DD Form 2873: Military Protection Order (MPO)

In 1a, enter the date the MPO was issued; in 1b, select one: Initial MPO or Modification to Existing MPO.

In g, enter the DOB (YYYYMMDD).

In m, provide the EAS (End of Active Service) date (YYYYMM).

In l, race and ethnicity, select all that apply: American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Middle Eastern or North African, Native Hawaiian or Pacific Islander, White.

For o-t, provide information of an acceptable form of government identification, to include: driver's license, state ID card, passport or naturalization number.

The social security number is required when the Service Member does not have other acceptable identification.

Omit any information from item 3 that could endanger the protected person, if known to the subject Service member in item 2.

In d-f, driver's license, state ID card, passport or naturalization number are acceptable forms of identification.

Provide information of current civil orders in a-d: Civil protection order issued (Date), Court, in County, State of.

Line b also has Property Settlement, line c has Custody and/or Visitation and line d has Restriction on Firearms Possession.

Section 5 is Information Supporting Issuance of Military Protection Order.

Avoid identifying anonymous sources and victim information that might endanger protected person, if known to the subject Service member.

Is this military protection order being issued for an allegation of one or more of the following reasons? If Yes, please indicate which. If No, use "Other" to indicate reason.

Check each applicable box that correlates with comments in item #5: Domestic Violence, Dating Violence, Sexual Assault, Stalking, Child Endangerment, Other.

Initial each applicable order and/or requirement.

a: The Service member is restrained from assaulting, threatening, abusing, harassing, following, interfering with, or stalking the protected person and/or the additional listed protected parties.

b: The Service member is restrained from initiating any contact or communication with the protected person either directly or through a third party.

In b, if the protected person initiates any contact with the Service member, the Service member must immediately notify me regarding the facts and circumstances surrounding such contact.

c: The Service member shall remain at all times and places at least the number of feet entered away from the protected person and additional protected person's family or household including, but not limited to, residences and workplaces.

For each additional protected person in c, enter NAME, DOB (Date of Birth) (YYYYMMDD), SEX and RACE AND ETHNICITY (Select All That Apply).

d: The Service member will vacate the military residence shared by the parties located at: e: Until further notified, the Service member will be provided temporary military quarters at:

f: The Service member has visitation or custody rights of the child or children named: g: The protected person has temporary exclusive custody of the child or children named:

h: The Service member will attend the following counseling:

i: The Service member will surrender his/her government weapons custody card at the time of issuance of this order. j: The Service member will dispose of his/her personal firearm(s) that are located or stored on the installation at the time of issuance of this order. k: The individual will comply with any applicable law requiring him or her to dispose of his or her privately owned firearms and ammunition and provide information that this order has been carried out.

l: Exceptions to this order will be granted only after an advance request is made to me and approved by me.

ENFORCEABILITY: Violation of this order shall constitute a violation of Article 90 of the Uniform Code of Military Justice.

Section 8, Commanding Officer's Signature: sign in a and enter the date in b (YYYYMMDD).

Section 9 is the Service Member's Signature, a-c.

STOP - Generate Subject Copy using the button at top left of Page 1 before obtaining Service Member signature. Utilize it before this form is digitally signed by the service member subject or provided to subject.

Acknowledge receipt of a copy of this order with such redactions as are appropriate and attest that you understand the terms and conditions it imposes.

Obtain subject signature via external CAC reader to prevent unauthorized disclosure of protected person information.

Enter the date in b (YYYYMMDD) and the TIME ORDER SERVED in c.

10. DATE OF REVIEW: Upon review, the order may be modified or terminated.

In Section 12, enter a. ORI (Originating Agency Identifier), b. NCIC# (National Crime Information Center) and c. DATE PLACED IN NCIC.

DD Form 2873 is the Military Protection Order, a commanding officer's order to a Service member prohibiting contact or communication with the protected person. The order informs the Service member and the protected person that the commanding officer is issuing an order to the member prohibiting contact or communication with the protected person or members of the protected person's family or household and directing that the member take specified actions that support, or are in furtherance of, the prohibition.

DURATION: This is a NON-EXPIRING ORDER. The terms of this order shall be effective until modified or rescinded in writing by me.

Distribution: Service member (Print Subject Copy), Protected person (custodial parent of protected child), Service member's local personnel file, and Installation Law Enforcement for entry in the National Crime Information Center (NCIC).