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COMMONWEALTH OF PENNSYLVANIA
SEXUAL MISCONDUCT/ABUSE DISCLOSURE RELEASE
(Pursuant to Act 168 of 2014)
Instructions
This standardized form has been developed by the Pennsylvania Department of Education,
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How to fill out sexual misconductabuse disclosure information
How to fill out sexual misconductabuse disclosure information
01
Start by opening the sexual misconduct/abuse disclosure form
02
Read the instructions carefully to understand the purpose and requirements of the form
03
Provide your personal information, such as your name, contact details, and any other identifying information required
04
Clearly state the details of the sexual misconduct/abuse incident, including the date, time, location, and any witnesses present
05
Describe the nature of the misconduct/abuse in detail, providing specific examples or incidents
06
Include any supporting evidence or documentation, such as photographs, messages, or medical reports if available
07
If there were multiple incidents or perpetrators, provide separate sections for each incident or individual involved
08
Sign and date the disclosure form to affirm the accuracy of the information provided
09
Submit the completed form to the designated recipient or follow the instructions for submission outlined in the form
10
Keep a copy of the filled-out form for your records
Who needs sexual misconductabuse disclosure information?
01
Sexual misconduct/abuse disclosure information may be needed by various entities or individuals, including:
02
- Law enforcement agencies investigating the incident
03
- Legal authorities such as lawyers, prosecutors, or courts involved in legal proceedings
04
- Organizational or institutional bodies responsible for addressing and investigating misconduct/abuse allegations
05
- Support services or counseling organizations that offer assistance to survivors of sexual misconduct/abuse
06
- Educational institutions or employers that have a duty to investigate and address such incidents
07
- Individuals seeking documentation or evidence of the misconduct/abuse for personal or legal purposes
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What is sexual misconduct/abuse disclosure information?
Sexual misconduct/abuse disclosure information is information related to incidents of sexual misconduct or abuse that are reported by individuals or organizations.
Who is required to file sexual misconduct/abuse disclosure information?
Certain individuals or organizations, as mandated by law or regulations, are required to file sexual misconduct/abuse disclosure information.
How to fill out sexual misconduct/abuse disclosure information?
Sexual misconduct/abuse disclosure information can be filled out online through a designated portal or submitted in person to the relevant authorities.
What is the purpose of sexual misconduct/abuse disclosure information?
The purpose of sexual misconduct/abuse disclosure information is to track and monitor incidents of sexual misconduct or abuse, and to ensure accountability and transparency.
What information must be reported on sexual misconduct/abuse disclosure information?
Information such as the nature of the incident, the individuals involved, and any actions taken in response to the incident must be reported on sexual misconduct/abuse disclosure information.
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