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Click ‘Get Form’ to open the DD Form 2910 in the editor.
Begin by entering your full name and Social Security Number in the designated fields at the top of the form.
Discuss your reporting options with a Sexual Assault Prevention and Response Victim Advocate (SAPR VA) or a Sexual Assault Response Coordinator (SARC). Initial next to your chosen option: Unrestricted Reporting or Restricted Reporting.
If you select Unrestricted Reporting, acknowledge that law enforcement will be notified. If you choose Restricted Reporting, understand that this will remain confidential unless exceptions apply.
Sign and date the form at the bottom, ensuring all information is accurate before submission.
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32 CFR 103.6 - Reporting options and sexual assault
the victim must file a Restricted Report by signing a DD Form 2910 before the SARC is informed of an ongoing independent investigation of the sexual assault.
DD Form 2910, Victim Reporting Preference Statement,
ACT STATEMENT VICTIM REPORTING PREFERENCE STATEMENT. I am a victim of sexual assault. reporting a sexual assault that occurred prior to or while. DD FORM 2910,
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