Enclosure (3) to COMDTINST 1750.7C
Terms and Instructions For
Completing CG-Form 5488
Family Advocacy Report
1. Case Number: FY--, #1, etc.
2. Reporting FAS: Typed name of the FAS reporting to the Central Registry.
3. Date of Alleged Family Violence/Neglect: The month, day and year the case was reported to the
FAS.
4. Twelve Week Determination Date: The month, day and year the final case status determination
is due. This date is 12 weeks from the date of the allegation.
5. Name of Unit: Name of the unit the involved member is attached.
6. Date CG Central Registry Checked: The month, day and year the FAS called the FAPM to have
the Central Registry checked for past history of abuse/neglect.
7. Source of Initial Referral: Initial source who reported the allegation. The source can be
Military, Civilian, or Non-Affiliated.
8. Type of Allegation: Indicate if the allegation is child abuse, child neglect, parent abuse, spouse
abuse, cohabitating partner abuse, sibling abuse, elder abuse or elder neglect.
9. Notification Forwarded to Child Protective Services (CPS): Indicate whether or not a report was
made to CPS and provide the name of the CPS Agency and date of notification.
10. Type of Report to Registry: Indicate type of report.
a. Initial: This is the first report made to Commandant (CG-1112) that
allegations have been made. No identifying data will be included. All other information will
be entered. Initial reports of allegations are made only to Commandant (CG-1112) to
statistically track the number of reports per fiscal year Coast Guard-wide.
b. Extension Request: If the final case status determination will not be made in the 12 week
period, the FAS will send in a second Form 5488 requesting an extension. Block # 19 must
contain the written explanation for why the extension is necessary.
c. Final Case Status Determination: This is the final report to Commandant
(CG-1112) specifying whether the allegations are substantiated or unsubstantiated. If the
allegations are substantiated, all identifying information must be contained in the report. If
the allegations are unsubstantiated, no identifying data will be included.
11. Case Status: The status of the case at the time of the report to the CG Family Advocacy Central
Registry. A case can be Suspected, Substantiated or Unsubstantiated.
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