Dd Form 2951 - Initial Report Of Suspected Child Sexual Abuse In Dod Operated Or Sponsored Out-Of-Home Care Activities

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REPORT CONTROL SYMBOL
INITIAL REPORT OF SUSPECTED CHILD SEXUAL ABUSE
DD-P&R(Q)2052
IN DOD OPERATED OR SPONSORED OUT-OF-HOME CARE ACTIVITIES
SECTION A - ADMINISTRATIVE INFORMATION
1. NAME OF INSTALLATION
2. STATE/COUNTRY
3. POINT OF CONTACT
a. NAME (Last, First, Middle Initial)
b. POSITION
c. CONTACT INFORMATION
(1) DSN TELEPHONE NUMBER
(2) COMMERCIAL TELEPHONE NUMBER
(3) FAX NUMBERS (DSN and Commercial)
(Include Area Code)
(4) E-MAIL ADDRESS
4. ACTIVITY WHERE SUSPECTED ABUSE OCCURRED
5. DATE REPORTED TO (Enter all dates as MM/DD/YYYY)
a. INSTALLATION FAP
b. SERVICE/DEFENSE AGENCY FAP HQ
c. DUSD(P&R)
6. AGENCIES INVOLVED (X all that apply)
a. MILITARY CRIMINAL INVESTIGATIVE ORGANIZATION:
d. INSTALLATION FAP
CID
NCIS
AFOSI
b. CIVILIAN LAW ENFORCEMENT OF:
e. ACTIVITY MAJCOM/HQ
c. CHILD PROTECTIVE SERVICES OF:
f. SERVICE FAP RESPONSE TEAM
7. PUBLICITY (X all that apply)
a. RUMORS/DISCUSSION ON INSTALLATION
b. INSTALLATION "TOWN MEETING"
CONDUCTED
SCHEDULED
c. INQUIRIES FROM CIVILIAN MEDIA
LOCAL
NATIONAL
d. REPORTED IN CIVILIAN MEDIA
LOCAL
NATIONAL
DD FORM 2951, JUN 2012
Adobe Professional 8.0

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