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.
Please provide your name (if victim)-or-relationship to victim (if third party):
Description of the Incident or Crime:
Location of the Incident/Crime:
Identify building name, address, etc. Be as specific as possible
Examples of sex offenses are rape, sodomy, sexual assault with an object, fondling, incest, and statutory rape.
Hate crime information is required to be reported for each of the following crimes: criminal homicide, sex offense, robbery, aggravated assault, burglary, motor vehicle, theft, arson, simple assault, larceny, vandalism, intimidation, national origin, and gender identity. And for any other crime involving bodily injury.
If yes, provide a brief explanation of the determination.If no, enter "NA."