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Use to provide a status of the civil affairs and civilian-military cooperation and relations situation. Reference: FM 41-10.

LINE 1 -- DATE AND TIME______________________________(DTG)

LINE 2 -- UNIT________________________________________(Unit Making Report)

LINE 3 -- LIAISON_____________________________________(Establishment of and Changes in Liaison Arrangements Between Civil and Military)

LINE 4 -- CONTROL___________________________________(Establishment and Changes in Location, Status, Activity of Control Nodes and in the CMO AO)

LINE 5 -- AREA OF OPERATIONS________________________(CMO AO Name)

LINE 6 -- US CIVILIANS________________________________(Total Number of US Civilians in AO)

LINE 7 -- THIRD COUNTRY_____________________________(Total Number of Third Country Civilians in AO)

LINE 8 -- FOREIGN NATION____________________________(Total Number of Foreign Nation Civilians in AO)

LINE 9 -- TOTAL CIVILIAN POPULATION_________________(Total Civilian Population in the AO)

LINE 10 -- MALES UNDER 16____________________________(Total Number of Dislocated Males Under 16 Years of Age)

LINE 11 -- UNACCOMPANIED MALES UNDER 16__________(Total Number of Dislocated Unaccompanied Males Under 16 Years of Age)

LINE 12 -- MALES OVER 60_____________________________(Total Number of Dislocated Males Over 60 Years of Age)

LINE 13 -- MARRIED MALES____________________________(Total Number of Dislocated Married Males)

LINE 14 -- SINGLE MALES______________________________(Total Number of Dislocated Single Males)

LINE 15 -- FEMALES UNDER 16 _________________________(Total Number of Dislocated Females Under 16 Years of Age)

LINE 16 -- UNACCOMPANIED FEMALES UNDER 16________(Total Number of Dislocated Unaccompanied Females Under 16 Years of Age)

LINE 17 -- FEMALES OVER 60___________________________(Total Number of Females Over 60 Years of Age)

LINE 18 -- MARRIED FEMALES__________________________(Total Number of Dislocated Married Females)

LINE 19 -- SINGLE FEMALES____________________________(Total Number of Dislocated Single Females)

LINE 20 -- DISLOCATED MALES_________________________(Total Number of Dislocated Males in AO)

LINE 21 -- DISLOCATED FEMALES ______________________(Total Number of Dislocated Females in AO)

LINE 22 -- TOTAL MALES AND FEMALES_________________(Total Number of Dislocated Males And Females in AO)

LINE 23 -- CONTROLLED_______________________________(Total Number of Dislocated Civilians in Controlled Movement)

LINE 24 -- UNCONTROLLED____________________________(Total Number of Dislocated Civilians in Uncontrolled Movement)

LINE 25 -- MANPOWER_________________________________(Changes in Civilian Manpower Indicate Changes/Shortages in Labor Availability)

LINE 26 -- PUBLIC ADMINISTRATION____________________(Changes in Capability to Continue Essential Functions)

LINE 27 -- LEGAL______________________________________(Changes in Status of Legal Accommodations and Accords)

LINE 28 -- INTELLIGENCE______________________________(Changes in Civilian Attitude; Identification of Collaborators, Agents, and Dissident Elements; Espionage, Sabotage, and Political Subversion)

LINE 29 -- LAW AND ORDER____________________________(Changes in Civilian Law and Order)

LINE 30 -- PUBLIC HEALTH_____________________________(Changes in Status of Public Health)

LINE 31 -- SUPPLY_____________________________________(Changes in Status of Civilian Supplies)

LINE 32 -- TRANSPORTATION___________________________(Changes in Status of the Civil Transportation System)

LINE 33 -- DRINKING WATER___________________________(Water Potability Status; Potable, Local Only; Nonpotable; to US Standards, as Applicable)

LINE 34 -- WATER PRODUCTION________________________(Adequacy of the Water Production Capability; Adequate, Not Adequate, or None, as Applicable)

LINE 35 -- SEWAGE TREATMENT________________________(Status of Sewage Treatment; Adequate, Not Adequate, or None, as Applicable)

LINE 36 -- REFUSE_____________________________________(Status of Refuse Collection Adequate, Not Adequate, or None as Applicable)

LINE 37 -- RADIO______________________________________(Status of the Radio Capability Using OPERATIONAL, NONOPERATIONAL, or UNKNOWN)

LINE 38 -- TELEVISION_________________________________(Status of the Television Capability Using OPERATIONAL,

LINE 39 -- NEWSPAPER________________________________(Status of the Newspaper Capability Using OPERATIONAL,

LINE 40 -- POSTAL_____________________________________(Status of the Postal Capability Using OPERATIONAL, NONOPERATIONAL, or UNKNOWN)

LINE 41 -- TELEPHONE_________________________________(Status of the Telephone Capability Using OPERATIONAL,

LINE 42 -- TELEGRAPH_________________________________(Status of the Telegraph Capability Using OPERATIONAL,

LINE 43 -- TELETYPE___________________________________(Status of the Teletype Capability Using OPERATIONAL,

LINE 44 -- ELECTRIC NAVIGATION SYSTEM______________(Status of the Electric Navigation System Using OPERATIONAL, NONOPERATIONAL, or UNKNOWN)

LINE 45 -- WORD OF MOUTH___________________________(Status of Word of Mouth Communications Using OPERATIONAL, NONOPERATIONAL, or UNKNOWN)

LINE 46 -- CIVIL DEFENSE______________________________(Civil Defense Incidents Affecting Civilian Community, Critical Events, and Assistance Provided US Forces)

LINE 47 -- SHORTAGES_________________________________(Changes or Shortages Community (Water Shortages, Quarantines, Road Restrictions, Curfews))

LINE 48 -- SUPPORT RECEIVED__________________________(Changes in Support Received From Civilian Community)

LINE 49 -- PSYOP______________________________________(Changes in Enemy PSYOP Actions Targeted at Civilian Community)

LINE 50 -- PROTECTED PROPERTY_______________________(Changes in Status of Arts, Monuments, and Archives)

LINE 51 -- CULTURE___________________________________(Changes in Local Civil, Social, Cultural, Religious, and Ethnic Characteristics)

LINE 52 -- RECOMMENDATIONS________________________(Narrative Summary and Recommendations Concerning the Status of Civil-Military Operations Activities)

LINE 53 -- NARRATIVE_________________________________(Free Text for Information Required Clarification of Report)

LINE 54 -- AUTHENTICATION___________________________(Report Authentication)