Prevention and Response to Sexual Exploitation & Abuse in Liberia
Prevention and Response to Sexual Exploitation & Abuse in Liberia
Prevention and Response to Sexual Exploitation & Abuse in Liberia
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4.13 SEA Report<strong>in</strong>g Template<br />
1. Date of report:<br />
2. Date of violation (date on which the violation allegedly <strong>to</strong>ok place):<br />
3. Location where violation allegedly <strong>to</strong>ok place:<br />
4. Name, title <strong>and</strong> office of compla<strong>in</strong>ant:<br />
5. Relationship of compla<strong>in</strong>ant <strong>to</strong> victim:<br />
6. Contact details of compla<strong>in</strong>ant (office/mobile phone #, e-mail address, etc.):<br />
7. Name, title <strong>and</strong> office of person tak<strong>in</strong>g the compla<strong>in</strong>t:<br />
8. Mission/Agency reference number (erg.001/06/NAME OF Mission/Agency):<br />
9. Violation reported: <strong>Sexual</strong> exploitation <strong>and</strong> abuse (SEA)<br />
Specific allegation reported:<br />
⎕ Sex with a m<strong>in</strong>or (under age 18)<br />
⎕ Rape<br />
⎕ Attempted rape<br />
⎕ <strong>Sexual</strong> assault<br />
⎕ Attempted sexual assault<br />
⎕ Prostitution<br />
⎕ Solicit<strong>in</strong>g for prostitution<br />
⎕ Exchang<strong>in</strong>g sex for work<br />
⎕ Exchang<strong>in</strong>g sex for food<br />
⎕ Exchang<strong>in</strong>g sex for other favors, services or benefits<br />
⎕ Withhold<strong>in</strong>g assistance due <strong>to</strong> a beneficiary on basis or sexual or exploitative relationship.<br />
⎕ Traffick<strong>in</strong>g <strong>in</strong> children <strong>and</strong>/or women for sexual exploitation or abuse*<br />
⎕ Suspicions/rumors/<strong>in</strong>-the-air allegations<br />
⎕ Other: please specify: ___________________<br />
10. Name, title <strong>and</strong> office of person(s) allegedly committ<strong>in</strong>g violation:<br />
11. Contact details of person(s) allegedly committ<strong>in</strong>g violation (office/mobile phone #, e-mail address,<br />
etc.):<br />
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