0567-2806-MTDC: Accident Investigation Guide 2005, Exhibit 3-2

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Accident Investigation Guide: 2005 Edition

Exhibit 3-1

	USDA Forest Service	Witness Statement	Case/File Number Initial Report Followup
Nature of Investigation
Person Making Statement (Last, first, middle)	Home Phone No. (Area code) (____)___-_____
Home Address (Street, city, state, zip code)	Work Phone No. (Area code) (____)___-_____
Employment (Occupation and location)
Location Statement Taken	Name of Investigator Taking Statement	Date/Time Started ___ /___ /___
Statement
I have read the foregoing statement consisting of ____ pages. I fully understand this statement and declare that the foregoing is true, accurate, and complete to the best of my knowledge. I have signed or initialed each and every page and have been given an opportunity to make any corrections or additions. I have made this statement freely and voluntarily, without threats or rewards, or promises of rewards having been made to me in return for it.
Signature of Person Giving Statement:	Date/Time Ended
Investigator's Signature	Witness' Signature (If applicable)
Note: This document is for OFFICIAL USE ONLY.

USDA
Forest Service

Witness Statement

Case/File Number

Initial Report Followup

Nature of Investigation

Person Making Statement (Last, first, middle)

Home Phone No. (Area code)

(____)___-_____

Home Address (Street, city, state, zip code)

Work Phone No. (Area code)

(____)___-_____

Employment (Occupation and location)

Location Statement Taken

Name of Investigator Taking Statement

Date/Time Started

___ /___ /___

Statement

I have read the foregoing statement consisting of ____ pages. I fully understand this statement and declare that the foregoing is true, accurate, and complete to the best of my knowledge. I have signed or initialed each and every page and have been given an opportunity to make any corrections or additions.

I have made this statement freely and voluntarily, without threats or rewards, or promises of rewards having been made to me in return for it.

Signature of Person Giving Statement:

Date/Time Ended

Investigator's Signature

Witness' Signature (If applicable)

Note: This document is for OFFICIAL USE ONLY.

Witness Statement

Case/File Number

Initial Report Followup

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since July 21, 2005