This form should be completed by individuals identified as “Campus Security Authorities” who are required to report information they receive about specified crimes pursuant to the Jeanne Clery Act of 1990. These crimes include: Murder, Negligent Manslaughter, Aggravated Assault, Robbery, Auto Theft, Arson, Burglary, Hazing, Sex Offenses, Dating Violence, Domestic Violence, Stalking, Weapon Law violations, Drug Abuse violations, and Liquor Law violations.

It is very important that CSAs report crime on a timely basis, as a reported crime may warrant a university-issued Timely Warning to the university community. 

The information collected from these forms will be used to compile crime statistics for reporting in the IUP Annual Security and Fire Safety Report. 

Person Completing Report
Date
Report made by
Date and time the incident/crime occurred
Identify building name, address, etc. Be as specific as possible
The location where this incident occurred was
Incident Category*
Select all that apply.
*Incident descriptions

Homicide/murder

Non-negligent or negligent manslaughter (including vehicular manslaughter).

Aggravated Assault

Unlawful attack upon another with intent to inflict severe injury or great bodily harm.

Sex Offense

Rape, fondling, statutory rape or incest

Burglary

Unlawful entry into a structure to commit a felony or theft.

Robbery

Taking or attempting to take something by force, violence, threat or by putting the victim in a state of fear.

Motor Vehicle Theft

Theft of automobiles, motorcycles, etc., including "joyriding" (taking by a person without lawful access).

Arson

Willful or malicious burning/attempt to burn a structure, vehicle, or personal property of another.

Hate Crime

A crime reported to local police agencies or to a CSA that manifests evidence that the victim was intentionally selected because of the perpetrator's bias against the victim. For the purposes of this section, the categories of bias include the victim's actual or perceived race, religion, gender, gender identity, sexual orientation, ethnicity, national origin and disability.

For Clery Act purposes, hate crimes include any of the following offenses that are motivated by bias: murder and non-negligent manslaughter, manslaughter by negligence, sex offenses (rape, fondling, incest and statutory rape), robbery, aggravated assault, burglary, motor vehicle theft, arson, larceny-theft, simple assault, intimidation, or destruction/damage/vandalism of property.

Dating Violence

Violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim.

Domestic Violence

Domestic violence is violence committed by a current or former spouse; intimate partner of the victim; person with whom the victim shares a child in common; current or former cohabitant who lived as a spouse or intimate partner with the victim; a person who, by law, is similarly situated to a spouse of the victim; or any other person against an adult or child victim who is protected from that person's acts under the domestic or family violence laws in the jurisdiction where the crime of violence occurred.

Stalking

Engaging in a course of conduct directed at a specific person that would cause a reasonable person to fear for their safety or the safety of others, or suffer substantial emotional distress.

Liquor

Underage possession or consumption, or distribution to minors.

Drug Use

Possession or distribution of controlled substances or possession of drug paraphernalia.

Weapon Law

Possession or use of an illegal weapon

Hazing

Hazing is any activity expected of someone joining or participating in a group that humiliates, degrades, abuses, or endangers them, regardless of a person's willingness to participate.

There are three components that define hazing:

  • It occurs in a group context
  • Humiliating, degrading, or endangering behavior
  • Happens regardless of an individual's willingness to participate
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