Domestic Abuse Victim Reporting Option Statement

The information collected will be used for purposes of filing an official report for a victim of domestic abuse. When a restricted report is filed, the victim is able to receive advocacy and counseling services without a report being made to command or law enforcement. In cases of an unrestricted report, command and law enforcement will be notified, and the victim is eligible to receive advocacy and counseling services from the Family Advocacy Program. The information collected for the form in unrestricted report cases may be used to initiate an investigation, and subsequently make an incident status determination following the Incident Determination Committee procedures and processes outlined in DoD Manual 6400.01, Volume 3. If an incident meets the definitions outlined in DoDM 6400.01, Volume 3, the incident is subject to entry into the Central Registry (DoDM 6400.01, Volume 2).

The latest form for Domestic Abuse Victim Reporting Option Statement expires 2026-07-31 and is listed under ICR 202302-0704-008.