Da Form 3975 1 PDF Details

In the structured environment of military law and procedure, the documentation of offenses plays a critical role in ensuring accountability and justice. Among these essential documents is DA Form 3975-1, titled "Military Police Report - Additional Offenses," which serves as a continuation for detailing offenses beyond the initial report captured in DA Form 3975. This form, governed by AR 190-45 and overseen by the proponent agency PMG, is designed to comprehensively record multiple facets of an offense, ensuring that each incident is meticulously documented. Key sections of this form include the military police report number, which links back to the original report, identifiers for the offense, subject, victim, and the Nature of Incident Based Reporting System (NIBRS) codes. Detailed fields allow for recording the offense description, the involvement of alcohol, drugs, computer equipment, or other substances, the type of criminal activity, statutory basis, and even the type of weapon or force used. It goes further to delineate circumstances of aggravated assault or homicide, potential bias motivation behind the offense, and other specifics like the number of premises entered during the commission of a crime, offering a holistic view of the event. This high level of detail aids in the pursuit of clarity and precision in military legal proceedings, highlighting the form's importance in the broader context of military discipline and justice.

QuestionAnswer
Form NameDa Form 3975 1
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesda 3975 military police report, da form 3975 fillable, form 3975 military police report, da 3975

Form Preview Example

MILITARY POLICE REPORT - ADDITIONAL OFFENSES

For use of this form, see AR 190-45; the proponent agency is PMG.

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 (YYYYMMDD)

ORI NUMBER

USACRC CONTROL NUMBER

THRU

TO

FROM

SECTION II - OFFENSE

1a.

OFFENSE NO.

1b. SUBJECT NO.

1c. VICTIM NO.

1d. NIBRS

1e.

1f. SAME OFFENSE DATA FOR ALL

 

 

INVOLVEMENT

 

INVOLVEMENT

LOCATION CODE

 

ATTEMPTED

OFFENSE CODES

 

 

 

 

 

 

 

 

 

COMPLETED

 

YES

 

NO

1g.

OFFENSE

1h. OFFENSE DESCRIPTION(s)

 

1i. OFFENSE LOCATION ADDRESS

CODE(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2a.

BEGIN DATE

 

 

3. TYPE OF CRIMINAL ACTIVITY

4. OFFENSE STATUTORY

5. OFFENDER USED

(YYYYMMDD)

 

 

(Check up to three)

 

BASIS

 

 

 

(Check up to three)

 

 

 

 

 

B Buying/Receiving

 

 

A UCMJ

 

 

 

 

A Alcohol

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2b.

BEGIN TIME (24 Hour)

C Cultivating/Manufacturing/Publishing

 

B Non-Criminal Fatality

 

C Computer Equipment

 

 

 

 

 

D Distributing/Selling

 

 

C State

 

 

 

 

D Drugs/Narcotics

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2c.

END DATE

 

 

 

E Exploiting Children

 

 

D Local

 

 

 

 

N Not Applicable

(YYYYMMDD)

 

 

 

O Operating/Promoting/Assisting

 

E Foreign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P Possessing/Concealing

 

F Federal, Non-UCMJ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2d.

END TIME (24 Hour)

T Transporting/Importing

 

 

 

 

 

 

 

UUsing/Consuming

6.TYPE OF WEAPON/FORCE. Check up to three 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

Shotgun

 

 

 

 

 

65

Fire/Incendiary

 

 

99 None

7.

 

NUMBER OF PREMISES ENTERED (For

 

 

 

40

Personal Weapons

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burglary/Housebreaking only)

 

 

 

 

 

 

 

 

70

Narcotics/Drugs

 

 

 

 

 

 

 

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 a civilian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Domestic Quarrel

 

33

Other Negligent Weapon Handling

 

 

 

D Criminal attempted flight from a crime

 

7

Mercy Killing

 

35

Other Negligent Killings

 

 

 

 

 

 

E Criminal killed in commission of a crime

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

Other Felony Involved

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F Criminal resisted arrest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G Unable to determine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. BIAS MOTIVATION (As applicable)

 

 

YES

 

NO

 

 

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

DA FORM 3975-1, DEC 1998

PAGE

 

OF

APD V1.01

1a.

OFFENSE NO.

1b. SUBJECT NO.

1c. VICTIM NO.

 

1d. NIBRS

 

 

 

1e.

 

 

 

 

 

 

1f. SAME OFFENSE DATA FOR ALL

 

 

 

 

INVOLVEMENT

 

 

INVOLVEMENT

 

LOCATION CODE

 

 

 

 

 

ATTEMPTED

 

OFFENSE CODES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETED

 

 

YES

 

NO

 

 

 

1g.

OFFENSE

1h. OFFENSE DESCRIPTION(s)

 

 

 

 

 

 

 

 

 

 

 

1i.

OFFENSE LOCATION ADDRESS

 

 

 

CODE(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2a. BEGIN DATE (YYYYMMDD)

 

3. TYPE OF CRIMINAL ACTIVITY

 

 

 

4. OFFENSE STATUTORY

5. OFFENDER USED

 

 

 

 

 

 

(Check up to three)

 

 

 

 

 

 

 

 

 

 

 

BASIS

 

 

 

 

 

 

 

(Check up to three)

 

 

 

 

 

 

 

B Buying/Receiving

 

 

 

 

 

 

 

 

 

 

 

A UCMJ

 

 

 

 

 

 

A Alcohol

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2b.

BEGIN TIME (24 Hour)

 

 

C Cultivating/Manufacturing/Publishing

 

 

 

 

 

 

B Non-Criminal Fatality

 

 

C Computer Equipment

 

 

 

 

 

 

 

D Distributing/Selling

 

 

 

 

 

 

 

 

 

 

 

C State

 

 

 

 

 

 

 

 

 

D Drugs/Narcotics

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2c.

END DATE

 

 

 

E Exploiting Children

 

 

 

 

 

 

 

 

 

 

 

D Local

 

 

 

 

 

 

 

 

 

N Not Applicable

(YYYYMMDD)

 

 

 

O Operating/Promoting/Assisting

 

 

 

 

 

 

E Foreign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P Possessing/Concealing

 

 

 

 

 

 

F Federal, Non-UCMJ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2d.

END TIME (24 Hour)

 

 

T Transporting/Importing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

U Using/Consuming

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. TYPE OF WEAPON/FORCE. Check up to three 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

65 Fire/Incendiary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14 Shotgun

 

 

 

 

 

 

 

 

 

99 None

 

7.

 

NUMBER OF PREMISES ENTERED (For

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burglary/Housebreaking only)

 

 

 

 

 

 

40 Personal Weapons

 

 

 

 

 

 

 

70 Narcotics/Drugs

 

 

 

 

 

 

 

 

 

 

 

 

 

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 a civilian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6 Domestic Quarrel

 

 

33 Other Negligent Weapon Handling

 

 

 

 

D Criminal attempted flight from a crime

 

 

 

 

 

7 Mercy Killing

 

 

 

35 Other Negligent Killings

 

 

 

 

E Criminal killed in commission of a crime

 

 

 

 

 

8 Other Felony Involved

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F Criminal resisted arrest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G Unable to determine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. BIAS MOTIVATION (As applicable)

 

 

YES

 

 

NO

 

 

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1a.

OFFENSE NO.

1b. SUBJECT NO.

1c. VICTIM NO.

 

1d. NIBRS

 

 

 

1e.

 

 

 

 

 

 

1f. SAME OFFENSE DATA FOR ALL

 

 

 

 

INVOLVEMENT

 

 

INVOLVEMENT

 

LOCATION CODE

 

 

 

 

 

ATTEMPTED

 

OFFENSE CODES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETED

 

 

YES

 

NO

 

 

 

1g.

OFFENSE

1h. OFFENSE DESCRIPTION(s)

 

 

 

 

 

 

 

 

 

 

 

1i.

OFFENSE LOCATION ADDRESS

 

 

 

CODE(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2a. BEGIN DATE (YYYYMMDD)

 

3. TYPE OF CRIMINAL ACTIVITY

 

 

 

4. OFFENSE STATUTORY

5. OFFENDER USED

 

 

 

 

 

 

(Check up to three)

 

 

 

 

 

 

 

 

 

 

 

BASIS

 

 

 

 

 

 

 

(Check up to three)

 

 

 

 

 

 

 

B Buying/Receiving

 

 

 

 

 

 

 

 

 

 

 

A UCMJ

 

 

 

 

 

 

A Alcohol

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C Cultivating/Manufacturing/Publishing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2b.

BEGIN TIME (24 Hour)

 

 

 

 

 

 

 

 

B Non-Criminal Fatality

 

 

C Computer Equipment

 

 

 

 

 

 

 

D Distributing/Selling

 

 

 

 

 

 

 

 

 

 

 

C State

 

 

 

 

 

 

 

 

 

D Drugs/Narcotics

 

 

 

 

 

 

 

E Exploiting Children

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2c.

END DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D Local

 

 

 

 

 

 

 

 

 

N Not Applicable

(YYYYMMDD)

 

 

 

O Operating/Promoting/Assisting

 

 

 

 

 

 

E Foreign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P Possessing/Concealing

 

 

 

 

 

 

F Federal, Non-UCMJ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

T Transporting/Importing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2d.

END TIME (24 Hour)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

U Using/Consuming

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE 2, DA FORM 3975-1, DEC 1998

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE

 

OF

 

APD V1.01

6. TYPE OF WEAPON/FORCE. Check up to three 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

Shotgun

 

 

 

 

 

 

65

Fire/Incendiary

 

 

99 None

7.

 

NUMBER OF PREMISES ENTERED (For

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burglary/Housebreaking only)

 

 

 

40

Personal Weapons

 

 

 

 

 

 

70

Narcotics/Drugs

 

 

 

 

 

 

 

 

 

20

Knife/Cutting

 

 

 

 

 

 

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 attached 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 a civilian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Domestic Quarrel

 

 

33

Other Negligent Weapon Handling

 

 

 

 

 

D Criminal attempted flight from a crime

 

7

Mercy Killing

 

 

35

Other Negligent Killings

 

 

 

 

 

 

 

 

E Criminal killed in commission of a crime

 

8

Other Felony Involved

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F Criminal resisted arrest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G Unable to determine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. BIAS MOTIVATION (As applicable)

 

 

YES

 

NO

 

 

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE 3, DA FORM 3975-1, DEC 1998

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