Campus Security Authority Crime Reporting Form

Campus Security Authority Name *

First Last

Campus Security Authority Phone Number *

Campus Security Authority Email Address *

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Date the incident was reported to you *

Date the incident occurred (approx) *

Time the incident occurred *

:

AM/PM

Please write a description of the crime *

Victim Information (Name, ID#, etc.) *

For tracking purposes and to avoid double counting incidents, please include a victim identifier such as their first, middle and last name, or their initials. This information will not be published in any campus safety alerts or crime statistics.

Location of Crime *

If known, provide specific occurrence location (building name, street address, etc.)

What best describes the location of the crime? *

On-campus, not in a residence hall
On-campus, residence hall
On-campus, fraternity/sorority housing
Public Property immediately adjacent to campus (sidewalks, streets, etc)
Off-campus in University owned or controlled space
Off-campus
Off-campus, not affiliated with Boise State and not adjacent to campus
Unknown location

If the crime occurred in multiple places, check all that apply

Category that best fits the description of the crime. *

If you are reporting a crime of violence or threat of violence, are the victim and the accused in a social relationship of a romantic or intimate nature or have they ever been (i.e. dating, seeing one another)?

Yes
No

Victim/Suspect relationship

Partner
Ex-Partner
Spouse
Ex-Spouse
Family Member
Other

Is there evidence that this crime was motivated by bias? *

Yes
No

Hate Crimes Only

Larceny
Vandalism
Intimidation
Simple Assault

Boise State University is also required to report statistics for hale (bias) related crimes by the type of bias as defined above for the following classifications: murder/non-negligent manslaughter, negligent manslaughter, sex offenses (forcible and non-forcible), robbery, aggravated assault, burglary, motor vehicle theft, arson, dating violence, domestic violence, and stalking (see definitions above) and larceny, vandalism, intimidation, and simple assault (see definitions below).

If you answered "Yes" to the above question, identify the potential category of prejudice (check all that apply):

Race
National Origin
Religion
Sexual Orientation
Ethnicity
Disability
Gender
Gender Identity

Please describe the evidence that this crime was motivated by bias.

Have you reported this incident to any other department or agency? *

Yes
No

If you have reported this incident to any other department or agency, please specify which one(s).

Supporting Documentation

Drop files here or

Max. file size: 12 MB.

Photos, video, email, and other supporting documents may be attached here by dragging and dropping them into the box above or by uploading them by clicking on the "Select Files" box.

Clery Crime Definitions

Campus Security Authority Crime Reporting Form

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Department of Public Safety