CID Form 11 interview record, ROI 967-76-0643
Title revised to match the document’s own text.
Original title: Army CID Form 11 interview record, ROI 967-76-0643
Document date 3 November 1976
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Id: Cooper-Part-41:153-153
Subject: Cooper Files: Cooper-Part-41:153-153 Document: CID Form 11 interview record, ROI 967-76-0643 Id: Cooper-Part-41:153-153 Page: https://cooper.theunsolved.net/documents/Cooper-Part-41%3A153-153 What is wrong (title, date, type, which pages belong together, copies)? What does the scan show?
A person reads every report. Corrections are made by hand, to the data — titles, dates, names, which pages belong together — never to the scans, and they can take a while to appear.
FBI 164-81, Vault Part 41 p. 153 (DB Cooper-15266), Form, dated 3 Nov 1976, serial 967-76-0643 (as read from the transcript) — cooper.theunsolved.net/documents/Cooper-Part-41%3A153-153
CID FORM 11
1. NAME (Last, First, Middle): [REDACTED] 2. ROI/SEQ NO. (Include Primary Offense Code): 967-76-0643 Information Report 3. ALIASES/NICKNAMES: None 4. ORGANIZATION/ADDRESS: Co A, 5/68th Armor Sullivan Barracks, APO NY 09086 5. MCAC: Telo: MM-823 6. SEX: M 7. RACE: Cauc 8. GRADE: SSG 9. DOB (Yr, Mo, Day): [REDACTED] 10. POB (City, State): [REDACTED] 11. SSN: [REDACTED] 12. FORMER SERVICE NO.: E1 13. HT: 69 14. WT: 170 15. HAIR: Fr [Brown] 16. EYES: Br 17. IDENTIFYING MARKS: None 18. SECURITY CLEARANCE: SECRET 19. MOS: [REDACTED] 20. DUTY ASS: Tank Commander 21. ACTION TAKEN: YES [ ] NO [ ] NA [X] 22. INTERVIEWEE RELATIONSHIP TO CASE: SUSPECT [ ] SUBJECT [ ] VICTIM [ ] WITNESS [X] 23. OFFENSE CODES RELATING TO INDIVIDUAL ONLY: [REDACTED] SECTION B - OPTIONAL 24. PERMANENT HOME ADDRESS: [REDACTED] 25. TELEPHONE: QTR [REDACTED] 26. ETS: 19 Nov 78 27. DEROS/PCS: Feb 79 28. CITIZENSHIP (Reg No.): US 29. MARITAL STATUS: Married 30. PASSPORT NUMBER: None 31. EDUCATION LEVEL: HS Grad 32. KNOWN FRIENDS/ACQUAINTANCES: [REDACTED] 33. VEHICLE DATA: [REDACTED] 34. OFFENSE(S) UNDER INVESTIGATION: Hijacking 35. DATE, PLACE, TIME INTERVIEW BEGAN: 0830//3 Nov 76//CID Office 36. RIGHTS READ AND EXPLAINED BY: [REDACTED] 37. COUNSEL REQ/PRESENT (Full Name): [REDACTED] 38. WRITTEN STATEMENT TAKEN: [ ] YES [X] NO 39. LINEUP USED: [ ] YES [X] NO 40. POLYGRAPH REQUESTED: [ ] YES [X] NO 41. PERSON FINGERPRINTED: [ ] YES [X] NO 42. CO NOTIFIED (Date and Name): N/A 43. CRD CHECK (If Yes, give Date): [ ] YES [X] NO 44. INTERVIEW CONDUCTED BY: SA [REDACTED] 45. TIME AND DATE TERMINATED: 0915//3 Nov 76 46. DISPOSITION OF INTERVIEWEE: Released to duty REMARKS: [blank/empty]
CID FORM 11 [handwritten notation at bottom] PREVIOUS EDITIONS OF THIS FORM ARE OBSOLETE. DB Cooper-15266
Serials: 967-76-0643
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