USSF Supplemental Report

U.S. Soccer Federation Referee Program Supplemental Referee Report
Complete and submit this form as directed for the dismissal of team officials, sending-off offenses, serious injuries, game abandonment or other substantial occurrences. For instances of referee assault or referee abuse. CRO will submit this confirm this report is written correctly and send to the appropriate league office.
Home Team*
Away Team*
Association / League*
Example: NPL, ECNL, Etc...
Division / Age Group*
Example: U13, U14..Adult Coed, Adult O35
Game Number*
If the league match report has a specific game number us that. otherwise use the Arbiter or the specific assigning platform game number
Game Date*

MonthDayYear
Date of the game
Score*
Score*
Referee Name*
Supplemental Report Write Up*
Include all relevant information
Date*

MonthDayYear
Date of report filed
USSF ID Number*
Referee Phone Number*
Referee Email Address*
example@example.com
Match Report Picture

Cancelof
Should be Empty: