Campus Security Authority Incident Report

This form is to be used by identified campus security authorities who are under the Federal Clery Act to report information they receive about crimes. The information collected from these forms will be used to compiled statistics to be included in the campus Annual Security Report.

No information should be included on this form that would personally identify the student or other individuals involved in the incident.

Please complete as much information as you know, University Police will use the information submitted to determine the appropriate category for the incident in the Annual Security Report.

(If known)
Type of Bias
Only select up to 4.
Classification (Crime Criteria)
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