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| Received Date |
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Domestic Violence Details
| Household Member |
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| Start Date |
| End Date |
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| Relationship To Offender |
Violence Description
Suspect Offender Details
If the suspect offender is a case participant, please select from below.
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If the suspect offender is not a case participant but is registered on the system, please select from below.
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If the suspect offender is not registered on the system, complete the suspect offender details below.
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