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Campus Security Authority Report Form

Complete this form if a crime was reported to you, if more than one crime was reported to you, fill out one of these forms for each crime reported. If you experience any difficulties with this form please fill out a hard copy of the reporting form and forward it to the Clery Compliance Office (clery@radford.edu or P.O. Box 6883).

Last Name

First Name

Department

Contact E-mail Address

Contact Phone Number

Date Incident Occurred

Date Incident Occurred
	Month	Day	Year



Enter the date the incident occurred:	Month - Enter the date the incident occurred:	Day - Enter the date the incident occurred:	Year - Enter the date the incident occurred:

Location of Incident (building name or address)

Brief Decrisption of Incident

SEX OFFENSES

Rape
Penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim. This definition includes any gender of victim or perpetrator.
Fondling
The touching of the private body parts of another person for the purpose of sexual gratification, forcibly and/or against that person’s will; or, not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental incapacity.
Incest
Non-forcible sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law.
Statutory Rape
Non-forcible sexual intercourse with a person who is under the statutory age of consent.

HATE CRIMES

If a hate crime occurs where there is an incident involving intimidation, vandalism, larceny, simple assault or other bodily injury, the law requires that the statistic be reported as a hate crime even though there is no requirement to report the crime classification in any other area of the compliance document.

A hate or bias related crime is not a separate, distinct crime, but is the commission of a criminal offense which was motivated by the offender's bias. For example, a subject assaults a victim, which is a crime. If the facts of the case indicate that the offender was motivated to commit the offense because of his bias against the victim's race, sexual orientation, etc. the assault is then also classified as a hate/bias crime.

Larceny
The unlawful taking, carrying, leading, or riding away of property from the possession or constructive possession of another.
Vandalism
To willfully or maliciously destroy, injure, disfigure, or deface any public or private property, real or personal, without the consent of the owner or person having custody or control by cutting, tearing, breaking, marking, painting, drawing, covering with filth, or any other such means as may be specified by local law.
Intimidation
To unlawfully place another person in reasonable fear of bodily harm through the use of threatening words and/or other conduct, but without displaying a weapon or subjecting the victim to actual physical attack.
Simple Assault
An unlawful physical attack by one person upon another where neither the offender displays a weapon, nor the victim suffers obvious severe or aggravated bodily injury involving apparent broken bones, loss of teeth, possible internal injury, severe laceration or loss of consciousness.

TYPE OF BIAS

If a hate (bias) related crime was reported to you, please complete the following information about the type of bias involved in the crime.