Page:Implementation of Combatant Status Review Tribunal Procedures for Enemy Combatants detained at Guantanamo Bay Naval Base, Cuba.pdf/19

Sample Detainee Election Form

Date/Time: ____________________

ISN#: _______________

Personal Representative: __________________________________________________
[Name/Rank]

Translator Required? __________Language? ____________________

CSRTA Procedures Read to Detainee or Written Copy Read by Detainee? _______________

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Detainee Election:

□ Wants to Participate in Tribunal

□ Wants Assistance of Personal Representative

□ Affirmatively Declines to Participate in Tribunal

□ Uncooperative or Unresponsive

Personal Representative Comments:

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

______________________________
Personal Representative

Enclosure (5)