Report Form for Campus Security Authorities

Instructions

Complete the form to the best of your ability. If necessary, reference the crime definitions on the Campus Security Authority Information page. Keep the person reporting the crime anonymous, but encourage him or her to contact the TUPD. Note that referring the person to the TUPD does not satisfy your reporting requirements; you must still complete the form below. Secondhand reports of crime should also be submitted.

After completing the form, you should also report the crime to the Office of Student Accountability and Restorative Practices or the Office of Human Resources as appropriate.

Any questions concerning the form or the Clery Act should be directed to the TUPD’s Clery Coordinator at 410-704-3381.

Incident Details

Reporting Person Campus Security Authority

Phone

Incident

Reference crime definitions if necessary.

Please select... Murder/Non-Negligent Manslaughter Negligent Manslaughter Domestic Violence Dating Violence Sexual Assault I and II Stalking Robbery Aggravated Assault Burglary Motor Vehicle Theft Arson Weapon Law Violation Drug Abuse Violations Liquor Law Violation Hate Crime

Date

Name of victim or witness

Enter "Refused" if the person reporting the crime would like to remain anonymous.

Brief description of the incident:

Date & time incident occurred:

Did the crime occur in a building or on the street? Specify Location, such as: Tower A 2nd Floor or University Avenue or Lot 6

Building

Street

Did the crime occur on TU owned, controlled or leased property?

YesNo

Did the crime occur at a TU sponsored activity or event?

YesNo

 

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