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, Sex Offenses, Dating Violence, Domestic Violence, Stalking, Weapon Law violations, Drug Abuse violations and Liquor Law violations. 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