Campus Security Authority Crime Reporting Form

CSA Reporting

This form is for use by Campus Security Authorities to make reports directly to the Boise State University Department of Public Safety. If you are aware of any crimes that have occurred, it is important that you fill out the form below as completely, promptly, and accurately as you can. If you had a crime(s) reported to you or that you are aware of, please fill out the form below for each crime. Please only use one form per crime report. If you need to report multiple crimes, use separate forms for each crime report.

When filling out the form, provide a brief description of the incident and exact location of where it occurred so that it can appropriately classified in accordance with the crime definitions published by the Federal Bureau of Investigations Uniform Crime Reporting Program. For more information regarding the definitions of crimes and locations required to be reported, please visit our website: http://security.boisestate.edu/csa/clery-crime-definitions.

In addition, if a serious crime that may cause an ongoing threat to the Boise State community is reported to anyone who is defined as a Campus Security Authority, that individual should not wait until the end of the year to report that incident to the Boise State University Department of Public Safety. The institution has a responsibility to notify the campus community about any crimes which pose an ongoing threat to the community, and as such, Campus Security Authorities are obligated by law to report crimes immediately to the Boise State University Department of Public Safety. If there is any question about whether an ongoing threat exists, immediately contact the Boise State Department of Public Safety by calling (208) 426-6911.

***For Annual Clery Reporting, please visit the CSA Training page to complete the annual training and certification: https://www.boisestate.edu/publicsafety-security/campus-security-authorities/clery-act-and-crime-reporting-training/csa-annual-training/

If you are completing the new employee training course, you do not need to complete a form, just bookmark this page for future use!

Campus Security Authority Name(Required)

First Last

Campus Security Authority Phone Number(Required)

Campus Security Authority Email Address(Required)

Incident Details

Date the incident was reported to you(Required)

YYYY

Date the incident occurred (approx)(Required)

YYYY

Time the incident occurred(Required)

AM/PM

Please write a description of the crime(Required)

Victim Information (Name, etc.)(Required)

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(Required)

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

What best describes the location of the crime?(Required)

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.(Required)

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

Victim/Suspect relationship

Partner

Ex-Partner

Spouse

Ex-Spouse

Family Member

Other

Is there evidence that this crime was motivated by bias?(Required)

Yes

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?(Required)

Yes

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

Supporting Documentation

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.

Drop files here or

Max. file size: 12 MB.

Clery Crime Definitions

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