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Use to provide notification of a Subversion and Espionage Directed Against the Army (SAEDA) incident. Reference: FM 34-60 and AR 310-50.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — INCIDENT TIME_______________________________(DTG of Incident)

LINE 4 — LOCATION___________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator)

LINE 5 — PERSONNEL__________________________________(Personnel Involved)

a. WITNESSES___________________________________

b. SOURCES_____________________________________

c. SUSPECTS ____________________________________

LINE 6 — ACTIONS ____________________________________(Actions Taken by Personnel and Unit Involved)

LINE 7 — POINT OF CONTACT__________________________(Unit POC and Contact Information)

LINE 8 — NARRATIVE__________________________________(Free Text for Additional Information Required for Clarification of Report)

LINE 9 — AUTHENTICATION____________________________(Report Authentication)