Defense Sexual Assault Incident Database

Defense Sexual Assault Incident Database

DSAID MSA Report Template (APY10-11 Sample) v1.6.3

Defense Sexual Assault Incident Database

OMB: 0704-0482

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1a. Unrestricted Reports (A-E)
Sexual Harassment and Violence at the US Military Service Academies APY10-11
US  Academy
A. APY10-11 REPORTS OF SEXUAL ASSAULT (rape, aggravated sexual assault, aggravated sexual contact, abusive
sexual contact, wrongful sexual contact, non-consensual sodomy, and attempts to commit these offenses) BY or
AGAINST Cadets/Midshipmen/Prep School Student
# VICTIMS in APY10-11 Unrestricted Reports
# Cadet/Midshipman/Prep School Student victims
# Non-Cadet/Midshipman/Prep School Student victims
# Unrestricted Reports in the following categories
# Cadet/Midshipman/Prep School Student on Cadet/Midshipman/Prep School Student
# Cadet/Midshipman/Prep School Student on Non-Cadet/Midshipman/Prep School Student (includes other Service Members or
Civilians)
#
Non-Cadet/Midshipman/Prep School Student (includes other Service Members or Civilians) on Cadet/Midshipman/Prep School
Student
# Unidentified Subject on Cadet/Midshipman/Prep School Student
# Unrestricted Reports of sexual assault occurring
# On Academy Grounds
# Off Academy Grounds
# Unidentified location
# Investigations Initiated (From APY2009-2010 Unrestricted Reports)
# Investigations pending completion as of 31-May-11
# Completed Investigations as of 31-May-11
# Restricted Reports
# Converted from Restricted Report to Unrestricted Report*
# APY10-11 RESTRICTED REPORTS REMAINING RESTRICTED
B. DETAILS OF UNRESTRICTED REPORTS IN APY10-11
Length of time between sexual assault and Unrestricted Report
# Reports made within 3 days of sexual assault
# Reports made within 4 to 30 days after sexual assault
# Reports made within 31 to 365 days after sexual assault
# Reports made longer than 365 days after sexual assault
# Unknown
Reported Time of sexual assault
# Midnight to 6 am
# 6 am to 6 pm
# 6 pm to midnight
# Unknown
Reported Day of sexual assault
# Sunday
# Monday
# Tuesday
# Wednesday
#
#
#
#

Thursday
Friday
Saturday
Unknown

C. SUMMARY OF INVESTIGATIONS OF UNRESTRICTED REPORTS (COMPLETED IN APY10-11)
# Investigations initiated and completed during APY10-11
# Investigations with more than one victim, subject, or both
# SUBJECTS in the completed investigations
# Cadet/Midshipman/Prep School Student subjects
# Service Member subjects
# Non-Service Member subjects
# Unidentified subjects
# VICTIMS in the completed investigations
# Cadet/Midshipman/Prep School Student victims
# Service Member victims
# Non-Service Member victims
# Unknown

Page 1 of 5

APY10-11
Totals
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
APY10-11
Totals
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
APY10-11
Totals
0
0
0
0
0
0
0
0
0
0
0
0

1a. Unrestricted Reports (A-E)
D. FINAL DISPOSITIONS FOR SUBJECTS IN APY10-11 INVESTIGATIONS
# SUBJECTS in APY10-11 completed investigations
DoD Action Precluded:
# Unknown Subjects
# Unfounded by Investigative Agency
# Civilian or Foreign Authority Prosecutions of Persons Subject to the UCMJ
# Civilian or Foreign Authority Prosecutions of Persons NOT Subject to the UCMJ
# Total Command Action Precluded or Declined for Sexual Assault

# Probable cause for only non-sexual assault offense
# Subject deceased or deserted
# Victim deceased
# Victim declined to participate in the military justice action
# Insufficient evidence of any offense
# Statute of limitations had expired
# Unfounded by Command
# Commander declined action pursuant to UCMJ Rules of Courts-Martial 306(c)(1)
# Subjects awaiting completion of command action as of 31-May-11
# Subjects for whom command action was completed as of 31-May-11
# Evidence Supports Command Action for the following APY10-11 Sexual Assault Subjects
# Court-martial charge preferred (Initiated)
# Cadet Disciplinary System Action
# Nonjudicial punishments (Article 15 UCMJ)
# Administrative discharges
# Other administrative actions
E. FINAL DISPOSITIONS FOR SUBJECTS IN Pre-APY10-11 INVESTIGATIONS (From prior year investigations completed
in APY10-11)
# Total Number of Investigations, from all reporting periods prior to current APY, pending completion at the end of
APY10-11
# Pre-APY10-11 Investigations STILL PENDING completion as of 31-May-11
# Pre-APY10-11 Investigations completed of 31-May-11

APY10-11
Totals
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
APY10-11
Totals
0
0
0

# SUBJECTS from Pre-APY10-11 investigations completed as of 31-May-11

0

# Final APY10-11 DISPOSITIONS for SUBJECTS from Pre-APY10-11 investigations that were completed in APY10-11

0

DoD Action Precluded:
# Unknown Subjects
# Unfounded by Investigative Agency
# Civilian or Foreign Authority Prosecutions of persons subject to the UCMJ
# Civilian or Foreign Authority Prosecutions of Persons NOT Subject to the UCMJ
# Total Command Action Precluded or Declined for Sexual Assault

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

# Probable cause for only non-sexual assault offense
# Subject deceased or deserted
# Victim deceased
# Victim declined to participate in the military justice action
# Insufficient evidence of any offense
# Statute of limitations had expired
# Unfounded by Command
# Commander declined action pursuant to UCMJ Rules of Courts-Martial 306(c)(1)
# Pre-APY10-11 Subjects awaiting completion of command action as of 31-May-10
# Pre-APY10-11 Subjects for whom command action was completed as of 31 May-10
# Evidence Supports Command Action for the following Pre-APY10-11 Sexual Assault Subjects
# Courts-martial charge preferred (Initiated)
# Cadet Disciplinary System Action
# Nonjudicial punishments (Article 15 UCMJ)
# Administrative discharges
# Other administrative actions
* The total number of reports that converted to Unrestricted Reports are included in the total number of Unrestricted Reports provided in Section A.

Page 2 of 5

1b. Unrestricted Reports (F-G)

Sexual Harassment and Violence at the Military Service Academies APY10-11 - Unrestricted Reports by
Status and Gender - US  Academy
F. REPORTED SEXUAL ASSAULTS INVOLVING
Male
Male
Female
Female
CADETS/MIDSHIPMEN/PREP SCHOOL STUDENT AS
on Female on Male
on Male
on Female
SUBJECTS OR VICTIMS IN THE BELOW
CATEGORIES FOR ALL APY10-11 UNRESTRICTED
0
0
0
0
REPORTS
# Cadet/Midshipman/Prep School Student on
0
0
0
0
Cadet/Midshipman/Prep School Student
# Cadet/Midshipman/Prep School Student on Non0
0
0
0
Cadet/Midshipman/Prep School Student
# Non-Cadet/Midshipman/Prep School Student on
Cadet/Midshipman/Prep School Student
# Unidentified subject on Cadet/Midshipman/Prep
School Student

Unknown
on Male

Multiple
Mixed
Gender

Unknown
on Female

APY10-11
Totals

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Sexual Harassment and Violence at the US Military Service Academies APY10-11, UNRESTRICTED REPORTS BY OFFENSE TYPE
UNRESTRICTED REPORTS MADE IN APY10-11

APY10-11 INCIDENTS (Occurred between 1 Jun 10 and 31 May 11 and Investigation Opened in this
APY)

Pre-APY incidents (Occurred between 1 Oct 07 and 31 May 10, but Investigation Opened in this APY)

0

0

0

0

0

0

0

0

0

0

0

0

0

Attempts
to
APY10Commit
11 Totals
Offenses
(Art. 80)
0
0
0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

# Non-Cadet/Midshipman/Prep School Student on
Cadet/Midshipman/Prep School Student

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

# Unidentified subject on Cadet/Midshipman/Prep
School Student

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

G. REPORTED SEXUAL ASSAULTS BY or AGAINST
CADETS/MIDSHIPMEN/PREP SCHOOL STUDENT IN
THE FOLLOWING CATEGORIES FOR ALL APY10-11
INVESTIGATIONS
# Cadet/Midshipman/Prep School Student on
Cadet/Midshipman/Prep School Student
# Cadet/Midshipman/Prep School Student on NonCadet/Midshipman/Prep School Student

# TOTAL Cadet/Midshipman/Prep School
Student Victims
# Cadet/Midshipman/Prep School Student Victims:
Female
# Cadet/Midshipman/Prep School Student Victims:
Male
TIME OF INCIDENT BY OFFENSE TYPE FOR
UNRESTRICTED REPORTS OF SEXUAL ASSAULT
MADE IN APY10-11
Time of sexual assault
# Midnight to 6 am
# 6 am to 6 pm
# 6 pm to midnight
# Unknown
Day of sexual assault
# Sunday
# Monday
# Tuesday
# Wednesday
# Thursday
# Friday
# Saturday
# Unknown

Aggravated
Indecent
Rape
Sexual
Assault
(Art. 120)
Assault
(Art. 134)
(Art. 120)

Aggravated
Sexual
Contact
(Art. 120)

Abusive
Sexual
Contact
(Art.120)

Wrongful
Sexual
Contact
(Art. 120)

Nonconsensual
Sodomy
(Art. 125)

Attempts to
Commit
Offenses
(Art. 80)

DEMOGRAPHICS ON VICTIMS IN COMPLETED APY10Pre-APYIncidents (Occurred between 1 Oct 07 and 31 May 10, and Investigation Completed in this APY)
11 INVESTIGATIONS

Aggravated
Sexual
Assault
(Art. 120)

Rape
(Art. 120)

Aggravated
Sexual
Contact
(Art. 120)

Abusive
Sexual
Contact
(Art.120)

Wrongful
Sexual
Contact
(Art. 120)

Nonconsensual
Sodomy
(Art. 125)

APY10-11 INCIDENTS (Occurred between 1 Jun 10 and 31 May 11 and Investigation Completed in
this APY)

Gender of VICTIMS
# Male
# Female
Victim Type of Victims

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

# Cadet/Midshipman
# Prep School Student
# Active Duty Member
# Other Military Member
# DoD Civilian
# DoD Contractor
# US Civilian
# Other Government Civilian
# Foreign National
# Foreign Military
# Unknown
Grade/Status of Service Member Victims
# Prep School Student
# 1st Year
# 2nd Year
# 3rd Year
# 4th Year
# Active Duty Service Member

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

DEMOGRAPHICS ON SUBJECTS IN COMPLETED
APY10-11 INVESTIGATIONS

Pre-APYIncidents (Occurred between 1 Oct 07 and 31 May 10, and Investigation Completed in this APY)

APY10-11 INCIDENTS (Occurred between 1 Jun 10 and 31 May 11 and Investigation Completed in
this APY)

Subject Type of Victims

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

# Cadet/Midshipman
# Prep School Student
# Active Duty Member
# Other Military Member
# DoD Civilian
# DoD Contractor
# US Civilian
# Other Government Civilian
# Foreign National
# Foreign Military
# Unknown
Grade/Status of Service Member SUBJECTS
# Prep School Student
# 1st Year
# 2nd Year
# 3rd Year
# 4th Year
# Active Duty Service Member

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Gender of SUBJECTS
# Male
# Female
# Unknown

Page 3 of 5

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

2. Restricted Reports
RESTRICTED REPORTS OF SEXUAL ASSAULT - MILITARY SERVICE ACADEMIES, APY10-11
U.S.  Academy
A. APY10-11 RESTRICTED REPORTS OF SEXUAL ASSAULT
# Cadet/Midshipman/Prep School Student VICTIMS in Restricted Reports
# Converted from Restricted Report to Unrestricted Report*
# APY10-11 RESTRICTED REPORTS REMAINING RESTRICTED
# Reported sexual assaults AGAINST Cadet/Midshipman/Prep School Student victims in the following
categories
# Cadet/Midshipman/Prep School Student on Cadet/Midshipman/Prep School Student
# Non-Cadet/Midshipman/Prep School Student on Cadet/Midshipman/Prep School Student
# Unidentified subject on Cadet/Midshipman/Prep School Student
# Reported sexual assaults occurring

APY10-11
TOTALS
0
0
0
0
0
0
0
0

# On Academy Grounds
# Off Academy Grounds
# Unidentified location

0
0
0

B. INCIDENT DETAILS

APY10-11
TOTALS

Length of time between sexual assault and Restricted Report
# Reports made within 3 days of sexual assault
# Reports made within 4 to 30 days after sexual assault
# Reports made within 31 to 365 days after sexual assault
# Reports made longer than 365 days after sexual assault
# Unknown
Time of sexual assault incident
# Midnight to 6 am
# 6 am to 6 pm
# 6 pm to midnight
# Unknown
Day of sexual assault incident
# Sunday
# Monday
# Tuesday
# Wednesday
# Thursday
# Friday
# Saturday
# Unknown
C. DEMOGRAPHICS FOR APY10-11 RESTRICTED REPORTS OF SEXUAL ASSAULT

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
APY10-11
TOTALS

Gender of Cadet/Midshipman/Prep School Student VICTIMS
0
# Male
0
# Female
0
# Unknown
0
Grade/Status of Cadet/Midshipman/Prep School Student VICTIMS
0
# Prep School
0
# 1st Year
0
# 2nd Year
0
# 3rd Year
0
# 4th Year
0
* The Restricted Reports that converted to Unrestricted Reports are now included in the total number of Unrestricted Reports provided
in Worksheet 1a.

Page 4 of 5

3. Victim Services
APY10-11 SUPPORT SERVICES FOR VICTIMS OF SEXUAL ASSAULT
U.S.  Academy

NOTE: Totals of referrals and military protective orders are for all activities during the reporting period, regardless of when the sexual
assault report was made .
A. SUPPORT SERVICE REFERRALS TO Cadet/Midshipman/Prep School Student VICTIMS FROM UNRESTRICTED REPORTS:

APY10-11
TOTALS

# Support service referrals for Cadet/Midshipman/Prep School Student VICTIMS in the following categories
# MILITARY Resources

0

# Medical

0

# Mental Health

0

# Legal

0

# Chaplain/Spiritual Support

0

# Rape Crisis Center

0

# Victim Advocate/Uniformed Victim Advocate

0

# DoD Safe Helpline

0

# Other

0

# CIVILIAN Resources (Referred by DoD)

0

# Medical

0

# Mental Health

0

# Legal

0

# Chaplain/Spiritual Support

0

# Rape Crisis Center

0

# Victim Advocate/Uniformed Victim Advocate

0

# Other

0

# Unrestricted Reports where SAFEs were conducted

0

# Unrestricted Reports where SAFE kits or other needed supplies were not available at time of victim's exam

0

# Cadets/Midshipmen/Prep School Student making an UR that received service referrals for an incident that occurred prior to
military service

0

B. SUPPORT SERVICE REFERRALS FOR Cadet/Midshipman/Prep School Student VICTIMS IN RESTRICTED REPORTS:

APY10-11
TOTALS

# Support service referrals for Cadet/Midshipman/Prep School Student VICTIMS in the following categories
# MILITARY Resources

0

# Medical

0

# Mental Health

0

# Legal

0

# Chaplain/Spiritual Support

0

# Rape Crisis Center

0

# Victim Advocate/Uniformed Victim Advocate

0

# DoD Safe Helpline

0

# Other

0

# CIVILIAN Resources (Referred by DoD)

0

# Medical

0

# Mental Health

0

# Legal

0

# Chaplain/Spiritual Support

0

# Rape Crisis Center

0

# Victim Advocate/Uniformed Victim Advocate

0

# Other

0

# Restricted Reports where SAFEs were conducted

0

# Restricted Reports where SAFE kits or other needed supplies were not available at time of victim's exam

0

# Cadets/Midshipmen/Prep School Student making a RR that received service referrals for an incident that occurred prior to
military service

0
APY10-11
TOTALS

C. APY10-11 MILITARY PROTECTIVE ORDERS (MPO)*

# Military Protective Orders issued due to an APY10-11 Unrestricted Report of Sexual Assault
# Reported MPO Violations in APY10-11 Completed Investigations
# Reported MPO Violations by Subjects
# Reported MPO Violations by Victims of Sexual Assault
# Reported MPO Violations by Both
*In accordance with DoD Policy, Military Protective Orders are only issued in Unrestricted Reports. A Restricted Report cannot be made
when there is a safety risk to the victim.

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File Typeapplication/pdf
AuthorMarquietta Davis
File Modified2011-09-19
File Created2011-09-19

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