ACA-E 2

Code: ACA-E 2

WITNESS DISCLOSURE FORM

Name of witness:_________________________________________________

Position/Grade of witness:_______________________________________

Date of testimony, Interview:____________________________________

Description of Incident witnessed:_______________________________

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Any other information:___________________________________________

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I agree that all of the information on this form is accurate and true to the best of my knowledge. 

Signature:_____________________________________

Date:________________________________

Adopted:  8/18/20