DD Form 2951 "Initial Report of Suspected Child Sexual Abuse in DoD Operated or Sponsored out-Of-Home Care Activities"

What Is DD Form 2951?

This is a form that was released by the U.S. Department of Defense (DoD) on June 1, 2012. The form, often mistakenly referred to as the DA Form 2951, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.

Form Details:

  • A 4-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Editable, printable, and free to use;

Download an up-to-date fillable DD Form 2951 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

ADVERTISEMENT
ADVERTISEMENT

Download DD Form 2951 "Initial Report of Suspected Child Sexual Abuse in DoD Operated or Sponsored out-Of-Home Care Activities"

848 times
Rate (4.4 / 5) 242 votes
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
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
SECTION B - INFORMATION ON PROBABLE AND POTENTIAL VICTIMS
(If additional information is needed, continue on separate sheet.)
8. PROBABLE VICTIMS
a. NUMBER
b. AGE
c. SEX
d. SPONSOR'S SERVICE
a. NUMBER
b. AGE
c. SEX
d. SPONSOR'S SERVICE
1
6
2
7
3
8
4
9
5
10
10. TOTAL ESTIMATED POTENTIAL VICTIMS
9. POTENTIAL VICTIMS IN OTHER OUT-OF-HOME CARE
ACTIVITIES?
YES
NO
11. ESTIMATED AGE RANGE OF POTENTIAL VICTIMS
12. SPONSORS OF POTENTIAL VICTIMS FROM DIFFERENT
SERVICES?
TO
YES
NO
SECTION C - INFORMATION ON SUBJECT OF THE ALLEGATION
(If additional information is needed, continue on separate sheet.)
13. SEX
14. AGE
15. YEARS AT INSTALLATION
16. CURRENT POSITION WITHIN ACTIVITY
17. EMPLOYMENT STATUS
EMPLOYEE
CONTRACTOR/CONTRACT EMPLOYEE
VOLUNTEER
18. CURRENT POSITION(S) IN OTHER OUT-OF-HOME CARE ACTIVITIES ON INSTALLATION (List all)
19. PREVIOUS POSITION(S) IN OUT-OF-HOME CARE ACTIVITIES ON INSTALLATION (List all)
20. PREVIOUS POSITION(S) IN OUT-OF-HOME CARE ACTIVITIES ON OTHER INSTALLATIONS (List all and provide dates)
21. DATE, TYPES AND RESULTS OF BACKGROUND CHECK(S)
22. STATUS (If additional information is needed, continue on separate sheet.)
a. CURRENT SUBJECT STATUS IN ACTIVITY
b. CURRENT LEGAL STATUS
(1) REASSIGNED (Away from children/youth)
(1) INVESTIGATION OPEN
(2) ON ADMINISTRATIVE LEAVE
(2) CHARGES FILED
(3) RESIGNED/TERMINATED
(3) FUGITIVE
(4) REMAINS IN POSITION
(4) CLOSED INVESTIGATION ONLY
DD FORM 2951 (BACK), JUN 2012
Reset
INSTRUCTIONS 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
8. Probable Victims (Continued).
15. Years at Installation. Enter the number of years the
care provider currently has been at the installation.
d. Sponsor's Service. Enter the Service of the sponsor of
each child who has been identified as a probable victim. If a
16. Current Position Within Activity. Enter the care
child who has been identified as a probable victim is not a
provider's position title within the out-of-home care activity,
military dependent, enter "Unaffiliated".
such as program assistant, youth development specialist,
sports coach, teacher, etc.
9. Potential Victims in Other Out-of-Home Care Programs?
If there is reason to believe that the care provider who is the
17. Employment Status. Mark whether the care provider is
subject of the investigation has had significant opportunities
an employee, contractor or contract employee, or volunteer.
for access to other children in other DoD operated or
sponsored out-of-home care activities at the installation,
18. Current Position(s) in Other Out-of-Home Care
mark "Yes". If there is reason to believe that the subject has
Activities on Installation. List all other employed, contract, or
not had significant opportunities for access to other children
or youth in other DoD operated or sponsored out-of-home
volunteer positions the care provider currently has in
care activities at the installation, mark "No".
out-of-home care activities on the installation.
10. Total Estimated Potential Victims. Estimate the number
19. Previous Position(s) in Out-of-Home Care Activities on
of children or youth who may be victims, including those
Installation. List all other employed, contract, or volunteer
already identified as probable victims, because the care
positions the care provider previously had in out-of-home
provider had significant opportunities for access to them in
care activities on the installation.
DoD operated or sponsored out-of-home care activities at
the installation.
20. Previous Position(s) in Out-of-Home Care Activities at
Other Installation(s). List all other employed, contract, or
11. Estimated Age Range of Potential Victims. Based on
volunteer positions the care provider previously had in
the DoD operated or sponsored out-of-home care activities
out-of-home care activities on other military installations and
at the installation where the care provider had significant
the names of the installations. Provide dates if known.
opportunities for access to children and youth, enter the age
of the youngest child or youth and the age of the oldest child
or youth in such activities.
21. Dates, Types, and Results of Background Checks. List
the dates, types, and results of background checks
12. Sponsors of Potential Victims from Different Services?
performed on the care provider. Consult the Service's
If a child or youth who is a potential victim but who has not
out-of-home care policy that implements DoD Instruction
been identified as a probable victim has a sponsor in a
1402.5 for the types of background checks that should be
Service different from any sponsor of a child or youth who
and may have been performed.
has been identified as a probable victim, mark "Yes". If the
sponsors of all children or youth who are potential victims
22. Subject Status. Mark the current status of the care
but who have not been identified as probable victims are of
provider within the out-of-home care activity on the
the same Services as the sponsors of all children or youth
installation. Mark the current legal status of the allegations
who have been identified as probable victims, mark "No".
against the care provider.
Section C - Information on Subject of the Allegation.
13. Sex. Enter "M" if the care provider who is the subject of
the allegation is male and "F" if the subject of the allegation
is female.
14. Age. Enter the age of the care provider on his or her
last birthday.
DD FORM 2951 INSTRUCTIONS (BACK), JUN 2012
Page of 4