Dd Form 2951 - Initial Report Of Suspected Child Sexual Abuse In Dod Operated Or Sponsored Out-Of-Home Care Activities Page 3
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4INSTRUCTIONS FOR COMPLETING INITIAL REPORT OF SUSPECTED CHILD SEXUAL ABUSE
IN DOD OPERATED OR SPONSORED OUT-OF-HOME CARE ACTIVITIES
GENERAL.
6. Agencies Involved. Mark (X) the box of each agency that is
Within 72 hours of being notified of a suspected incident of
involved in the investigation and/or assessment of the
child sexual abuse in an DoD operated or sponsored
suspected incident.
out-of-home care activity, as defined in Enclosure 1 of DoDI
6400.3, the information about such an incident shall be reported
a. If 6a. is applicable, indicate whether the Department of the
through Service or Defense Agency Family Advocacy Program
Army Criminal Investigative Division (CID), Department of the
(FAP) channels to the Deputy Under Secretary of Defense
Navy Naval Criminal Investigative Service (NCIS), or the
(Personnel and Readiness) (DUSD(P&R)) by fax to (703)
Department of the Air Force Office of Special Investigations
602-4983 (DSN 332-4983) or electronically. Information
(AFOSI) is involved.
contained on the form must be coordinated with the criminal
investigative organization or law enforcement agency
b. If 6b. is applicable, enter the name of the state, county or
conducting the investigation, in addition to other offices or
city civilian law enforcement agency involved.
agencies having relevant information. If civilian agencies
exercising jurisdiction over the incident have not provided
c. If 6c is applicable, enter the name of the state, county or city
required information within the 72 hours, all other information
civilian child protective services agency involved.
should still be submitted to the DUSD(P&R) in as much detail as
possible.
d. Mark 6d if the installation leadership has established a
response team consisting of representatives from the activity
Section A - Administrative Information.
where the suspected abuse occurred, the FAP, the installation
detachment of the military criminal investigative organization in
1. Name of Installation. Enter the name of the installation
6a., the office of the Staff Judge Advocate, the public affairs
submitting the "Initial Report".
office, and any other relevant office.
2. State/Country. Enter the name of the state or country in
e. Mark 6e. if the office at the major command or at the Service
which the installation is located.
or Defense Agency headquarters level of the activity where the
suspected abuse occurred has established a response team.
3. Point of Contact. Enter the name, official position, DSN and
commercial voice telephone numbers, DSN and commercial fax
f. Mark 6f. if the FAP at the Service or Defense Agency
telephone numbers, and electronic mail address of the person
headquarters level has established a response team.
submitting the "Initial Report".
7. Publicity. Mark the box for each applicable type of publicity
4. Activity Where Suspected Abuse Occurred. Enter the name
concerning the suspected sexual abuse.
of the out-of-home care activity, such as child development
center, family home care, youth program, chapel program, DoD
Section B - Information on Probable and Potential Victims.
Dependents Schools System school, DoD Elementary and
Secondary School, etc., in which the incident allegedly
8. Probable Victims.
occurred.
a. Victim Number. Assign a number for each child who has
5. Date Reported To: Enter the dates that the following were
been identified as a probable victim. If more than ten (10)
notified of the suspected abuse incident, using the format
probable victims have been identified, attach an additional
MM/DD/YYYY:
sheet.
a. Installation Family Advocacy Program (FAP),
b. Age. Enter the age on his or her last birthday of each child
who has been identified as a probable victim.
b. Service or Defense Agency FAP Headquarters, and
c. Sex. Enter "M" for each male child and "F" for each female
c. Deputy Under Secretary of Defense (Personnel and
child who has been identified as a probable victim.
Readiness) (DUSD(P&R)).
DD FORM 2951 INSTRUCTIONS, JUN 2012
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