Statements of Guantanamo Hospital Personnel and Military Police re: Oct. 7, 2004 Incident at Guantanamo Hospital

For use of this form. ace AR 19945; the proponent agency Is ODCSOPS PRIVACY ACT grimmam. AUTHORI7Y: Title 10 USC Sscdon 301;Tithi5 WC Section 2951; E.O. 930 dated November 22. 1943 (SSW PRINCIPAL PURPOSE: To provide en , and Ira splowarnantafficlais with means by which Intsemstlemmsy ba accurst* ROUTEM USES: Your social security tumber.is used as en additionafialtemate mans of idantificadon to facilitate *Eng and DISCLOSURE: Disclosure of Your b)(2) jthitmtaasmo bX3): 10 USrgiYea;. " 1b)(2) pasatatismo Bay, Cabo 09360 ...--.................., 9. b)( 1. b)(3):10 USC it W THE FOLLOWING STATEMENT UNCER.M. 116.1 1"--r" C9 g", dileed 1° . 04/.2 Z retpcidsoi (to a Gil/ fem. IA, 4. Ore 144.; *I Kw i.. :. 'I."-'94 !Ws rwt Atrotit'av/ of miligio-4bA3110 U.S.0 pone MG ii• fro- "1 bw,,,,,A,A,/,,./.• Ace Avir,p4 'Pe. MO e 41 'VC' On 1646414•It i eii...er 01 PA # hre c jprol(b)(2) b) red ‘,4 144,44.4.f (,..,.,,,,, b i b,) 3.).:1,0nUS.C,.Itie,,,,, A.,..,.„,,dx. •„„i 4,,,,,t4 bAriOvIS,C okty,,,,t-rei 14.44 kol ,kf A ed,,./.4ef 77eiPAry ric Is,'" • 4..-Per at dato# I ;I, 1 fo..." b_)(3):17) _File^. woof C141141‘4..diere01;;Pf h 7 Ma ea' 441 r X c fl'e 4:fle? 141f ; 7 aria e..1.0%;!, aor evotmal Ad. 06.44m# fe.4440 ctAtee. 41eVerm in r'w., AA, 40%,•.-iwavediso• itrdix....4. memi•41 figetede ,40.014' re.)41, ffeeenOief 4..-071;,a f c4-the 4 Os Nov:4/ 0•10.;otto, small kr pa, goof Ms deAcs4di. 64 th.e. Or Pe..9*. 041,eni folio/wog 4414' r44 owelAbX3):1 "%ware Aeir• rie Area 7Xe. ilow/r4 lad • A :1 011:14,44-if# dreg, MA, gloom 400 0#0 old Ibi)(3):10 sr*, fent to The. Vor0- c . ..e/r ?i;.74e • c4b.)(3):1°.rxe. viikeiVo 4 &ewe 4,„kb)(3):10 US b)(3):10 USC :4„„ 44,..„;," /04 ode.. 401/11.. 11.A1011 /kVA iew b)(3):10 644‘ AS LOOP.. Ar074 rimc. b)(2) e 04/711;cci bX3): 1 0 b)(2),(b)(3):10 USC Aro" iji•rar.cs /if ei.k.re A 7.147*-- b)(3):10 .f.ccapsa• • 1.11 •••••¦•••••¦••••••• •••• ••••¦••• 471004e/r r+..-;. • e 41T(.. v-,.Lc, • ..C vi. mut bX3): 1 0 USC NG sTATEFAENT 10. EXHIBIT 13C1b,(b)(6) PAGE 1 OF 2 PAGE: DATEDADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEME na vorrom OF EACH ADDITIONAL PAGE MUST AMR THE INITIALS OF THE PERSON MAKING THE STATEMENT. AND PAGE NUM& MUST SE SE INDICATED. . DA FORM 2823, DEC 1998 DOD JUNE 2 524 DOD056340 -b)(3):10 1 kb)(3):10 ITS-dr1-30b,(b)(6) SC ____ STATEMENT OF1 DATED 7 OC 74- C.) ? STATEMEN1 (Cont;twed) b)(3):10 USC §130b,(b)(6) Kb)(3) :10 USC §1-3-0-b-,(6)-(6j1 AFFIDAVIT I, I . HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICIttstGINS-OWPADE-ITANO ENDS ON PAGE 2 I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT hum BY ME. THE STATEMENT IS TRUE. I HAVE INMALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEIVIENT. I HAVE MADE THIS STATEMENT PREF' Y wn'u¦ • „r: 7. "-- -- — THREAT OF PUNISHMENT, AND wn-Hour COERCION, UNLAWFUL IN b)(3): 1 V L)Se-... §130b,(b)t6) WITNESSES: ORGANIZATION OR ADDRESS ORGANIZATION OR ADDRESS INITIALS OF PERSON MAKING (b)(3):10 USC PAGE .1, DA FORM 2823, DEC 1998 DOD JUNE ----rmgnarEffrd erse fir—WihienG Statement) Subscribed and sworn to before me. e person authodzed by law adminl this day of toerb vex._ , 2004 at b)(3):10 USC §130b,(b)(6) m-r-vrsorrx.g ath Article 136 (b) (4) UCMJ (Authority To Administer Oaths) PAGE 2 OF 2 PAGES USAPA V1 .00 — Alb 2525 DOD056341 PRIVACY ACT STATEMOT AUTHORITY: T'Tlit 10 6.S: Ser.!*.q• 5 JSC SeIKAP 7451. P 1 9347 iisted o•-••Pe• 22 '.341 PRINCIPAL PURPOSE. 1'1 ;" -• ..•*; ..* ":•- .!:r ROUTINE USES. .•4. •.Co.! t sy, 41! J : T.!:^t : /: t,:, ! ...3 • DISCLOSURE: r r4f:Jf "umba, vewntaV. (b)(2) 2." DA"E ME IWO,. 4. F ..E!' VEER Guarmana Bay Cuba 2A7VV/007 • . s(b)(3): 10 u iii,(b)(8) Al ,b13 :10 USC bX3):1 (b) (2) Guatitonanin Bay: Calla 09360 97(b)(3):10 USC §130b,(b)(6) _.INANT TO MAKE THE FOLLOW:NG STATimply uNDEa ON Olocroq .nit perviunedidosAmt. TA, 4/YR,o; 0000m ifiGilladeir 77)4 K Ace ,mv4r-voip b)(3):10 USC opn• bernewors Degysau'a 04s144.41 X4Fer. MAI P&TIOMae bi(2 Me Sikr 77/440 /hi ow. 4,,,tw /raj The PoninAke .11.47. •Itaavo .rneoghoc. roe -071. TAlar SW-r fAMJ Jar -7-Pe 11/41Puomr la Leer P fr, Yeuwo Ha Moo 1,..erfif raid' or Me Dell*Imeldt /#A4. P erithOides. r Awe) ro.Am) Or *ern "0 nye . fithwe-T Aitrio.e tivrride- or. Mirada ly bool•Ate. Attevra Rd", borMorisaf WA/ ILIODisierOesive) Por. hrivaage. A 1.:i.F? ity &Daiwa* 'yr/ Arr 144444L. 04773Ainft, Agrifrooc4r. lunibmo rnilithrb Algvit ody estA-. Airy ativigre Rdertsbet....vvrdisseeit rog Atair.41, Au•sref.. 00C. &vim; c.ssi.sswabc.o. b 7,1earnsve'A,7. b)(3): 1 0 041a p.s 0 6. a .USC .(-494, of J-771,774•14407-1.113,----.--- 1!. .!..T ALS OF PEFr3):1 S-A.-EVE4T 67W-- PAGE I . PAGEs -oc. .045E .14:JSr 9E.41? TME WITTAIS OF :WE PERSON MAKING rha STATEMENT: AVG PAGE FIGAIGEN lithrST EE fiE ihOiCATEG. ANWP 111•111mans nA FORM 2823, DEC 1928 .'.2,91E.RIEFISOLETE DOD JUNE 252 6 STA ,(b)(3):10 USC §130b,(b)(6)I )(3):10 USCvanh thwA) TAKEN AT 6-gawrAwo,A.oca SA", 4.•-51.„7--Eo 0)(3):41; 4-c_iji 0 OC)...s7c, it S ji(b)(3): ed-1(b)(3)*• , 0, Ni10 les . 0)(3):10 USC AFFIDAVIT iNap61_ , HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH-Bt.-To FrAGE-1, ANO ENDS—ON PAGE . I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE. i HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE 1.:§1301 CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND wiTHOuT COERCION. UNLAWFUL INFIIImurr r'" ntdi Atm' L"^"CEMENT. (b)(3):10 USC §130b,(b)(6) .1 , 4f:eking Stinemettil V,1--;NESSES: SJbscnbed and ow-on tO botwo Irv. a poison aothonzed t.tv :ow to ittoo 49/Zr dab. of OcTbitrg. zes2L. (b)(2) __J Guantanamo Bay. Cuba 09360 -0)(3):10 USC §130b,(b)(6) ZA" Z 1(b)(3):10 uSC §130b,(b)(6) Anidt: .3ti it)! AI L'CNI1 Lk, . Authorir,..Adrrir:iste, •:(b)(3):10 USC PA,SE Z.. OF zA 1:ES PAGE .3. DA F.ORM 282..i, DEC 7998 2527 DOD JUNE DOD056343 • •MO •••¦•••••••••••• PRIVACY ACT STATEMENT mITHORITY: ; 5*.r. 11. 5 .:SC Sarezt¦ fi•P 76‘' • 9151 4dtri N:,-""ra. 2/ ' SS'e pgiNcipAL PURPOSE: r ..• . • GO s' .".1 S.' ."..1.; .1 ."/ t: t" ri ROUTINE USES. DISCLOSURE: .0) t numbts, 2. ZA'E 'Y tr74.14AMD, b)( 4. F .E N.S0E14 b)(2) Guantana no Bay Cuba • QOptipoq 1:1 HTTNTO USG §130b,(b)(6) 1F171k3): 1 0 USG •••••••¦¦ • IsliwaYINMINIM 7Guantartamolia). Cuba 09360' 10)(3)10 USC §130b,(b)(6) • WANT TO MAKE THE FOLLOW:NG STATEMENT UNDER c2,ei-oe.asreivSn'S•fr ".2-6,45 ra2fr.a.rear aA P-1/06 4a4.) of OF chr/aier011.50 b .sr.A.r7ity • 4,:f leet4t Atr • ett oks. ditv-.Seif,VA, 444 0741 3- *rodAdeNto 4/3. As,v2 .7.17 hel 0/44. 4ct A:rot/ad, isoirkt orp/ 4.4,2! voiew* 604/ 14:r Atek 4Ie- r4et &NM . 1 .47.c C if. b.:, 4101. nurgwy r rei:f -/.40 "cm" o/ — ¦•¦¦¦¦¦¦ •••¦••••••• sa•¦••¦¦•••¦ •••••¦•¦••¦•; • EAr•.6.7 77.71:-FrA)(3):I.IN V.AK •0,2 S "A—EVENT 10 PAGE 1 CF 2 PAGES :0" 7 • :C "VIA, A4 GE .WIJST BE.IR !HE WIT:ALS OF THE AERSCH MAKINI ME SU Man?: AND PArie NGIASEN AlLiS EIE.5E )hLICA 7E4. • !TS rl A PORIVI 2823, DEC 1998 2528 DOD JUNE DOD056344 i(b)(3):10 USC b)(1 (b)(3] rm. i fj+E ¦ T §130130)(6) 05q419:9- :1 0 . TAKEN AT 0 DA -F0 4 : ¦••.. (b)(3):1 0 USC &iv% NN ,(b)(3):10 USC AFFIDAVIT _5130b,(b)(6) HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH ercx..)IN-oNFA-Gt-T, AND ETIO-S-0-N PAGE . I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE ay ME• THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR FIEVVARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION. UNLAWFUL INFLUkb)(3): 10 USC §130b,(b)(6) lafenterill S.11:n.cribf:d and tov'or bcfraru my. a peffinn auttr...n:od thg. if do., of Cie/ 14•¦¦ • r.th.. b)(3):10 USC §130b,(b)(6) ---1 _•„r fl d f?'47: q; nrs .7¦01 • • _pi-0)10 USC §130b,(b)-(6) fl Ankle , (b. 4 LCMJ Auff.rivi Adrr.risto, - ,l(b)(3): 0 f'A':."1•E ;L. Di- • -• ' PAGE .3 DA FORM 2823, DEC 1998 DOD JUNE 2529 DOD056345 • . T . r...:. Jii.:! It7 f• !: . otnief't .wiercv a SCCSSPS Mater PRIVACY ACT STATEMENT AUTHORITY; T.1.8$ ¦ .3 ....SC Se[t :r le • • 1"*.f 5 JSC &Wile. 74#S 1 ' E n i157 dated "i....-te. 22 't.L't ssa, PRiNCIPAL PURPOSE: '7 ;..1.• • 1...:-.^.:. Ja.... •" 3 I,. :' ' :,• •.• '''' •-•• :'' . : . •• ..''' ' ..• ; t., .:. - ;It ...r,!.... t .• •i. c . ‘,..1... • ..‘ ROUTINE USES: I .-.• .. : , ........:, . ....1...• : , ,..I v., s? oil : ..•':1 1 - •••...15: 'T.: IC... :f 1.."t • :4:..-• :: ' 1..: 1414. .! • r 2 ..• 1 • .:. 4 . . DISCLOSURE: l'.. sf:r.IIu'r ,:' to).., V.: ii ne•tur ty rturnbaf :it vckantary, ..--- 2, 3A E lebeY?&0110)(3)3. .ME b)( 4. F -E %;.NEER 1(b)(2) 'Guantanamo BaN Cuba .:........ .7 :la—. „,,,,,,„ ):, •¦¦••¦ ••¦•¦¦ sp)iii:‘i Os CreCiiiili;,(iilic -b)(3):10 USC )(3):10 3uantanamo Bay, Cuba 09360 9. 10)(3)10 USC §130b,0)(6) WANT TO MAKE THE FOLLOWING STATEMENT UNDER f: 0)(S 1-- _dxst4-.4? Cosa #4. beeds-144. eitA.••• d•A ft p•71:4;) o fe4a.it, 44 "N.44147151..h :0/ 0/..:c 43-/0 ,,AATiAl.... 7410.- t4"e AD 4144, 4Ave,/ Odevist. -4.0.- I *AL. 4.,ed /1/'''''''i- a'`' '6/404 . two a ,u)-1(..1 , 0.1 Az-/ trivw. ii /4earad-.40"--t 4444.4 • -3 1-1-4. 44. `4-41/ /kr //lg. Pop.t,.74--0 04 e-0."...0.1r 5%, h /RA.1 de.A.. ice. 14, C/e44- ..s.44.),.o..7 6 0/4- it•POA pialie, /Y0 0-4-7442+ 61.14}4.4.Adt. I. ¦•• . .1-PV, i el .1e.0.,.; — trio ea Ple Asot -AA-. *•:0 Occ. Ate41. 40,4, ote oit vcat: /. AO .0•10;fti. C.49-/Ied ;el 716-e A" 4 14-‘. •••¦ e.449.h.h r;v1 4.""lot- )(b)(3):1 I /v6' 4E4,4 • i4.4 •••¦••••¦••••••¦••••••¦•¦•••¦•¦ EX • 1 : •N.T ALS .3F PERS3N VAit %,•3 S-A-EVENIT , PAGE :F 2 PAGES)(3) -in :C VAL GE .14vEr REtA :NE :N1r.•Ar 5 OF 7PE PERSCN MAKING me sr.: rEMENT. AND PAGE PlIAIGER HuST liE BE it,DICA'rED. r•A FORM 2823, DEC 1998 Amertf-S SOLETS 2530 DOD JUNE DO D056346 0)(410 USC (b)(3) al rt STA-FMENT :F 4130b (Jam E E•••1E' .7 '(0)(3):10 USC AFFIDAVIT t. 2M30b,(b)(61 . HAVE READ OR HAVE HAD FIEAD TO ME THIS STATEMENT WHICH1Scutiv5-014-PA I, ANDENDS ON PAGE '2 ,. I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY N4E. THE STATEMENT tS TRuE, I HAvE NiTIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE co r•J T AlIVING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD. WITHOUT THNEAT OF PUNISHMENT, AND WITHOUT COERCION. UNLAWFUL INFLUENR3):10 USC DUCEMENT. ,6130h.(b)(6) (Signature of Person Making Stormont) V.' rs,E. SSES: SAlt.tribed and uworn to betoto me. a person authorlzed bV ;Jiro to adrrnn.st ¦ :* .04, •-7 0, of ocr at 113)(2) anlmn 11h1 360 b)(3):10 USC §130b,(b)(6) ;.,:iLRESS rb)(3):10 USC §130b,(b)(6) ,ft. •- --J. Aridc ;6 113, • 4 , CSIJ Lt.{ „ TD AdTir.iSter DaTh. . ' . S7 (b)(3): 0' • .* PAGE PAGE .3 DA FoRM 2823. DEC /99.8 a 2531 DOD JUNE DOD056347 SWORN STATEMENT Fix of this Senn sae AR 10045: OATE TIME FILE NUMBER i(b)(2)- IG1140, APO AE 09360 0 0‘ re: AI /61 Kb)(3):1 0 U.,..S‘C !NIA SOCIAL S GRADE/STA!' Arl b)(3):10 Eb)( I 41641.6 ¦1•1—I.L.J..1 . ter. t3 bk• 1(b)(3):10 USC §130b,(b)(0) , WANT TO IAAKE THI FOLLOWING STATEMENT UNDER OATH: 1•• A.T APPDX. • 4. INVM116_ I • /Lit 11-1141• :1..to . I II II :11 INVOLVING b 3 -1 U C • fib v ; 1 41; i ;4 oll :figYficilirlii THAT • z. -:,..,. I • 1 wAs oN DETAINEE BECAME WOLEN'T . 1;4 3111‘31;1111 6 16 Lie/Looswil. THE DETAINEE SPAT ON : SOT, THEN HI7' 1111/4 WITH ELI LEFT - k- I /11401614i izfiall 'DIV31' in I YELLED AT THE INMATE TO STOP. THE SGT WAS OBSERVED STRIKING 1: ) : I ' :I: ' • - •TO THE LEFT' SIDE OF THE DETAINEE AND PUSHED NIS HEAD DOWN TO PREVENT FURTIBIR sprrnNo OR I IITTING BY THE DETAINEE. TELLING sant OF TIMM TO STOP IN A LOUD VOICE. i OBSERVED THAT THE DETAINEE WAS BLEEDING PR tWT V 11711(114 ' MOUTH AND IMMEDIATELY GOT MEDICAL ASSISTANCE FOR TfiE DETAINEE • 1 ,..-....16. ED TO MY CALL CALL FOR MEDICAL ASSISTANCE. BLEED I. - Nu a • ' :Is :A".1715TPXMM 66 ¦ I I:4, 064. N. : TMENT. DOC WAS NOTIFIED ALONaRITII ARABI« , • 0 '4'0 b (3):10 USC Q3113)(q)'1.0.—._, ' At12)(3.110 ___j Q:WITH WHICH HAND DID kh.11.30STIUKE TIEFTAINEE/ A: I'M NOT SIJRE, IT HARP pAgrQ:D1D THE DETAINEE STRXE A:I SAW THE DETAINEE SV/INO AT THE SGT. I DON'T KNOW .a..1::. THE BLOW EXACTLY LANDEDgb)(3) I Q: D0 YOU KNO DETAINEE MADE CONTACT WITH IDIOM A:I DONIT_KNOW Q:DIDth.1(111.1! MAKE ANY COMMENT ABOUT THE DETAINEE BEFORE THE INSENTIENT? A:THE SGT MADE A COMMEN'T'ABOE WAY THE /4AN PRAYED. A SECOND COMMENT"THAT I PAID NO HEED TO AND DON'T REMEMBERJEM Q:IS THERE ANYTHIN YOU WOULD LIKE TO ADD TO THIS STATEMENT/ A:NOT AT THIS TIME./ - --END OF STATEMENT -I/ EXHIBIT INITIA b)(3): ION MAKING STATEM_ENT__1 PAGE I OF 2 PACES 1 0 ADDITIONAL PAGES MUST CONTAIN THE HEADING SrATEmgNi OF _TAKEN AT..— DATED_CONTINUED.• 7'HE COTTOM OF EAC.H ADDIT7ONAL PAGE MUST REAR 774E INMALS OF THE PERSON MAKING THE STATEMENT AND SE INMALED AS 'War _ _ OF.PAGES.° WHEN ADDITIONAL PAGES ARE 1/77LIZED, THE RACK OF PAGE I WILL RE LINED OUT, AND THE , STATEMENT WILL BE CONCLUDED ON THE REVERSE WE OF ANOTNEA COPY OF THIS FORM. DA FORM 2823, JUL 72 SUPERSE0 S 68, WHICH WILL BE USEO. u10/2C V2.0o DOD avinc 2532 DOD056348 STATEMENT (Continued) AFFIDAVIT 0)(410 USC , HAVE READ OR HAVE HAD READ TO ME THIS STATF-MENT WHSC4-i BEGINS ON PAGE 1 AND ENDS ON PAGE 2 FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME. THE STATEMENT IS TRUE. I HAVE iNITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT, HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEF T OR REWARD, WITHOuT THREAT OF PuNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFO% /3 ¦ EMENT. .4.4-1.4,1 .4. s R ):10 USC 1§130b,(b)(6) n Making Statement) NiTNESSES: Subscribed and b)(3): orn to before me a person authorized 14n.._. ad OCTOBER 04 at (b)(2) 071¦40 APO AE 09360 b)(3):10 USC §130b,(b)(6) ORJAMZATION OR ADDRESS hi (Typed Name of Person Administering Oath) ART 136 (B)(4) UCMJ ORGANIZATION OR ADDRESS (Authority ro Admsnister Oaths) ,N111ALS CI: PERSON MAKING STATEiviEN ORO): ' PAGE 2 OF 2 PAGES 10 USAPP0 V2.00 2533 DOD JUNE DOD056349 ott n°" 37'. III W R1GHT$ wiARNING.RAKION ERTIFIL.ATE For usir of this form, see AR 190-30: the proponent agency is ODCSOPS I DATA REQUIRED BY THE PRIVACY ACT . . AUTHORITY: Title 10, United Sta ea Code, Section 301210) PRINCIPAL PURPOSE: To provide comman ere and law enforcement officials with means by vvhich 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. 1. LOCATIO"; . ' —I DATE r)(3 TIME (b)(3): FILE NO. JTF- GTM0.11(10) (2 ) ;Guantanamo Bay, Cuba 7ot4e ' in zs.,..z.,,, ,s,..,___MASI.E...H..i.w_ga_ct_14./1 ,g_' filltnArill7eTWIN 9/1 ADDRESS Kb)(3):10 US C .. 1(b)(2) [ . SSN czliAttriATATIIR Guantanamo Bay, Cuba APO AE 09360 (b)(3):10 1 (b)(3): 1 0 11_1C, .1", PART I - RIGHTS WAIVERINON-WAIVER CERTIFICATE Section A. Rights Th,. ir,yearioatal sNnosa. name aciocara halnw tow me that he/she is with the United States Army JTF-OT mo, (b)(2) _ 21_,_ , and wanted to question. me about the follewing affirms(*) of which I em sospecied,....„t Assault Article 128 UCM3 Were he/she asivad mc any questions about the offense(s), however, he/she made it clear to me that I have the 'Wowing rights: ii;'.i.` do not haYe to answer any question or say anything, • f , 4 icAnything I say of do can be used as evidence against me in a criminal trial. r-, St', ii; fFor personnel subject othe UCMJ.I have the right to talk privately to a lawyer before, during, and after questioning and to haw a lawyer present with me :-¦ -• , Z during questioning. This lawyer can be a civilian lawyer I arrange for at no expense to the Government or a military lawyer detailed for me at no expense to Ink or both. ii Or -;;For civilians not subject to the ucmo I have the right to talk privately to a lawyer before, during. end after queetioning and to have a lawyer present with !i ' ,e dUr 419 iiiriistioning, I understand that this lawyer can be one that I arrange for at my own expense, or if .1 cannot afford a lawyer and went one, a lawyer ,.:,..,11bo ap.-uritod for ma before any questioning begins. eit.r.i ii i am no, ',ling to o.,icuss the offense(*) under investigation, with or without a lawyer present, I have a right to stop answering questions at sny time, or ,,i-v ..-....paak priva:aly wyth a lawyer belore answering further, even if I sign the waiver below. 5. Ma/WIEN-TS (Continua on reverse side/. $.10 Haw. you had your rights read to you in the last 30 days? 1.'71 kb)(3. ): 1 4.1 iln Sect:on B, Waiver I und:rstand my rigirs as stated above. I am now willing to discuss the offensels) under investigation and make a statement without talking to a lawyer first end without havirl; a Iawyer ruirsznt with me. WITNESSES Of available) % eintdtell Mg fig IiiiTtlaldiglIkfgg kb)(3). 1 0 USC I a, NAME (Typo or Print) p130b,(b)(6) b. ORGANIZATION OR ADDRESS AND PHONE 4:1b)(3). 1 0 USC §130b,(b)(6) 2a. NANIE (Typo or Print) 7,11CIAIN:17.,',-,ON OR ADDRESS AND PHONE . 6. ORGANIZArkle2F)INvmMAToR JIT- CITIVM I)) Kb)(2) I Section C. Norr-vvaivor 1 ! dcr not want to give ur., my rights L.1 I w,=,,t a lawyer 0 I do not want to be questioned cat say 'anything li:GNATUH + INTERVIEWEE 1 A7T,' CH THiS V,,,'VEF: CERTIFICATE To ANY SWORN STilfilEfiffillefatrig/WOWSEOUENTLY EXECUTED BY THE SUSPECTMCCuSED DA 33Si, NOV 89 1st Tellau 8SOLETE USAPA 2.0 I DOD JUNE 2534 DOD056350 SWORN STATEMENT For of Otis form, as AR 1110.46; the FILE NUMBER i(b)(2) irmannummr Bay. Cube IASI.NAME...11116. NAN* SOCIAL SE b)(3): 1 0 US_C cuMitalr42""E110j3 o ) DaaANI7Ariniu ennficrao j(D)(2) lb)(3):10 USCI , WANT TO MAKE THE FOLLOWING STA UNDER OA Ott 07 October 2004 at At this time detainee leaded and smwg his arm at me, mov away es wu spitting at me hitting me die face and chest several limes. tben attempted to mice -Control of his head by garbing Ws head and amiss away from me. As I tried to take cootrol of bie bead Ibit bbn in the mouthwith my right hand. The situation happened all in about 20 seconds. .1 ltilOW that I moved very quickly when my heed made contact with his face. My instincts took over after the swing and spitting. The Nowt made to tbe detainee's mouth le fumy in my head and I can not ow dist at that moment I did or did not intend to stags the delibise based Misty emotional MIES everything happen so fast. I believe that based on the got to nty band I may balf sande bini with KS melba Whte detidnees mouth began bleeding and he continued' to spit at me hitting me in the face and cheat. I Mated to the other that we needed to take control of his head In loud voice. I did EX to help the other HP tales control of dle situadon because I didn't want to make things any worst then they shady were. I any to avoid any further acalation of the *Atkin. The other MP WaS making statement, statement that I do not recallQ; Dp..y.o..0 wish to add anything to this etatement A:nol(G)1 ..... •¦••••• EXHISIT INITIALS OF PERro)(3):IING STATEMENT 1 PAOE 1 OF PAGES in I AontrioNAL PACES mUST CONTAIN THE HEADING 'STATEMENT OF _TAKEN AT- DATED ..___CON77NUED.' THE SOTTOM OF EACH ADDITIONAL MG! musr.INI77ALS OF THE PERSON MAKING THE STATEMENT AND SE INMALED AS 'MOE.PAGES.' WHEN ADDITIONAL PAGES ARE UTILIZED, 77M SACK OF PAGE 1 WILL SE LINED OUT, AND. THE STATEMENT WILL BE CONCLUDED ON THE REVERSE SIDE OF ANOTHER COPY OP 7716 FORM. DA FORM 2823, JUL 72 SUPERS wisCH WILL BE USED. VIIAPOC 011.00 2535 DOD JUNE STATEMENT (Continued) AFFIDAVIT (b)(3):1 0 USC HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH BEGINS ON PAGE 1 AND ENDS ON PAGE 2 I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ML. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENC "" '''" b)(3):10 USC §130b,(b)(6) Subscribed and sworn to before me, a person authorizedlyAty to WITNESSES: ad I - • day of October 44-04 . at b)(2) Guantanamo Ba Cuba b)(3):10 USC 130b,(b)(6) ORGANIZATION OR ADDRESS g Oath) (Typed Name of Person Administering Oath) ART 136 (b)(4) UCMJ ORGANIZATION OR ADDRESS (Authority To Administer Oaths) I NIT OF PEFiSON MAKING STATEMENT PAGE 2 op 2 PAGES 05AFTC VZ.00 D OD JUNE 2536 DOD056352 PHOTO DENIED IN FULL EXEMPTION 6&7 2537 PHOTO DENIED IN FULL EXEMPTION 6&7 2538 DOD056354 PHOTO DENIED IN FULL EXEMPTION 6&7 PHOTO DENIED IN FULL EXEMPTION 6&7