S W O R N S TAT E M E N T

For usa of IhH form, sm AR 1KMS; ttio preponml agoncy Is PMG.
PRIVACY ACT STATEMENT

AUTHORITY: TItIs 10. USC Section 301; Tllle 5. USC Section 2931; E.G. 9397 Social Security Numtwr (SSN).
PRINCIPAL PURPOSE: To document potenUal criminal activity Involving l^e U.S. Army, and to allow Army ofRcials to maintain dlaclpllne.
law and order ttirougli InveaUgaUon of complalnta and Inddenta.

Information provided may Iw further disclosed to federal, slate, tocaf. and fUralgn government taw enfbrcemant
agencies, prosecutore. courts, child protective services, victims, witnasses, the Department of Veterans Affairs, and

ROUTINE USES:

the Office of Personnel Management. Information provided may be used for detennlnatlons regarding Judicial or
non-judldal punishment, other administrative disdpllnary actions, security clearances, recruitment, retention,
placement, and other personnel actions.

Olsdosurs of your SSN and other Information Is voluntary.

DISCLOSURE:

12.DA
TEY
(YYYMMDM

I89ch MP CO. S2Sth Military Police BN
5. LAST NAME. FIRST NAME. MIDDLE NMST

I 8. SSN

7 . G R A D E / S TAT U S

8.ORQANIZAhrO
l NO^ADDRESS
189th MP CO. S2Sth Military Police Battalion JTF GTMO APO AE 09360
. WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

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10. EXHIBIT

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—-—

11 INITIALS OF PERSON MAKING STATEMENT
PA G E 1 O F

1-OiHONAL PAlir.S .VliST CON ,A N ifc OlaOING 'STATi-.i.lENT OF

TA K E N AT

D AT E D

THE BOTTOM OF EACH AODmCNM PACE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT. AND PAGE NUMBER
MUST BE INCICA TED

OA FORM 2823, NOV 2006

IjOfqi^OBSOLETE

ENCLOSURE ( b )

 TA K E N AT

STATEMENT OF

D AT E D

9 . S TAT E M E N T ( C o n t l t t u e d )

A F F I D AV I T

I. ^ . HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT

WHICH BI^^BNPAGE 1 ■ >Ob
l ENDS ON PAGE ^ . I FULLYUNDERSTANDTHE CONTENTS OFTHE ENTIRE STATEMENTM/
BY ME. THE STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE

CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT BENEFIT OR REWARD. WITHOUT

THREAT OF PUNISHMENT. AND WITHOUT COERCION. UNLAWFUL INFLUENCEJlUArittUUIIiyfiadg^(Slgnabin at Person KSking Statement)
Subscribed and swom to before ma. a person authorized by law to

'WITNESSES:

administer oaths, this day of

(Signatura of Person Adminlstoring Oath)

O R G A N I < i AT [ C M O R . A D D R E S S

(Typed Name of Parson Ad'r- fstering Oath)

Art 136(b)(4)
( A u t h o r i t y To A d w - U h s )
.NITIALS OF PERSON MAKING STATEMENT

F 2 PAGES I
APO PE vt 00

OA FORM 2823. NOV 2C88

FOR

S E O N LY

^^0

 ^«^«ir Ji^1grONLY ^
sw8rn statement

For use of this form, ass AR180-4S; ths proponent agency is PMQ.

~ PRIVACY ACT STATEIMEHT

authority: Title 10. USC SecUon 301; Tite 5. USC Secticn 2951; E.G. 9397 Social Security Number (SSN)
PRIWaPALPURPOSE:To document potenta
i l crm
in
i alactvitiyn
i vovln
i g the U.S.Army,and to ao
l wArmy offica
i sl to man
i tan
i dslco
ln
le

law and order through Investigation of complaints and Incidents. '

ROUIIKE USES: 1.'''?!^^''^'^^"'««« ««., ted. M to#:::, ..tototo, tew ^todnd

pwsocutofs. auris. child protective services, victims, witnessee. the Department of Veterans Affairs, and
*7"""' Management Infbrmatlon provided may ba used fbr determinations regarding Judicial or

DISCLOSURE: Dlsdoauro of your SSN and other Infbrmation is voluntary.
DISCLOSURE:
^^^YYYYMMDD)

9th MP CO, S25th Military Police BN

Z o o f * s - 3 o

FIRST NAME. MIDDLE NAMF

■^ ^ K i a t u s '

i MP TO, S2Sth Military Police Battalion JTF OTMO APO AE 09360

^ ' WANT
TO MAKE
THE« FOLLOWINO
STATEMENT
UNDER OATH:
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3ou.
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10. EXHIBIT

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mS STATEMENT
PA G E 1 O F
TA K E N AT

DA FORM 2823..

FOROI

PA G E S

D AT E D

"'''=* ''^"SOIV MAKING THE STATEMENT. AND
OA FORM 2823, NOV 2006

^

A

,

11. INITIALS OF PE

.J JO/;.'CiVAL PAiico *■,(/» f COiVIAiA i.-J ncAO/A/G "STArjiWEA/TOF

AC.

PACE NUMBER

B. IS OBSOLETE

USE ONLY

ENCLO.SURE ( C)n^

 STATEMENT OF

TAKEN AT

9. STATEMENT (Conenued)

^o•r

us^

ApnoAvrr

-

HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT

WHC
I HBEGN
I SONPAGE1.ANDENDSONPAGE FUUYUNDERSTANDTHECONTENTSOFTHEENTR
I ESTATEMENTMADE
BYME.THE STATEMENTISTRUE. I HAVE INITIALEDALLCORRECTIONSAND HAVE INITIALEDTHE BOTTOM OF EACH PAGE

CONTAININGTHESTATEMENT.IHAVEMADETHISSTATEMENTFREELYWITHOUTHOrefltBENEFITORREWARDWITHOUT

THREAT OF PUNISHMENT.AND WITHOUT COERCION. UNUWFUL INFLUENCg^Bfi^MiEUUBUfiEMENT.

Statement)
WITNESSES:

Subscribed andswor^^etoe mo. a person authorlzad by law to
administgrjjalha.^WW^y^ day of
f ft ft I m

CRGANIZAHOM OR ADDRESS

(Signature of Person Administering Oath)

PA G E S

DA FORM 2833, NOV 2008

Hal use only

APO PE vt 00

18?

 NAVAL CREVflNAL INVESHGATiyE SERVICE
DELETED PAGE INFORMATION SHEET
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wtl^eld
entirely at this locaHon. One or more of the following explain this
decision:

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you.

.Pages con^ mfoi^tion furnished by other government

agOTcy(ies). We wil advise you of releasability of informflrinn

following consultation with agency(ies). nrormation
Comments:

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No duplication fee for this page

 NAVAL CRIMINAL INVESTIGATIVE SERVICE
DELETED PAGE INFORMATION SHEET
Page(s)_

—

Ur>

withheld entirely at this location. One or more of the following explain this

decision:

_Deleted under

Refee
i d to them for reve
i w and dgovernment
riect responsagen(?Ki
e to yotes).
Pages ranNn infoimation furnished by other govemmoit

Comments:

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No duplication fee for this page

 NAVAL CSIMINAL INVESTIGATIVE SERVICE
DELETED PAGE INFORMATION SHEET
Page(s)_

wthheldentitely at this location. One or more of the following explain this
decision:

Deleted under exemption(s)

.D
tstooritghie
nm
atefdorwi
othaer
Rocui
eferre^d
retvhiew
ndgovernment
direct responsagen<ki
e to es)
you.
.Pages contan infoi^tion fiimished by other govemmwit
agency(ies). We wil advise you of releasability of information
following consultation with agency(ies). nronnanon

Deleted pages(s)

No duplication fee for this page

 STATEMENT
f o r

OSE ONLY

Place : NdSRAo-mn
Date : June 3.2007

to Joint Medical Oroup, JTF-GTMO. 1 am cimently aaaigned

or mule, heading over to Camp 6 when I heard someone in a mu£ I ®u ^®l"cle

Sally to speed up because he had to g? recTa '^'= «the

hU

snowbau or any code. At that ovi to "J?""® ^ « L

While they were waitng on an answer I saw the1i^HBkfB^ro% j roe to come over.b
of Joint Medical Group running into cLmp 5.
and he called me to come along, so I followed. H j      with them

thennmeoanyovern^cJmco^'^'nr^X^r^^^^

doingcheatcompmaaionaa.thetin.c^^^rro^riiS'rr^;^^^^^

Wor to doing chest compression I saw the detainee 1 vine un-«traniv«r*«tka. • u j

detan
i ee had tmpanta on wtih no aWrt or shoea on. me detaS
i ^^irWIlTte^l L ■

a ^h n
j  gd he appears, to hefiee
i aa. , aa
i o notcied tTatS
' ^rnL
'li^'n.Jn^lrn
NCIS SS8(V26 (1/2001)
(FonneriyNClSFOB

FOR

Exhibit ( fl

C^l

 on Juiie 3.20Q7^M

again. This went on until the OIC pronounced the detainee
Once the detainee was pronounced dead, I waited and the • j

people in the room for a moment. Once this was over som«I?T? °«®cal

medical personners names also in the medical roomAfS^hil r^
the snow ball. I did not notice at anytime any land of hand nsstraim!" ^ debrief from

asssitWth
i thece
lann
igupofthemSroJmo^r'

opportumty to make any changes or corecto
i ns I desrie to h I nave oeen gvi enth^

chaigesorconectton,.

Signature;

Swon.» »d,„b«»ibed b.fo„ „„ *i,^day„f^30t^£_in
Witnessed:

Ju^'aUPWiemce
AUTH: DERIVED FROM ARTICLB136.

UCMJ (10 U.S.C 936)AND 5 U.S.C. 303

1.^

U S E O N LY

NCIS 5580/26 (1/2001)

(Fomieriy NCISFORM 016/04-81)
e r / . r t

 FOu %^tik

STATEMENT

O N LY

Place : NdSRAn-mn
Date : June 4.2007

' '*

Service. I make this statement of my own frJUuLTJ^^^ T Investigative

exbrnded IfiilyundCT^ that this statement is given conceiniW "r? ^ "® or promises

detainee             [  m^ my knowledge of the death of

andlweighappn»in».elymound.. I„»

^^urrently

'as present at the situation that occuned on Mav 30*^ 9007 t

« working at the detention hosmJTfuTJzLl^. ^ ^ ^

wh
ti o
furmedcialofifcerso
t respondo
th
teemer^cyKX?pS
'i j

Ui« wc naa an unresponsive detainee with no niil«. r ir^^IJTvr. 1 . ^ ' responoers at

When I arnved at the medical space in Camn 5 ppo t»o« *

measures.The detan
i ee sltiappeared^ip^svie

I was responsible for drawing up medications that are stand^^ measures that were being atempted,

protocol. The medical officer was communicatiM^ib^^^. u-1 '"PP°rt
that he wanted to use.The friet medciato
i n was aLn
i sitem?£° whcih medciato
i n and the amount

the exact order or type of'medication, please refer to the after a 1320. I can not recall

event The life saving ^ O,,.

•..w was aeceaseci
T h e .

as wediscus'ilJd^ " ' H ' I I —

oppoituniiy to make any changes or collections I desire to make and hS"'!' j ***" ""
ch.ng«orco,mctio,s. ™» a.aten»..t is the

Signature:

Sworntoandsubscrb
iedbeforemethsi ^dayof

the year An at

Page I of 2'

NCIS 5580/215 (1/2001)

FORO

(Fonneriy NCISFORM i ^

I

BthiblK

J7

.

I

 ^"''tjnuajjonofvolu^^ of
O N LY

on June 4, 2007

AUTH: DBRim

UCMf (10 U.S.C. 936) AND 5 U.S.C 303

NCISSS8(V26(1/2001)

Page 2 of

ONIY <^°"*^yNCISFORM016rt)4-8l)

 STATEMENT
FOR
Place : NQSRAn,.
Date ; Jum4.2fln7

^■■■■■■Wmake the following free and voluntary statement to u r
understand that this statement is riven con^i^!! ^ promises extended. 1 fully

'Fot puiposesofiM my full nameisMMMBHBp ^v SSN

^ S: IZ in^otc^ 5/6. , ™ outside
waadngwidi. UMiguani told the

lying on Us back on the exam table and there was somebody '

detamee. I also observed bruisine around the n-'ir nf Ao a K compressions on the

the supply cabinets. I had recently restocked the suoolies ^ of the room by

passing out anything the docs called for i e IV Cathetos I ^5^ evetythmg was. I started

compressions and I did a few rouncfa m^setf I L

=Z7.,;5E5E.x'zr5rrs'^2SiL
corpsmen. The OIC declared tbedS^^a^TwStjS^m^t'S
took it with us. We then went to Camo 6 for debrief r thr 51^!! bagged up the trash, and

^ere
a1bi
sleSbyS"
^msa
te
tmothey
ticonsn
itgofhave
h
tsi pageand
oh
teg
rpagL'
e(s)^wa2'
sytc
perp
do
frm
chajgrnmeorrecons. This s.atem«.t is the pfip
Signature:

Page 1 of 2

NCIS 5580/26(1/2001)

(Fonnerly NCISFORM 016/04-81)
FOR

O N LY

I Bxhlbll ( J©

5^5'

 ^ alinuationofvoljjMa^^s^^lj^
on June 4,2007

Swon
r ot ondm
t bsb
circdbeofe
r mehsti^f"y^ojf
A/0 IS ^ 6u»f»4wm>ieu> ^

l>4
in the yearZ^^ at

UCMJ(10U.S.C93<9AND5U.S.C.303

NCIS 558(V26 (1/2001) **"8® 2 of 2
NCISFORM 016/04-81)

s(f(p

 naval criminal investigative'service
DELETED PAGE INFORMATION SHEET
Page(s)_

Dee
l ted under exempto
i n(s)
ated with other goverament agencvfieat
Refered toorithgeinm
forreve
i w ard
i dhectreap^se ^

■f
®®®'™
°^'"'f<
»™a'
imisshed
byofoth
Bovemment
agency(i
es).
We
wiio
l nf
advi
e you
relereasati
m?^^??^ •

following consultation
ation with
with
agency(ies).
aB<!n™r.,..% ^ f information
Comments.'^

Deleted pages(s)

No duplication fee for this page

 statement for
ONLY

« ptomises CTten^TfiX^f^f®™"' o' my own fine wiU and CHininal

■iivfnlgiiiiK^
•

A

loii

and

1

we

Task Force Guantanamo Bay, ®® cun^nUy assigned
.Roesyoi
n
,
M
edi
c
a,
(
^„p.
,„,„;»-,X?S^7.^^ 
uscftaMon Note/Narratfve;

s=^=sir=i~3s=^

=SSS5SSSS^:^^~
_^"«uan tnrough conb, « omaming lube In lo ihs taS^. '°^"™a using special —'

mecifcenon. In aci„SSS^S?!fAf '>»b<aral br^^JS ^

~Srsu^;5gis'''g-"'^

,

lavewedbi^sldsml^-'

Detainee examined bvmeTh '^yslofe protocol

Modfcal

History:

I

^

Prior Hunger Striker

HopaW
l aa(Ine
lco
linolUe
i Uw)i

GH®(QasboesopbagealReu
l*obeaseJ^i*
NCIS 5580^6 (1/2001)

Page 1 of 2

r o R o

iONlY "^""^raaMoiMiM,,
I Eabttia I -J /

 CooOmMm of volumay sworn fQ
on June 5,2006
Kidney Stones

Past Mental Health History:

N00u™nM
, HDh„lb
f.Seemonm>yO,Camp

no"®"! M be present ona
' e°My°m(?!^!sl ^ene^'^^ " "™™""'««»
' « "ere

have been present in medical waste. TTie n»m wi cT» ^ and busy. Pieces may

concerns of possible additional suicide attempts sTd ^'^'='='5'«'» h) the

^f^ty
mate
changes
gesto
or correcti
ons.any
TTiis statement
is the or correction's^,IhavebeengivS?
Signat

Sworno
t andsubscdbedbeo
fremeh
tsi S_daTo^ZT
yearc.3c»g'7at

AUTH: DERIVED

UCMJ(10U.S.C.93QAND5U.S.C.303

NCIS558(W6 (1/2001)

for Of^lSiC^ ONLY

(FonneyrlNCS
IFORM016W-81)^g^

 0023B/MPMP/ADLANT -

"• s. CRIMINALIMVSSTIOATIVR SBRvciR
*SMHTOPraVBSTIGATIOM(OPEN)
death (II)

V/ALOMARI ABDALR. "'"'"-"««'-»01S-7HMA

«/«/PMRA/M//„i;ji,^^fJ^^H»PIR AL HILALA/CIV

a/RLAMRI,AROOLrahmS^AS
MWS at/mpgt/odaotahamo bay
N A R R AT I V E

SPECIAL

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approRlS® "? "li. "Ubin-Bzl^: "a.

peroonnel v/al 'aMayo?, by joIm Detentl™ A "*®- at

S5S13-4C

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 30MAY07-MPGT-0015-7HNA
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. S. NAVAL CRIMINAL INVESTIGATIVE SERVICE

V/AlOMMI,„0M.RAHHA.l M«U)I»DHAFIRM,HILRLR/CIV

distribution
NCISHQ; 002 38

INFO: MPMP/ADLANT

secrejj^5porn -

page 2 LASTHilp I

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