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Appendix B

Summary Data Component Data Collection Form

These forms and instructions and a glossary were sent to all States, the District of Columbia, the territories, and the Armed Services in the spring of 1996. Some items in the 1995 form have been renumbered in the data tables and the discussion throughout the report in order to facilitate comparisons with previous years. Item 11 in the data form is renumbered as item 14 in the data table; item 12 in the data form is renumbered as item 13; item 13 is renumbered as item 11; and item 14 is renumbered as item 12.

Cover Page

Notice to Respondents

Section I - General Information

Section II - Report Data

1. Number of Reports Alleging Maltreatment

2. Number of Children Who Were the Subject of a Report

3. Number of Reports by Source

Section 3 - Disposition Data

4. Number of Completed Investigation or Assessments by Disposition

5. Number of Children and Families Who Were The Subject of a Completed Investigation

6. Number of Children by Disposition

Section IV - Victim Data

7. Number of Victims by Maltreatment Type

8. Age of Victims

9. Sex of Victims

10. Race/Ethnicity of Victims

11. Number of Victims Who Died as a Result of Child Abuse or Neglect

12. Number of Victims and Families Receiving Additional Services

13. Number of Victims Removed From the Home

14. Number of Victims For Whom Court Action Was Initiated

Section V - Perpetrator Data