Form DD Form 2985 DD Form 2985 DoD Sexual Assault Prevention and Response Office (SAPRO

Per General Records Schedule DAA-0330-2016-0005, resolved case files are to be
cut off at the end of the calendar year and destroyed 25 year(s) after cut off.

(Updated 20241101)

DEPARTMENT OF DEFENSE
SEXUAL ASSAULT PREVENTION AND RESPONSE OFFICE (SAPRO)
REQUEST FOR SAPRO'S ASSISTANCE

OMB No. 0704-0565
OMB approval expires
December 31, 2025

The public reporting burden for this collection of information, 0704-0567, is estimated to average 30 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number. Return form to
Department of Defense, Sexual Assault Prevention and Response Office,
4800 Mark Center Drive, Suite 07G21, Alexandria, VA 22350-8000
or by email at whs.mc-alex.wso.mbx.SAPRO@mail.mil.

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 1561 note, Improved Sexual Assault Prevention and Response in the Armed Forces; DoD Directive 6495.01, Sexual Assault
Prevention and Response (SAPR) Program; DoD Instruction 6495.02, Sexual Assault Prevention and Response (SAPR) Program Procedures.
PRINCIPAL PURPOSE(S): To track victim-related inquiries received by the Sexual Assault Prevention and Response Office (SAPRO) via e-mail,
SAPR.mil, the DoD Safe Helpline, phone, or postal service. Once received, inquiries are referred to the appropriate agency POC and/or to the DoD IG
in order to address the issue(s) raised and facilitate a resolution. This form does not constitute a report of a sexual assault.
ROUTINE USE(S): Disclosure of records are generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended. Applicable Blanket
Routine Use(s) are: Law Enforcement Routine Use, Congressional Inquiries Disclosure Routine Use, Disclosure to the Department of Justice for
Litigation Routine Use, Disclosure of Information to the National Archives and Records Administration Routine Use, and Data Breach Remediation
Routine Use. Additional routine uses may be found in the applicable System of Records Notice, DHRA 18, DoD Sexual Assault Prevention and
Response Office Victim Assistance Data System at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/OSDJS-Article-List/
DISCLOSURE: The completion of this form is voluntary. However, failure to provide information may result in the inability to provide requested
services.

SECTION I - SAPRO INTAKE
(For Internal SAPRO use only)

2. WOULD YOU LIKE DOD SAPRO TO FOLLOW UP WITH YOU?

1. DATE (YYYYMMDD)

Yes

No

3. NAME (Last, First, Middle Initial)

4. RELATIONSHIP TO VICTIM/SURVIVOR

5. PREFER FOLLOW-UP BY:

EMAIL

TELEPHONE

a. E-MAIL ADDRESS

EITHER

b. TELEPHONE NUMBER (Include Area Code)

c. OK to leave message?
Yes

No

d. BEST TIME TO FOLLOW UP:
N/A

During working hours

After working hours

6. VICTIM / SURVIVOR INFORMATION:
a. NAME (if different from above)

Between

and

EST

N/A

FIRST:

LAST:
c. SERVICE STATUS

b. SERVICE AFFILIATION

d. RANK

Air Force

Air National Guard

Active Duty

Reserve

Army

Army National Guard

Retired

Dependent

Marine Corps

Navy

Other:

N/A

Discharged

7. INCIDENT INFORMATION
a. DATE OF INCIDENT b. WAS IT REPORTED TO MILITARY PERSONNEL AND CIVILIAN LAW ENFORCEMENT?

c. YEAR REPORTED

(YYYYMMDD)

Yes

No

8. INQUIRY RELATED TO PROVIDING INFORMATION ABOUT:
a. CATEGORY (You may choose more than one.)
General Complaint

Feedback of SAPR Personnel

General Information Request

Raising a Policy Issue

Regarding Retaliation

Request for Referral to Service

Report of Sexual Assault

Regarding Misconduct

Prevention

DD FORM 2985, FEB 2018

PREVIOUS EDITION IS OBSOLETE.

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Per General Records Schedule DAA-0330-2016-0005, resolved case files are to be
cut off at the end of the calendar year and destroyed 25 year(s) after cut off.

(Updated 20241101)

b. COMMENTS

9. DO YOU GIVE SAPRO PERMISSION TO FORWARD THIS FORM TO THE APPROPRIATE SERVICE OR AGENCY FOR
FURTHER ACTION IF DEEMED NECESSARY?
Yes

No

I would like to talk to someone first.

SECTION II - RESPONSE
(For Internal SAPRO use only)

10. NAME OF STAFF RESPONDING TO INQUIRY

11. HOW WAS INQUIRY RECEIVED?
Safe Helpline

Telephone Call

SAPRO Website

Email

Letter

Other:

12. SUMMARY OF INQUIRY

13. a. INQUIRY REFERRED TO: (Agency and POC)

b. DATE (YYYYMMDD)

14. AGENCY FEEDBACK

15. DATE ACTION CLOSED (YYYYMMDD)

DD FORM 2985, FEB 2018

PREVIOUS EDITION IS OBSOLETE.

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