Form MA-2012 EMBARC Job Aids - Reporting Prohibited Behavior Aboard U

U.S. DEPARTMENT OF TRANSPORTATION
Maritime Administration

OMB # 2133-0553
Expiration: XX/XX/XXXX

Job A id - Reporting Prohibited Behavior Aboard U.S. Registered Vessel Carrying Cadets
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject
to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information
collection is 2133-0553. Public reporting for this collection of information is estimated to be approximately 6 hours per response, including the time for reviewing instructions, completing, and
reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Maritime Administration, MAR-390, 1200 New Jersey Avenue, SE, Washington, DC
20590.

Job Aid Step 1 of 2: IMMEDIATE REPORT

Timeframe: Immediate per EMBARC Standards (see instructions)
Section I – Reporting Vessel Information
1. Vessel Name

2. Vessel Official Number

3. Vessel Operator (DOC Holder)

4. Vessel Type

Section II – Reason for Submitting this Report
1. Date and Time of Alleged Prohibited Behavior Incident

2. Date and Time Vessel Operator was made Aware of
Alleged Incident

3. Type of Alleged Prohibited Behavior Incident (select
applicable option)

4. Date and Time USCG Notified

5. Geographic Position or Location of Vessel when Incident Occurred

6. Category of Personnel Involved (Cadet, Crew, Other). If applicable add names at bottom.
Complainant(s)
Respondent(s)

Witness(s)

7. Brief Description of alleged Prohibited Behavior

Section III – Person Making this Report
1.

Name (PRINT) (Last, First, Middle)

2.

Position/ Title

4.

Company/Organization

5.

Address

6.

Telephone No.

7.

Email

Proceed to Job Aid Step 2 of 2: FINAL REPORT
MA-2012 (07/2024)

3.

Date and Time

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General Instructions

• This Job Aid may be used to aid in meeting the reporting requirements of the United States Coast Guard, MARAD,
and the Maritime Academy reporting requirements for the cadets carried onboard. Applicable requirements should be
verified.
• Submitting this job aid does not alleviate the responsible entity of reporting to the United States Coast Guard in
accordance with 46 U.S.C. 10404.
• The use of this Job Aid is not required and should not delay the action of making an immediate report.
• Do not include Personally Identifiable Information (PII) on this job aid such as Date of Birth, SSN, etc.…

Immediate Report, Job Aid Step 1 of 2: Instructions

• An Immediate Report required per the EMBARC Standards must be made immediately after the responsible entity of a
vessel gains know ledge of a sexual assault or sexual harassment incident by the fastest telecommunication channel
available (email, phone, satellite phone, etc.) per EMBARC Standard III.8.a.
• Sect. II.3: Type of Alleged Prohibited Behavior Incident - List the type of alleged SASH involved behavior.
• Sect. II.6: Personnel include Cadet, Crew, Other.

Final Report, Proceed to Job Aid Step 2 of 2 for Instructions

-Blank-

Recordkeeping Recommendations

• The vessel operator should record and maintain the records of complaints and incidents of prohibited behavior by
shipboard personnel occurring anytime on board or ashore for a minimum of five years.
• The vessel operator should make the records required under this paragraph available to MARAD or the USCG upon
request, and to the appropriate SMA for complaints and incidents involving the SMA’s cadet(s).

United States Coast Guard

National Command Center (NMC)

Notifications can be made to the Coast Guard National Command Center at +1 (202) 372-2100, or;

Coast Guard Investigative Services (CGIS)

An attributed report through CG Tips—a web-based and mobile alternative to submit reports
about crimes witnessed or experienced aboard a vessel directly to a Coast Guard criminal
investigator. The CG Tips App can be downloaded from a mobile provider’s marketplace using the
following QR code: For more information about CGIS, or to submit a tip via the web, visit:
https://www.uscg.mil/Units/Coast-Guard-Investigative-Service/.
MA-2012 (07/2024)

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PAGE INTENTIONALLY
LEFT BLANK

MA-2012 (07/2024)

U.S. DEPARTMENT OF TRANSPORTATION
Maritime Administration

Job Aid - Reporting Prohibited Behavior Aboard U.S. Registered Vessel Carrying
and Training Cadets
Job Aid Step 2 of 2: FINAL REPORT
Section I – Reporting Vessel Information (Same as Section I, Job Aid 1 of 2)
1. Vessel Name

2. Vessel Official Number

3. Vessel Operator (DOC Holder)

4. Vessel Type

Section II – Reason for Submitting this Report (Same as Section II, Job Aid 1 of 2)
1. Date and Time of Alleged Prohibited Behavior Incident
2. Date and Time Vessel Operator was made Aware of
Alleged Incident
3. Type of Alleged Prohibited Behavior Incident (select
applicable option)

4. Date and Time USCG Notified

5. Geographic Position or Location of Vessel when Incident Occurred

6. Category of Personnel Involved (Cadet, Crew, Other), If applicable add name at bottom
Complainant(s)
Respondent(s)

Witness(s)

7. Brief Description of Alleged Prohibited Behavior

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MA-2012 (07/2024)

Final Report, Job Aid Step 2 of 2: Instructions
• If the incident involves a USMMA cadet, operators must provide a complete report of investigation to USMMA
when concluded. Vessel Operator policies must require that:
(1) thorough investigation of alleged violations of the SASH policy meets best practices for investigations of sexual
assaults and sexual harassments; and,
(2) interviews be conducted using trauma-informed interview methods. If the incident involves a SMA cadet, operators
should provide a complete report of investigation to the SMA when concluded.
• Reports containing PII should be submitted using encrypted means with passwords shared separately.
• The Final Report may be attached to this job aid for submission. Utilize page 1 of this Job Aid as a Cover Sheet.
• The vessel operator must protect the confidentiality of any complainant, witness, or respondent of a prohibited
behavior incident, and limit the distribution of the parties’ personal identifiable information (PII), as well as information
containing facts and circumstances of the incident, to only those with a need-to-know.
• Examples of those with a need-to-know include vessel owner and operator leadership, law enforcement, complaint/
incident investigators, MARAD, USMMA, and cognizant SMA representatives.
• The vessel operator must conduct comprehensive investigations of complaints and incidents of prohibited behavior, in
accordance with industry best practices including the use of a trauma informed approach such as outlined in the SOCP
Best Practices Guide (BPG) and notify the complainant of the outcome as detailed in EMBARC Standard III.8a.
• Reports should include detailed information to describe the actions taken by the responsible entity after becoming
aware of the prohibited behavior(s) incident, including the results of any investigation into the complaint or incident and
any action taken against the offending individual.
General Instructions

• This Job Aid may be used to aid in meeting the reporting requirements of the United States Coast Guard, MARAD, and

the Maritime Academy reporting requirements for the cadets carried on board. Applicable requirements should be
verified.
• Submitting this job aid does not alleviate the responsible entity of reporting to the United States Coast Guard in
accordance with 46 U.S.C. 10404.
• The use of this Job Aid is not required and should not delay the action of making an immediate report.
• Do not include Personally Identifiable Information (PII) on this job aid such as Date of Birth, SSN, etc.…
Recordkeeping Recommendations

• The vessel operator should record and maintain the records of complaints and incidents of prohibited behavior by
shipboard personnel occurring anytime on board or ashore for a minimum of five years.
• The vessel operator should make the records required under this paragraph available to MARAD or the USCG upon
request, and to the appropriate SMA for complaints and incidents involving the SMA’s cadet(s).
United States Coast Guard

National Command Center (NMC)

Notifications can be made to the Coast Guard National Command Center at +1 (202) 372-2100, or;

Coast Guard Investigative Services (CGIS)

An attributed report through CG Tips—a web-based and mobile alternative to submit reports
about crimes witnessed or experienced aboard a vessel directly to a Coast Guard criminal
investigator. The CG Tips App can be downloaded from a mobile provider’s marketplace using the
following QR code: For more information about CGIS, or to submit a tip via the web, visit:
https://www.uscg.mil/Units/Coast-Guard-Investigative-Service/.

2

MA-2012 (07/2024)