APPREHENDING PMO (UIC/MPC):Accessory Military (YYYY/MM/DD): Conspiracy Surrender 15e DETENTION TYPE X Principle Civil Authorities 15f. HOW DRESSED AT TIME OF APPREHENSION: N Non-Uniformed Svc. Solicit Other (Specify) U Uniformed Svc. 15g DISPOSITION OF PERSON UNDER 18 YEARS 15h. FBI FORM 249 SUBMITTED 16a. INVOLVEMENT 16b. ALCOHOUDRUGH Handled Internally Yes El No Alcohol TEST RESULTS:R Referred to Other Authorities (Specify) Drug 151. FBI FORM R-84 SUBMITTED None ¦¦•¦•¦• Yes No ' 16c. ILLNESS/INJURY: 16d. ALCOHOUDRUG INVOLVEMENT REMARKS: 17a. CHEMICAL TEST TYPE 17b DRUG. TYPE Blood Test A "Crack" Cocaine G Opium M Other StimulantsBreathalyzer B Cocaine H Other Narcotics N BarbituratesSaliva Test C Hashish I LSD O Other DepressantsUrine Test D Heroin J PCP .11¦MMON P Other DrugsOther (Specify) E Marijuana10¦1 K Other Hallucinogens Q Steriods ¦¦•¦ F Morphine L Amphetamines/Methamphetamines M Unknown Type Drug :17c. DRUG TEST AND MEASUREMENT I.e.: parts per million, cubic centimeters, etc.) 17d. DRUG DETECT ON BY OTHER LAW ENFORCEMENT MEANS El Yes No Section IV - Victim la. VICTIM lb. NAME (Last, First, Middle Name, JR., Sr., III): 1c. SSN/FNN/ALIEN REG NO: ld. PROTECTED IDENTITY: NO: 1 SAYARI, MOHAMED SSN le. CATEGORY: 1f. DOB ( YYYY/MM/DD): 1g. POB: City, State, Country: 1h. GRADE; 11. HOME PHONE: A Army AF CIVC Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: F AlrForce US Country (Specify):H Public Health Resident Alien: M Marine N Navy 1m. COMPONENT 1n. DRIVER LICENSE O NOAA 10. S LICENSE G Nat'l Guard NO:. P Family Member FR Foreign State (Specify): R Regular V Reserves Q Civil Service IT Internationa X R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: S Contractor 2d. Zip/APO: ADDRESS: T Other Gov. Empl. U Foreign Nat'l Empl. 2c. STATE/COUNTRY: 2e. UNIT PHONE: V Other Foreign Nat'l W Retired. Military 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: 3d. ZIP/APO: MORGAN 3c. STATE/COUNTRY: AF 4a. TYPE OF VICTIM: 4b. SEX 4c. AGE 4d. RACE 4e. ETHNICITY B Business R ReligioUs Org Male X Under 24 Hours A Asian/Pac. Islander H HispanicF Financial S Society/Public Female 1: 6 Days Old B Black ' N Not of Hispanic OriginG Govemment 0 Other Unknown 7 - 364 Days Old I American Indian/ U UnknownX I Individual U Unknown Years Old Alaskan Native Range (Specify): W White U Unknown 5. BIAS MOTIVATION riYes ( Check Applicable Bias ) AK Anti-Female Homosexual AU Anti-Protestant AA Anti-Athiest/Agnostic AL Anti-Heterosexual AV Anti-White AB Anti-Alaskan Native AM Anti-Hispanic AW Anti-Homosexual Bias AC Anti-American Indian AN Anti-Islamic(Moslem) AY Anti-Other ReligionAD Anti-Arab AO Anti-Jewish AZ Anti-Other EthnicityAE Anti-Asian AQ Anti-Male Homosexual BA Anti-Mental DisabilityAG Anti-Bisexual AR Anti-Multi-Racial Group BB Anti-Physical DisabilityAH Anti-Black AS Anti-Multi-Religious Group BC Sexual Harassment Al Anti-Catholic AT Anti-Pacific-Islander AX.Unknown Bias DA FORM 3975, JUN 2001 00134-2003 MPC259 DA FORM 3975, MAY 88, IS OBSOLETE Page 3 of 19 Pages , U0003 _ 6. RELATIONSHIP OF VICTIM TO OFFENDER ( For multiple offender relationships, 7. VICTIM _ X Principle enter the subjects number ) INVOLVEMENT — Conspiracy Solicit _ AA Spouse AV Step-Sibling BL Homosexual Relationship 8. INJURY TYPE ( Check up to fve ) _ _ AB Child AZ Friend BN Extended Family _ B Broken Bones 0 Major Injury _ __ AC Sibling BA Neighbor BY Employee — I .Internal — T Tooth Loss _ — — L Severe Laceration U Unconsciousness — AD Parent BB Corn. Law Spouse — BZ Employer _ AE Parent-in-Law — _ BC Acquaintance — BX Stranger M Minor Injury — Z None — AF Step Child BD Baby-Sittee(baby) CA Otherwise Known — — 9a. DD FORM 2701 PROVIDED VICTIM AG Grandparent BE Boy/Girlfriend 4 CB Relationship Unknown — Yes.X_No AH Step-Parent — BF Child of Boy/Girlfriend VO Offender AK Grandchild — BH Former Spouse 9b. IF NOT PROVIDED, WHY NOT? Declined.X_Not Required Section V - Persons Related To Report 1 a. PERSON RELATED TO REPORT NUMBER 1 b. STATUS — Civil Authorities X Complaint.Military Police 1 Sponsor Witness lc. NAME (Last, First, Middle Name, JR., Sr., III): ld. SSN/FNN/Alien Reg No: le. CITIZENSHIP US. Resident Alien SSN Country (Specify): MIIIIIIMINIO 16,1-G. .lo 6- tit X lf. CATEGORY: 1g. DOB (YYYY/MM/DD): lh. POB: City, Stale, Country: 11. GRADE: 1j. HOME PHONE: SSG A Army _ 1k. WORK PHONE: 11. NICKNAMES/ALIAS: 1m. COMPONENT G Nat'l Guard C Coast Guard R Regular V Reserves — F Air Force — _ H Public Health ln. DRIVER LICENSE NO: 1o. S LICENSE M FR Foreign State (Specify):.Other (Specify): . — 'N Navy IT International _ — 0 NOAA — 2a. ORGANIZATION, UIC, STREET ADDRESS: 2b. NSTALLATION/CITY: 2d. ZIP/APO: P Family Member BAGRAM AF 09354 — 0 Civil Service — R Civilian.-2c. STATE/COUNTRY: 2e. UNIT PHONE: A CO 519TH MI BN_• S Contractor AE AF T Other Gov. Empl. 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: 3d. ZIP/APO: U Foreign Nat'l Empl. _ V Other Foreign Nat'l — 3c. STATE/COUNTRY:, W Retired Military 4a. DD FORM 2701 PROVIDED VICTIM/WITNESS: 4b. IF NOT PROVIDED WHY NOT? 5. NUMBER OF VICTIMS ( 0 ) AND WITNESSES ( 0 ) Yes. X.No Declined.x_Not Required NOTIFIED WITH DD FORM 2701 Section VI - Property la. ITEM NO: lb. CODE: lc. QUANTITY: ld. VALUE: 1e. DESCRIPTION lf. SERIAL NUMBER: 1g. DATE RECOVERED (YYYY/MM/DD): 11h. DATE RETURNED (YYYY/MM/DD): li. SECURITY 1j. PROPERTY OWNERSHIP 1k. PROPERTY LOSS TYPE ( Check all that apply ) .--— SS Secured A Federal E Foreign Govt. 1 None 5 Recovered — — — U Unsecured B State — F Private 2 Burned 6 Seized — — — — Z Unknown — C City U Unknown 3 Counterfeited/Forged 7 Stolen — — — D County/Borough 4 Damaged/DestroyedNandalized PROPERTY DESCRIPTION CODE TABLE 01 Aircraft. 12 Farm Equipment. 23 Office-Type Equipment. 34 Structures-Storage 02 Alcohol. 13 Firearms. 24 Other Motor Vehicles. 35 Structures-Other 03 Automobile. 14 Gambling Equipment.25 Purse/Handbag/Wallet . 36 Tools/Hand and Power 04 Bicycle. 15 Heavy Construction Equip. .26 RadioITVNCR. 37 Trucks 05 Buses. 16 Household Goods. 27 AudioNisual Recording. 38 Vehicle Parts/Accessories 06 Clothing/Furs. 17 Jewelry/Precious Metals.28 Recreational Vehicle. 39 Watercraft 07 Computer Hard/Software .18 Livestock. 29 Structure-Single Occupancy .40 OTHER (Specify) 08 Consumable Goods. 19 Merchandise. 30 Structures-Other Dwellings 09 Credit/Debit Cards . 20 Money. 31 Structures-Commercial/Business 10 Drugs/Narcotics (See below).21 Negotiable Instruments.32 Structures-Industry/Manufacturing .41 Pending Inventory 11 Drugs/Narcotics Equipment.22 Non-Negotiable Instruments.33 Structures-Public/Community .42 Special Category DRUG/NARCOTIC MEASURES GM - Gram.KG - Kilogram.OZ - Ounce LB - Pound.FO - Fluid Ounce.GL - Gallon LT - Liter ML - Milliliter .DU - Dosage Unit.NP - Nimber of Plrits _ DA FORM 3975 , JUN 2001 00134-2003-MPC259 _ Page44.0(IQI Section VII - Narrative "THIS IS AN OPERATION STROGNGOLD INVESTGATION" THIS INVESTIGATION WAS INITIATED UPON NOTIFICATION FROM SSG _, THAT HE WASUSPICIOUS OF THE SHOOTING DEATH OF MR. SAYARI BY A SPECIAL _ AM. INVESTIGATION ESTABLISHED PROBABLE CAUSE TO BELIEVE SFC111111111W, SSG MINIM CPT11111111¦I; AND SSG=IVCOMMITTED THE OFFENSES OF MURDER AND CONSPIRACY WHEN THEY CONSPIRED TO LURE MR SAYARI' INTO AN AMBUSH TO MURDER HIM. SFC111111111R. AND SSG _ SHOT ANDIKILLED MR SAYAR UPON DETAINING HIM. INVESSTIGATION ESTABLISHED PROBABLE CAUSE TO BELIEVE CPT111111111111111111! COMMITTED THE OFFENSES OF DERELICTION OF DUTY AND OBSTRUCTION OF JUSTUCE WHEN HE VIOLATED THE UNIT STANDARD OPERATING PROCEDURES(SOP) FOR DETAINING CAPTIVES AND INSTRUCTED SFC _(FORMELY SSG) TO NOT FORWARD CERTAIN INCRIMINATING PHOTGRAPHS OF SAYARI'S BODY, AND TO DESTROY THEM. SFC_L AND SFC _COMMITTED THE OFFENSE OF DERELICTION OF DUTY WHEN THEY VIOLATED SOP FOR DETAINING CAPTIVES. SSG NOT COMMIT THE OFFENSE OF DERELICTION OF DUTY AS HE WAS. NOT DIRECTLY INVOLVED IN HANDLING A DETAINED CAPTIVE. INVESTIGATION ESTABLISHED PROBALE CAUSE TO BELIEVE CW2 COMMITTED THE OFFENSE OF ACCESSORY AFTER THE FACT WHEN HE TOOK THE WEAPON THAT MR SAYARI ALLEDGEDLY HAD PRIOR TO THE SHOOTING AND LOST IT. • THIS IS A FINAL REPORT. 1. Enclosures: 2. Distribution:. 3. Name: 7c. -3, L6-3 4. Grade: CPT 5. Title Of Reporting Official: - PROVOST MARSHAL ' 6:Signature: DA FORM 3975, JUN 2001 00134-2003-MPC259 5 MILITARY POLICE REPORT - ADDITIONAL OFFENSES For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION II, DA Form 3975. Please attach it to DA Form 3975 when completed. MILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: bl-C -3bE)-3 ODA 343, 2/3RD SFG ATTN: L BAGRAM AF,AE AF 09354 ECHO D a.. BAGRAM AIRFIELD, AE AF 09354 Section II - Offense la. OFFENSE NO. lb. SUBJECT NO. lc. VICTIM NO. ld. NIBRS le. , 1f. SAME OFFENSE DATA FOR ALL INVOLVEMENT: INVOLVEMENT: LOCATION CODE: — Attempted OFFENSE CODES: 2 1-2-3-4 1 13 X Completed 0 Yes X No (See 3975-1) 1g. OFFENSE lh. OFFENSE DESCRIPTION(s): 1i. OFFENSE LOCATION ADDRESS: CODE(s): CONSPIRACY TO COMMIT OTHER CRIMES AGAINST 7X2 PROPERTY (ARTICLE #134, UCMJ) (OFF POST) ROAD ADJACENT TO U.S. FIRE BASE, LWARA, AE AF 2a. BEGIN DATE: (YYYY/MM/DD): 3. TYPE OF CRIMINAL ACTIVITY 4. OFFENSE STATUTORY BASIS: 5. OFFENDER USED 2002/08/28 (Check Up To Three): (Check Up To Three) X A UCMJ _ _ B Buying/Receiving B Non-Criminal Fatality • A Alcohol 2b. BEGIN TIME (24hr.): C Cultivating/Manufacturing/Publishing C State C Computer Equipment 1500 — D Distributing/Selling — D Local D Drugs/Narcotics E Exploiting Children E Foreign X N Not Applicable , — _ 2c. END DATE: (YYYY/MM/DD): 0 Operating/Promoting/Assisting F Federal, Non-UCMJ _ 2002/08/28 P Possessing/Concealing _ T Transporting/Importing2d. END TIME: (24hr.): — U Using/Consuming 1800 — 6. TYPE OF WEAPON/FORCE. Check up to hree and indicate in the second block next to the item whether: F - Fully Automatic S - Semi-Automatic M - Manual U - Unknown 11 Firearm(Unk Type) 35 Motor Vehicle 90 Other(Specify) 12 Handgun 50 Poison 13 Rifle 60 Explosives 99 None 14 Shotgun 65 Fire/Incendiary 7. NUMBER OF PREMISES ENTERED 40 Personal Weapons 70 Narcotics/Drugs (For Burglary/Housebreaking only) 20 Knife/Cutting Instrument 85 Asphyxiation 30 Blunt Object 95 Unknown 0 Forcible Entry UNo Forcible Entry 8. AGGRAVATED ASSAULT/HOMICIDE CIRCUMSTANCES (Check up to two) 9. ADDITIONAL JUSTIFIABLE HOMICIDE CIRCUMSTANCES 1 Argument 20 Criminal Killed By Private Citizen A Criminal attacked police officer and that police officer _ 2 Assault on Law Officer 21 Criminal Killed By Law Enforcement killed the criminal _ 3 Drug Dealing 30 Child Playing With Weapon B Criminal attacked police officer and was killed by _ 4 Gangland 31 Gun Cleaning Accident another police officer _ _ 5 Juvenile Gang 32 Hunting Accident C Criminal attacked civilian __ __ _ 6 Domestic Quarrel _ 33 Other Negligent Wpn Handling D Criminal attempted flight from a crime — _ 7 Mercy Killing 35 Other Negligent Killings E Criminal killed in comminsion of a crime _ _ 8 Other Felony F Criminal resisted arrest G Unable to determine 10. BIAS MOTIVATION (As applicable) 0 Yes U No X Unknown Q 0i) C, CI L ' DA FORM 3975-1, JUN 2001 00134-2003-MPC259 Page 6 of 19 MILITARY POLICE REPORT - ADDITIONAL OFFENSES For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION II, DA Form 3975. Please attach it to DA Form 3975 when completed. MILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM FROM: i 3 66-3 ODA 343, 2/3RD SFG ATTN: LT BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 THRU: TO: COMMANDER ‘- Section II - Offense la. OFFENSE NO. lb. SUBJECT NO. lc. VICTIM NO. 1d. NIBRS 1e. 1f. SAME OFFENSE DATA FOR ALL INVOLVEMENT: INVOLVEMENT: LOCATION CODE: r-- Attempted OFFENSE CODES: 3 5 2 13 X Completed ' X_ Yes.No (See 3975-1) 1g. OFFENSE 1h. OFFENSE DESCRIPTION(s): 11. OFFENSE LOCATION ADDRESS: CODE(s): SOLICITATION - TO SEDITION, ACCESSORY AFTER THE 5X4 FACT (ARTICLE #78, UCMJ) (ON POST) AE AF 2a. BEGIN DATE: (YYYY/MM/DD): 3. TYPE OF CRIMINAL ACTIVITY 4. OFFENSE STATUTORY BASIS: 5. OFFENDER USED 2002/08/28 (Check Up To Three): , (Check Up To Three) X A UCMJ _ B Buying/Receiving B Non-Criminal Fatality A Alcohol 2b. BEGIN TIME (24hr.): C Cultivating/Manufacturing/Publishing — C State C Computer Equipment 1500 — _D Distributing/Selling D Local D Drugs/Narcotics E Exploiting Children _ E Foreign X N Not Applicable2c. END DATE: (YYYY/MM/DD): — _ 0 Operating/Promoting/Assisting _ F Federal, Non-UCMJ 2002/08/28 P Possessing/Concealing _ T Transporting/Importing2d. END TIME: (24hr.): — U Using/Consuming 1800 6. TYPE OF WEAPON/FORCE. Check up to hree and indicate in the second block next to the item whether: F - Fully Automatic S - Semi-Automatic M - Manual .U - Unknown 11 Firearm(Unk Type) 35 Motor Vehicle.I.I.I.90 Other(Specify) 12 Handgun 50 Poison 13 Rifle 60 Explosives. 99 None. ' 14 Shotgun 65 Fire/Incendiary 7. NUMBER OF PREMISES ENTERED 40 Personal Weapons 70 Narcotics/Drugs (For Burglary/Housebreaking only) 20 Knife/Cutting Instrument 85 Asphyxiation 30 Blunt Object 95 Unknown Forcible Entry.No Forcible Entry 8. AGGRAVATED ASSAULT/HOMICIDE CIRCUMSTANCES (Check up to two) 9. ADDITIONAL JUSTIFIABLE HOMICIDE CIRCUMSTANCES 1 Argument 20 Criminal Killed By Private Citizen A Criminal attacked police officer and that police officer _ 2 Assault on Law Officer 21 Criminal Killed By Law Enforcement killed the criminal _ — 3 Drug Dealing 30 Child Playing With Weapon B Criminal attacked police officer and was killed by _ 4 Gangland 31 Gun Cleaning Accident another police officer _ 5 Juvenile Gang 32 Hunting Accident C Criminal attacked civilian _ _ _ — _ 6 Dtic Qelomes.uarr 33 Other Negligent Wpn Handling D Criminal attempted flight from a crime 7 Mercy Killing — 35 Other Negligent Killings E Criminal killed in comminsion of a crime _ 8 Other Felony Involved F Criminal resisted arrest _ — G Unable to determine 10. BIAS MOTIVATION (As applicable) El Yes El No ElUnknown • ‘41 tie 6 io i _'J-. _ _ DA FORM 3975-1, JUN 2001 00134-2003-MPC259 Page 7 of 19 MILITARY POLICE REPORT - ADDITIONAL OFFENSES For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION II, DA Form 3975. Please attach it to DA Form 3975 when completed. MILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: (045-C,:-.3c14)-3 ODA 343, 2/3RD SFG ATTN: LTall111., BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 Section II - Offense la. OFFENSE NO. lb. SUBJECT NO. lc. VICTIM NO. ld. NIBRS le. lf. SAME OFFENSE DATA FOR ALL INVOLVEMENT: INVOLVEMENT: LOCATION CODE: Attempted OFFENSE CODES: 4 1-2-4 2 13 x Completed x.Yes.No (See 3975-1) 1g. OFFENSE lh. OFFENSE DESCRIPTION(s): 11. OFFENSE LOCATION ADDRESS: CODE(s): DERELICTION OF DUTY (ARTICLE #92, UCMJ) (OFF POST) . 5Y2D AE AF 2a. BEGIN DATE: (YYYY/MM/DD): 3. TYPE OF CRIMINAL ACTIVITY 4. OFFENSE STATUTORY BASIS: 5. OFFENDER USED 2002/08/28 (Check Up To Three): (Check Up To Three) X A UCMJ B Buying/Receiving B Non-Criminal Fatality _ A Alcohol 2b. BEGIN TIME (24hr.): — CCultivating/Manufacturing/Publishing — C State _ C Computer Equipment 1500 _ — D Distributing/Selling D Local D Drugs/Narcotics E Exploiting Children _ E Foreign X N Not Applicable2c. END DATE: (YYYY/MM/DD): — _ 0 Operating/Promoting/Assisting F Federal, Non-UCMJ 2002/08/28 P Possessing/Concealing _ T Transporting/Importing 2d. END TIME: (24hr.): — U Using/Consuming 1800 — 6. TYPE OF WEAPON/FORCE. Check up to hree and indicate in the second block next to the item whether: F - Fully Automatic S - Semi-Automatic M - Manual .U - Unknown 11 Firearm(Unk Type) 35 Motor Vehicle.I.I.1.90 Other(Specify) 12 Handgun 50 Poison 13 Rifle 60 Explosives. 99 None 14 Shotgun 65 Fire/Incendiary 7. NUMBER OF PREMISES ENTERED 40 Personal Weapons 70 Narcotics/Drugs (For Burglary/Housebreaking only) 20 Knife/Cutting Instrument 85 Asphyxiation 30 Blunt Object 95 Unknown El Forcible Entry.a No Forcible Entry 8. AGGRAVATED ASSAULT/HOMICIDE CIRCUMSTANCES (Check up to two) 9. ADDITIONAL JUSTIFIABLE HOMICIDE CIRCUMSTANCES __ 1 Argument 20 Criminal Killed By Private Citizen A Criminal attacked police officer and that police officer _ 2 Assault on Law Officer 21 Criminal Killed By Law Enforcement killed the criminal _ _ 3 Drug Dealing 30 Child Playing With Weapon B Criminal attacked police officer and was killed by _ _ , 4 Gangland 31 Gun Cleaning Accident another police officer. _ 5 Juvenile Gang 32 Hunting Accident C Criminal attacked civilian __ _ 6 Domestic Quarrel 33 Other Negligent Wpn Handling D Criminal attempted flight from a crime _ _ 7 Mercy Killing 35 Other Negligent Killings E Criminal killed in comminsion of a crime _ 8 Other Felony Involved F Criminal resisted arrest _ — G Unable to determine 10. BIAS MOTIVATION (As applicable) Yes El No.Unknown . 43 144.,¦.1. ci '.) 8 DA FORM 3975-1, JUN 2001 00134-2003-MPC259 Page 8 of 19 MILITARY POLICE REPORT - ADDITIONAL OFFENSES For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION II, DA Form 3975. Please attach it to DA Form 3975 when completed. MILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: ' TO: COMMANDER FROM: 199C--_ID ro "- I ODA 343, 2/3RD SFG ATTN: LT BAGRAM AF,AE AF 09354 ECHO DRIV BAGRAM AIRFIELD, AE AF 09354 Section II - Offense la. OFFENSE NO. lb. SUBJECT NO. lc. VICTIM NO. ld. NIBRS 10. lf. SAME OFFENSE DATA FOR ALL INVOLVEMENT: INVOLVEMENT: LOCATION CODE: Attempted OFFENSE CODES: 5 1 2 13 x Completed X Yes No (See 3975-1) 1g. OFFENSE 1h. OFFENSE DESCRIPTION(s): li. OFFENSE LOCA TION ADDRESS: CODE(s): ' OBSTRUCTION OF JUSTICE (ARTICLE #134, UCMJ) (OFF 7X6 POST) • AE AF 2a. BEGIN DATE: (YYYY/MM/DD): 3. TYPE OF CRIMINAL ACTIVITY 4. OFFENSE STATUTORY BASIS: 5. OFFENDER USED 2002/08/28 (Check Up To Three): (Check Up To Three) X A UCMJ B Buying/Receiving B Non-Criminal Fatality A Alcohol C Cultivating/Manufacturing/Publishing C State C Computer Equipment 2b. BEGIN TIME (24hr.): _ _ . 1500 _ — D Distributing/Selling D Local D Drugs/Narcotics E Exploiting Children _ E Foreign X N Not Applicable2c. END DATE: (YYYY/MM/DD): — _ 0 Operating/Promoting/Assisting F Federal, Non-UCMJ2002/08/28 P Possessing/Concealing _ T Transporting/Importing2d. END TIME: (24hr.): — U Using/Consuming1800 — 6. TYPE OF WEAPON/FORCE. Check up to hree and indicate in the second block next to the item whether: F - Fully Automatic S - Semi-Automatic M - Manual U - Unknown 11 Firearm(Unk Type) 35 Motor Vehicle 1 I 1 90 Other(Specify) 12 Handgun 50 Poison 13 Rifle 60 Explosives 99 None , 14 Shotgun 65 Fire/Incendiary 7. NUMBER OF PREMISES ENTERED 40 Personal Weapons 70 Narcotics/Drugs (For Burglary/Housebreaking only) 20 Knife/Cutting Instrument 85 Asphyxiation 30 Blunt Object 95 Unknown Forcible Entry No Forcible Entry 8. AGGRAVATED ASSAULT/HOMICIDECIRCUMSTANCES (Check up to two) 9. ADDITIONAL JUSTIFIABLE HOMICIDE CIRCUMSTANCES 1 Argument 20 Criminal Killed By Private Citizen A Criminal attacked police officer and that police officer _ 2 Assault on Law Officer 21 Criminal Killed By Law Enforcement killed the criminal 3 Drug Dealing 30 Child Playing With Weapon B Criminal attacked police officer and was killed by _ _ 0 4 Gangland 31 Gun Cleaning Accident another police officer _ 5 Juvenile Gang 32 Hunting Accident C Criminal attacked civilian 6 Domestic Quarrel ___ 33 Other Negligent Wpn Handling D Criminal attempted flight from a crime _ 7 Mercy Killing 35 Other Negligent Killings E Criminal killed in comminsion of a crime _ 8 Other Felony Involved F Criminal resisted arrest _ — .-G Unable to determine 10. BIAS MOTIVATION (As applicable) Yes No UUnknown . thiii i4. DA FORM 3975-1, JUN 2001 00134-2003-MPC259 Page 9 of 19 MILITARY POLICE REPORT - ADDITIONAL SUBJECTS For use of this form, see AR 190-45; the proponent agency is ODCSOPS - This form is a continuation of SECTION III, DA Form 3975. Please attach it to DA Form 3975 when completed. PRIVACY ACT STATEMENT AUTHORITY: Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES: Your Social Security Number is used as an additional/alternate means of identification to facilitate filing and retrieval. DISCLOSURE: Disclosure of your Social Security Number is voluntary. Military Police Report Number Date( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER iiir3 FROM: ma0676)-ODA 343, 2/3RD SFG ATTN: LT BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 Section III - Subject la. SUBJECT lb. NA.Last First, Middle.ame, JR., Sr., 11.1): lc. SSN/FNN/ALIEN REG NO: ld. PROTECTED IDENTITY: NO: 2 101-C -c tb6-S-SSN.11111.11111111497C-6.`, 46 . le. CATEGORY: lf. DOB (YYYY/MM/DD): 1 . POB: CITY,STATE,COUNTRY: lh. GRADE: 11. HOME PHONElliC-6 A Army 10-c -5-I k;c9--SFC X MEM 1111111111 '147.6' C Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: -F Air Force US. Country (Specify): _ H Public Health -Resident Alien: M Marine _ _ N Navy 1m. COMPONENT 1n. DRIVER LICENSE 10. S LICENSE _ 0 NOAA _ G Nat'l Guard NO: FR Foreign.0State (Specify): _ P Family Member M R Regular.V Reserves aiiS...G` -IT International 0 Civil Service _ R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: 2d. Zip/APO: _ S Contractor ADDRESS: BAGRAM AF 09354 T Other Gov. Empl. 2c. STATE/COUNTRY: 2e. UNIT PHONE: _ ODA 343, 2/3RD SFG U Foreign Nat'l Empl. AE AF V Other Foreign Nat'l 3a. RESIDENCE TREET ADDRESS: 3b. INSTALLATIQN./CITY: , 3d. ZIP/APO: W Retired Military -_-5" MININS e4C-.5 r. 40(0-5--MS b9c-51,e6 -45- 3c. STATE/COUNTRY: 4a. HAIR COLOR 4b. EYE COLOR 4c. COMPLEXION 4d. AGE 5. JUVENILE 7. RACE _ _ RANGE _ _ Brown Brown Albino Medium ( Specify ) Yes _____ A Asian/Pac. Islander _____ _ - Blond Black Black Medium Brown X No B Black _ _ _ _ - Black Gray -Dark Ruddy I American Indian/ _ - - GGray Blue Dark Brown Yellow 4e. HEIGHT wn -6. SEX' Alaskan Native _ Red Green Fair Sallow X Male X W White _ _ _ -White Hazel Light -Olive Female U Unknown _ Other (Specify) Violet -Light Brown -Unknown - _ 4f. WEIGHT: 8. ETHNICITY 9. IDENTIFYING MARKS AND LOCATION: 10. HOW DRESSED AT TIME OF INCIDENT H Hispanic (Clothing, Materials, Colors): X N Not of Hispanic Origin 11. OFFENDER'S DISPOSITION: U Unknown 4 Oki 14 i.4kj at DA FORM 3975-2, JUN 2001 00134-2003-MPC259 Page 10 of 19 12. SECURITY CLEARANCE 13. MARITAL STATUS _ _ 14. SUBJECT ARMED WITH ( Check up to 2 and indicate in 2nd box whetherNone Annulled _ F - Fully Automatic, M - Manual, S - Semi-Automatic, U - Unknown ) Confidential — Divorced — 1 Unarmed _ 16 Lethal Cutting InstrumentSecret — Divorce Decree, Not Finalized 11 Firearm (Unk Type) _ 17 Club/Blackjack/KnucklesTop Secret Legally Separated 12 Handgun ___ 15 Other (Specify)Other (Specify) Married _ _ 13 Rifle Single 14 Shotgun " — Widowed 15a SUBJECT INVOLVEMENT 15b APPREHENSION TYPE 15c. APPREHENSION DATE 15d. APPREHENDING PMO (UIC/MPC):Accessory Military (YYYY/MM/DD): Surrender 15e DETENTION TYPE X Principle Civil Authorities 15f. HOW DRESSED AT TIME OF APPREHENSION: — N Non Uniformed Svc. — Solicit Other (Specify) — — U Uniformed Svc. 15g DISPOSITION OF PERSON UNDER 18 YEARS 15h. FBI FORM 249 SUBMITTED 16a INVOLVEMENT 16b. ALCOHOUDRUGH Handled Internally ____ Yes X No Alcohol TEST RESULTS: _ .— Referred to Other Authorities (Specify) Drug , 15i. FBI FORM R-84 SUBMITTED — None Yes X_No 16c. ILLNESS/INJURY: 16d. ALCOHOUDRUG INVOLVEMENT REMARKS: Blood Test A "Crack" Cocaine G Opium M Other StimulantsBreathalyzer B Cocaine H Other Narcotics N BarbituratesSaliva Test ¦¦¦ C Hashish I LSD O Other Depressants •¦¦1 Urine Test D Heroin J PCP P Other DrugsOther (Specify) ¦¦¦• E Marijuana K Other Hallucinogens Q SteriodsF Morphine L Amphetamines/Methamphetamines M Unknown Type Drug 17c. DRUG TEST AND MEASUREMENT (i.e.: parts per million, cubic centimeters, etc.) 17d. DRUG DETECT ON BY OTHER LAW ENFORCEMENT MEANS Yes ri DA FORM 3975-2, JUN 2001 00134-2003-MPC259_ Page 11 of 19 MILITARY POLICE REPORT - ADDITIONAL SUBJECTS For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION III, DA Form 3975. Please attach it to DA Form 3975 when completed. PRIVACY ACT STATEMENT AUTHORITY: , Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES: Your Social Security Number is used as an additional/alternate means of identification to facilitate filing and retrieval. DISCLOSURE: Disclosure of your Social Security Number is voluntary. Military Police Report Number Date( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: iiiiiiitv2- 5 ODA 343, 2/3RD SFG ATTN: L BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 Section III - Subject la. SUBJECT lb. NAME (Last, First, Middle Name, JR., Sr., III): lc. SSN/FNN/ALIEN REG NO 1d_'. PROTECTED IDENTITY: NO: 3 1111111111.111111110 ID-4C,-- SI I be, -5 SSN 111111111111111W101-C.5-A\-1- 1e. CATEGORY: lf. DOB (YYYY/MM/DD): 1g. POB: CITY,STATE,COUNTRY: 1h. GRADE: 1i. HOME PHONEC -5 X A Army UMW 1111.11.11111b64L-5. ms`s SSG 011¦11.M¦b5'6-C Coast Guard _ 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: F Air Force _ -US.0 Country (Specify) : - H Public Health _ Resident Alien: M Marine - N Navy 1m. COMPONENT ln. DRIVER LICENSE 10. S LICENSE _ - 0 NOAA G Nati Guard NO: FR Foreign.State (Specify): P Family Member X R Regular.JJV Reserves -.-3 IT International Q Civil Service R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: 2d. Zip/APO: S Contractor ADDRESS: BAGRAM AF 09354 _ T Other Gov. Empl. U Foreign Nat'l Empl. _ 2c. STATE/COUNTRY: 2e. UNIT PHONE: ODA 343, 2/3RD SFG AE AF V Other Foreign Nat'l 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: 3d. ZIP/APO:hic, ....5" W Retired Military 111.111111) L-5-ih6-6 iii./. i''-*° IIIMMMUI'-5-1196-5- 3c. STATE/COUNTRY:., 11111111110 &I-C. -6/b& -4a. HAIR COLOR 4b. EYE COLOR 4c. COMPLEXION 4d. AGE 5. JUVENILE 7. RACE . _ RANGE g- Brown Brown -Albino Medium ( Specify ) Yes -A Asian/Pac. Islander _ _ - Blond Black Black Medium Brown X No B Black --_ _ - Black Gray _ Dark Ruddy I American Indian/ _ Gray -Blue Dark Brown Yellow 4e. HEIGHT 6. SEX Alaskan Native - _ Red Green Fair Sallow Male X W White _ _ X White Hazel Light -Olive Female U Unknown Other (Specify) Violet Light Brown 4f. WEIGHT: -Unknown - 8. ETHNICITY 9. IDENTIFYING MARKS AND LOCATION: 10. HOW DRESSED AT TIME OF I INCIDENT -H Hispanic (Clothing, Materials, Colors): N Not of Hispanic Origin 11. OFFENDER'S DISPOSITION: U Unknown 0 it ti:,y' 44 DA FORM 3975-2, JUN 2001• 00134-2003-MPC259 Page 12 of 19 12. SECURITY CLEARANCE 13. MARITAL STATUS 14. SUBJECT ARMED WITH ( Check up to 2 and indicate in 2nd box whether Annulled F - Fully Automatic, M - Manual, S - Semi-Automatic, U - Unknown ) _ Confidential Divorced 1 Unarmed 16 Lethal Cutting Instrument _ Secret — Divorce Decree, Not Finalized 11 Firearm (Unk Type) 17 Club/Blackjack/Knuckles _ Top Secret Legally Separated 12 Handgun 15 Other (Specify) — _ Other (Specify) Married 13 Rifle — — Single 14 Shotgun — Widowed 15a SUBJECT INVOLVEMENT 15b APPREHENSION TYPE 15c. APPREHENSION DATE 15d. APPREHENDING PMO (UIC/MPC): — Accessory Military (YYYY/MM/DD): _ Conspiracy Surrender 15e DETENTION TYPE 15f. HOW DRESSED AT TIME OF APPREHENSION:Civil Authorities N Non-Uniformed Svc. — Solicit Other (Specify) U Uniformed Svc. 15g DISPOSITION OF PERSON UNDER 18 YEARS 15h. FBI FORM 249 SUBMITTED 16a INVOLVEMENT 16b. ALCOHOUDRUG H Handled Internally Yes X_No Alcohol TEST RESULTS: _ R Referred to Other Authorities (Specify) Drug . 15i. FBI FORM R-84 SUBMITTED — _ None Yes X_No 16c. ILLNESS/INJURY: 16d. ALCOHOUDRUG INVOLVEMENT REMARKS: 17a CHEMICAL TEST TYPE 17b DRUG TYPE — Blood Test — A "Gracie Cocaine — G Opium M Other Stimulants __ _ Breathalyzer B Cocaine H Other Narcotics N Barbiturates ___ — Saliva Test C Hashish I LSD 0 Other Depressants _ -- _ — Urine Test D Heroin J PCP P Other Drugs — _ Other (Specify) E Marijuana K Other Hallucinogens 1 — Q Steriods . —— F Morphine L Amphetamines/Methamphetamines — M Unknown Type Drug , — 17c. DRUG TEST AND MEASUREMENT (i.e.: parts per million, cubic centimeters, etc.) 17d. DRUG DETECT ON BY OTHER LAW ENFORCEMENT MEANS Yes X No r A 04 11 tj U 12 _ DA FORM 3975-2, JUN 2001 00134-2003-MPC259 Page 13 of 19 _ MILITARY POLICE REPORT - ADDITIONAL SUBJECTS For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION III, DA Form 3975. Please attach it to DA Form 3975 when completed. PRIVACY ACT STATEMENT AUTHORITY:.Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES:.Your Social Security Number is used as an additional/alternate means of identification to facilitate filing and retrieval. DISCLOSURE:.Disclosure of your Social Security Number is voluntary. Military Police Report Number Date( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: Iiiiip4,-3 ODA 343, 2/3RD SFG ATTN: L BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 Section III - Subject la. SUBJECT lb. NAME (Last, First, Middle Name, JR. Sr., III): lc. SSN/FNN/ALIEN REG NO .,s ld. PROTECTED IDENTITY: NO: 4 SSN IIIIIIIIMIV-1„..Zs 5- TaTIIIIIIIMit4-7-c- 4.'.-5- le. CATEGORY: 1f. DOB (YYYY/MM/DD): 1g. POB: CITY,STATE,COUNTRY: 1h. GRADE: li. HOME PHONE: X A Army 111111110 (111.111111111110 b7C.,-S L.I0G-5--SSG C Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: F Air Force x US.UCountry (Specify): H Public Health _ -Resident Alien: M Marine N Navy lm. COMPONENT 1n. DRIVER LICENSE 10. S LICENSE _ 0 NOAA _ G Nat'I Guard NO: -FR Foreign.State (Specify): _ _ P Family Member R Regular.Ui V Reserves '.C-..-5"-' -IT International -0 Civil Service -R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: 2d. Zip/APO: _ S Contractor ADDRESS: BAGRAM AF 09354 _ _ 2c. STATE/COUNTRY: 2e. UNIT PHONE: T Other Gov. Empl. U Foreign Nat'I Empl. AE AF ODA 343, 2/3RD SFG V Other Foreign Nat'l 1 3a. RE51DENCE,g.TREET ADDRESS: 3b. INSTALLATION/C TY: .3d. ZIP/APO: W Retired Military. -5--/Ma vatilliimIMMO.-5-1 fL io6-6' 3c. STATE/COUNTRY: ...__.... io-i-C--5-(.40 -,-5 4a. HAIR COLOR 4b. EYE COLOR 4c. COMPLEXION 4d. AGE 5. JUVENILE 7. RACE _ RANGE _ - Brown Brown Albino Medium ( Specify ) Yes A Asian/Pac. Islander _ - Blond Black Black Medium Brown T No B Black _ - -Dk Black Gray Dark Ruddy I American Indian/ _ Gray Blue Dark Brown Yellow 4e. HEIGHT 6. SEX Alaskan Native __ -Red Green -Fair Sallow X Male X W White -White -Hazel Light -Olive Female U Unknown _ Other (Specify) -Violet -Light Brown 4f. WEIGHT: -Unknown ---- 8. ETHNICITY 9. IDENTIFYING MARKS AND LOCATION: 10. HOW DRESSED AT TIME OF INCIDENT _ H Hispanic (Clothing, Materials, Colors): _ N Not of Hispanic Origin 11. OFFENDER'S DISPOSITION: X U Unknown 1411,1.ti 3 i 4 DA FORM 3975-2, JUN 2001 00134-2003-MPC259 Page 14 of 19 12. SECURITY CLEARANCE 13. MARITAL STATUS 14. SUBJECT ARMED WITH ( Check up to 2 and indicate in 2nd box whether None Annulled F - Fully Automatic, M - Manual, S - Semi-Automatic, U - Unknown ) _ Confidential — Divorced 1 Unarmed 16 Lethal Cutting Instrument — Divorce Decree, Not Finalized 11 Firearm (Unk Type) 17 Club/Blackjack/Knuckles Top Secret Legally Separated 12 Handgun : 15 Other (Specify) _ Other (Specify) Married 13 Rifle — Single 14 Shotgun --Widowed 15a SUBJECT INVOLVEMENT 15b APPREHENSION TYPE 15c. APPREHENSION DATE 15d. APPREHENDING PMO (UIC/MPC): Accessory Military (YYYY/MM/DD): _ Conspiracy Surrender 15e DETENTION TYPE 15f. HOW DRESSED AT TIME OF APPREHENSION: Principle Civil Authorities — -- N Non-Uniformed Svc. — Solicit Other (Specify) — — — U Uniformed Svc. 15g DISPOSITION OF PERSON UNDER 18 YEARS 15h. FBI FORM 249 SUBMITTED 16a INVOLVEMENT 16b. ALCOHOUDRUG H Handled Internally Yes.X_No Alcohol TEST RESULTS: _ — R Referred to Other Authorities (Specify) Drug 15i. FBI FORM R-84 SUBMITTED — None Yes.X.No — 16c. ILLNESS/INJURY: 16d. ALCOHOUDRUG INVOLVEMENT REMARKS: 17a CHEMICAL TEST TYPE 17b DRUG TYPE _ Blood Test A "Ck" Cine r— G Opium — M Other Stimulants "Crack" Cocaine um _ _ _ — Breathalyzer B Cocaine H Other Narcotics N Barbiturates .— — _ — Saliva Test C Hashish 0 Other Depressants Saliva I LSD _ Urine Test D Heroin — J PCP P Other Drugs —_ _ _ Other (Specify) E Marijuana K Other Hallucinogens — Q Steriods _ — F Morphine L Amphetamines/Methamphetamines — M Unknown Type Drug 17c. DRUG TEST AND MEASUREMENT (i.e.: parts per million, cubic centimeters, etc.) 17d. DRUG DETECT ON BY OTHER LAW ENFORCEMENT MEANS.Yes X.No DA FORM 3975-2, JUN 2001 00134-2003-MPO259 Page 15 of 19 MILITARY POLICE REPORT - ADDITIONAL SUBJECTS For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION III, DA Form 3975. Please attach it to DA Form 3975 when completed. PRIVACY ACT STATEMENT AUTHORITY:_Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately identified. ROUTINE USES:_Your Social Security Number is used as an additional/altemate means of identification to facilitate filing and retrieval. DISCLOSURE:_Disclosure of your Social Security Number is voluntary. Military Police Report Number Date( YYYY/MM/DD) ORI NUMBER USACRC CONTROL NUMBER 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: trik_iiiiiiii6-3 ODA_343, 2/3RD SFG ATTN: LT_ BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 Section III - Subject la. SUBJECT lb. NAME (Last, First, Middle Name, JR., Sr., _III): / lc. SSN/FNN/ALIEN REQ NO: .__.Ad. PROTECTED IDENTITY: NO: 5 6/-C`5.1 SSN lommw44-5t6.-— b6- '- le. CATEGORY: if. DOB (YYYY/MM/DD): 1g. POB: CITY,STATE,COUI)ITRY: .___J h. GRADE: li. HOME PHONE: X A Army IIIIIIIII. 407C*-5-1 etaO CWO2 C Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: — F Air Force — x US Country (Specify): H Public Health — — Resident Alien:..M Marine — N Navy lm. COMPONENT ln. DRIVER LICENSE 10. S LICENSE — 0 NOAA G Nat'l Guard NO: _ _ _ FR Foreign.State (Specify): P Family Member X R Regular.V Reserves IT International Q Civil Service R Civilian 2a. ORGANIZATION, UIC, STREET 2b. INSTALLATION/CITY: 2d. Zip/APO:S Contractor ADDRESS: BAGRAM AF 09354 T Other Gov. Empl. 2c. STATE/COUNTRY:.V 2e. UNIT PHONE: . U Foreign Nat'l Empl. ODA 343, 2/3RD SFG_ AE AF — V Other Foreign Nat'l — 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: 3d. ZIP/APO:W Retired Military 3c. STATE/COUNTRY: 4a. HAIR COLOR 4b. EYE COLOR 4c. COMPLEXION 4d. AGE 5. JUVENILE 7. RACE RANGE _ _ ____ — — Brown Blond Black _ _ _ Brown Black Gray — _ _ Albino Black Dark _ _ — Medium Medium Brown Ruddy ( Specify ) X Yes No _ _ A Asian/Pac. Islander B Black I American Indian/ — Gray Blue — Dark Brown Yellow 4e. HEIGHT 6. SEX Alaskan Native Red Green — Fair _ Sallow x Male W White _ — White Hazel — Light — Olive Female X U Unknown _ _ Other (Specify) Violet Light Brown 4f. WEIGHT: — Unknown _ 8. ETHNICITY 9. IDENTIFYING MARKS AND LOCATION: 10. HOW DRESSED AT TIME OF INCIDENT H Hispanic — (Clothing, Materials, Colors): N Not of Hispanic Origin 11. OFFENDER'S DISPOSITION: X U Unknown • • _ ORM 3975-2, JUN 2001_00134-2003-MPC259 Page 0.16tiii9 I 12. SECURITY CLEARANCE 13. MARITAL STATUS 14. SUBJECT ARMED WITH ( Check up to 2 and indicate in 2nd box whether None Annulled F - Fully Automatic, M - Manual, S -Semi-Automatic, U - Unknown ) Confidential Divorced 1 Unarmed 16 Lethal Cutting Instrument Secret Divorce Decree, Not Finalized 11 Firearm (link Type) 17 Club/Blackjack/Knuckles Top Secret Legally Separated 12 Handgun 15 Other (Specify) Other (Specify) Married 13 Rifle ¦¦¦•¦• Single 14 Shotgun Widowed 15a. SUBJECT INVOLVEMENT 15b APPREHENSION TYPE 15c. APPREHENSION DATE 15d. APPREHENDING PMO (UIC/MPC): X Accessory Military (YYYY/MM/DD): Conspiracy Principle Solicit Surrender Civil Authorities Other (Specify) 15e DETENTION TYPE N Non-Uniformed Svc. U Uniformed Svc. 15f. HOW DRESSED AT TIME OF APPREHENSION: 15g DISPOSITION OF PERSON UNDER 18 YEARS 15h. FBI FORM 249 SUBMITTED 16a INVOLVEMENT 16b. ALCOHOUDRUG H Handled Internally r7 Yes 13 No Alcohol TEST RESULTS: R Referred to Other Authorities (Specify) Drug 15i. FBI FORM R-84 SUBMITTED None .0¦¦•¦¦ 1-7 Yes WS No rra 16c. ILLNESS/INJURY: 16d. ALCOHOUDRUG INVOLVEMENT REMARKS: 17a CHEMICAL TEST TYPE 17b DRUG TYPE Blood Test A "Crack" Cocaine G Opium M Other Stimulants Breathalyzer B Cocaine H Other Narcotics N Barbiturates Saliva Test C Hashish I LSD O Other Depressants Urine Test D Heroin J PCP P Other Drugs 1¦¦¦1 Other (Specify) E Marijuana K Other Hallucinogens Q Steriods F Morphine L Amphetamines/Methamphetamines M Unknown Type Drug 17c. DRUG TEST AND MEASUREMENT i.e.: parts per million, cubic centimeters, etc.) 17d. DRUG DETECT ON BY OTHER LAW ,n Yes ENFORCEMENT MEANS DA FORM 3975-2, JUN 2001 00134-2003-MPC259 Page 1.Z of 19 y u • _ MILITARY POLICE REPORT - ADDITIONAL VICTIMS For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION IV, DA Form 3975. Please attach it to DA Form 3975 when completed. ORI NUMBER USACRC CONTROL NUMBERMILITARY POLICE REPORT NUMBER DATE( YYYY/MM/DD) 00134-2003-MPC259 2003/05/25 AF09354DM THRU: TO: COMMANDER FROM: 0194C "3‘ ica.--3 ODA 343, 2/3RD SFG ATTN: LAIIIIIM BAGRAM AF,AE AF 09354 ECHO DRIVE BAGRAM AIRFIELD, AE AF 09354 SECTION IV - VICTIM la. VICTIM lb. NAME (Last, First, Middle Name, JR., Sr., III): lc. SSN/FNN/ALIEN REG NO: ld. PROTECTED IDENTITY: NO: 2 U.S. GOVERNMENT,. SSN 1e. CATEGORY: lf. DOB (YYYY/MM/DD): 1g. POB: City, State, Country: lh. GRADE: li. HOME PHONE: A Army C Coast Guard 1j. WORK PHONE: 1k. NICKNAMES/ALIAS: 11. CITIZENSHIP: _ F Air Force US Country (Specify): H Public Health Resident Alien: _ M Marine _ COMPONENT ln. DRIVER LICENSE 10. S LICENSE N Navy lm. _ G Nat'I Guard NO: FR Foreign a State (Specify): 0 NOAA — _ R Regular V Reserves IT International P Family Member _ — Q Civil Service — R Civilian 2a. ORGANIZATION, UIC, STREET 3b. INSTALLATION/CITY: 3d. Zip/APO: — BAGRAM AF , 09354 S Contractor ADDRESS: T Other Gov. Empl. 2c. STATE/COUNTRY: 2e. UNIT PHONE: U Foreign Nat'l Empl• — AE AF — V Other Foreign Nat'I W Retired Military 3a. RESIDENCE STREET ADDRESS: 3b. INSTALLATION/CITY: ' 3d. ZIP/APO: 3c. STATE/COUNTRY: 4e. ETHNICITY 4a. TYPE OF VICTIM: 4b. SEX 4c. AGE 4d.. RACE _ B R Religious Org Male x Under 24 Hours — A Asian/Pac. Islander H Hispanic _ _ F Financial S Society/Public — Female 1 - 6 Days Old B Black , N Not of Hispanic Origin, _ G Government 0 Other Unknown 7 - 364 Days Old I American Indian/ U Unknown I Individual — U Unknown Years Old Alaskan Native _ Range (Specify): W White _ U Unknown 5. BIAS MOTIVATION Yes X No ( Check Applicable Bias ) AK Anti-Female Homosexual AU Anti-Protestant _ AA Anti-Athiest/Agnostic AL Anti-Heterosexual AV Anti-White _ — _ AB Anti-Alaskan Native AM Anti-Hispanic _ _ AW Anti-Homosexual Bias _ AC Anti-American Indian AN Anti-Islamic(Moslem) AY Anti-Other Religion _ _ AD Anti-Arab AO Anti-Jewish AZ Anti-Other Ethnicity _ — AQ Anti-Male Homosexual BA Anti-Mental Disability AE Anti-Asian _ — AG Anti-Bisexual — AR Anti-Multi-Racial Group BB Anti-Physical Disability — — AH Anti-Black AS Anti-Multi-Religious Group BC Sexual Harassment — Al Anti-Catholic AT Anti-Pacific-Islander AX Unknown Bias — — _ 6. RELATIONSHIP OF VICTIM TO OFFENDER ( For multiple offender relationships, 7. VICTIM .— Accessory )( Principle enter the subject's number ) INVOLVEMENT Conspiracy Solicit _ — AA Spouse AV Step-Sibling BL Homosexual Relationship 8. INJURY TYPE ( Check up to f ve ) _ _ _ B Broken Bones 0 Major Injury AB Child AZ Friend BN Extended Family _ _ _ I Possible Internal T Tooth Loss AC Sibling BA Neighbor — BY Employee _ _ _ _ L Severe Laceration U Unconsciousness AD Parent BB Corn. Law Spouse i BZ Employer _ ____ _ _ — M Minor Injury Z NoneAE Parent-in-Law BC Acquaintance BX Stranger _ — AF Step Child BD Baby-Sittee(baby) CA Otherwise Known 9a. DD FORM 2701 PROVIDED VICTIM ' —— AG Grandparent BE Boy/Girlfriend — CB Relationship Unknown Yes X No AH Step-Parent BF Child of Boy/Girlfriend VO Offender — AK Grandchild — BH Former Spouse 9b. IF NOT PROVIDED, WHY NOT? U t) to 0 v 4 a Declined X Not Required Page 18 of 19 DA FORM 3975-3, JUN 2001 00134-2003-MPC259 MILITARY POLICE REPORT - ADDITIONAL PERSONS RELATED TO REPORT For use of this form, see AR 190-45; the proponent agency is ODCSOPS This form is a continuation of SECTION V, DA Form 3975. Please attach it to DA Form 3975 when completed. PRIVACY ACT STATEMENT Title 10 United States Code Section 301 Title 5 United States Code Section 2951 Executive Order 9397 dated Nov 22, 1943(SSN) AUTHORITY: To provide commanders and law enforcement officials with means by which information may be accurately identified. PRINCIPAL PURPOSE Your Social Security Number is used as an additional/alternate means of identification to facilitate filing and retrieval. ROUTINE USES: Disclosure of your Social Security Number is voluntary. DISCLOSURE: USACRC CONTROL NUMBER DATE( YYYY/MM/DD) ORI NUMBER MILITARY POLICE REPORT NUMBER 2003/05/25 AF09354DM00134-2003-MPC259 FROM: giiiii.“, -3 TO: COMMANDERTHRU: ATTN: LTODA 343, 2/3RD SFG ECHO DRIVE ' BAGRAM AF,AE AF 09354 BAGRAM AIRFIELD, AE AF 09354 SECTION V - PERSONS RELATED TO REPORT — Complaint.X.Military Police Civil Authorities lb. STATUSla. PERSON RELATED TO REPORT NUMBER — Sponsor Witness 2 Resident Alienld. SSN/FNN/Alien Reg No: le. CITIZENSHIP US.1c. NAME (Last, First, Middle Name, JR., Sr., III): SSN aINIIIIIIII 10. -3 e --3 Country (Specify): IOMMUMIIVI.C...,12G, 1.-GRADE: 1j. HOME PHONE: 1g. DOB (YYYY/MM/DD): 1h. POB: City, State, Country:1f. CATEGORY: ii. SA _ lm. COMPONENT G Nat'l Guard A Army lk. WORK PHONE: 11. NICKNAMES/ALIAS: — V ReservesC Coast Guard R Regular — — F Air Force 10. S LICENSEH Public Health 1n. DRIVER LICENSE NO: _ FR Foreign.State (Specify):.Other (Specify): M Marine _ IT International N Navy 0 NOAA 2d. ZIP/APO: 2b. NSTALLATION/CITY:2a. ORGANIZATION, UIC, And STREET ADDRESS: P Family Member ' BAGRAM AF 09354 — 0 Civil Service — 87TH MP DET . AE AF S Contractor 3b. INSTALLATION/CITY: 3d. ZIP/APO: T Other Gov. Empl. 3a. RESIDENCE STREET ADDRESS: U Foreign Nat'l Empl. — V Other Foreign Nat'l 3c. STATE/COUNTRY: — W Retired Military — 4a. DD FORM 2701 PROVIDED VICTIM/WITNESS: 4b. IF NOT PROVIDED, WHY NOT? 5. NUMBER OF VICTIMS ( 0 ) AND WITNESSES ( 0 ) Declined.X Not Required NOTIFIED WITH DD FORM 2701 Yes./.X No kri 0 i j *71 19 ms.-.e io of 10 00134-2003-MPC259 DA FORM 3975-4, JUN 2001