James Madison University Campus Security Authority
Crime Report Form
* Required
Section C: Is this a Secondary Report?
*Secondary Reporting Agency(s) the incident has also been reported to for documentation
The Office of Student Accountability and Restorative Justice, Title IX, and the Office of Residence
Life supply documentation of all Clery crimes reported to them. If a report has been made to them
please indicate as these crimes have been documented and been forwarded.
o
JMU Office of Student Accountability and Restorative Justice
o
Title IX
o
Office of Residence Life
o
None
o
Other:
Case Number
If Known
Law Enforcement Agency(s) The Incident Has Also Been Reported To:
o
James Madison University Police Department
o
Harrisonburg Police Department
o
Rockingham County Sheriff's Office
o
Virginia State Police
o
Virginia Department Of Alcohol Beverage Control
o
Other:
Case Number
If Known
The Campus Security Report Form
Campus Security Authorities (CSA’s) shall report, on a timely basis, any Clery Act qualifying
crimes occurring on Clery geography that they are made aware of to the James Madison
University Police Department. University Police will use the submitted information to verify the
appropriate classification of the crime. It is important for CSA’s to document sufficient incident
detail to allow University Police to properly classify the crime type.
Section D: When did it happen?
Date Crime Reported to CSA
Crime Occurrence Date
If Single Date
Crime Occurrence over a Period of Time
First Occurrence
Last Occurrence
Section D: Crime Occurrence Location
Crime Occurrence Location
Please provide building name, address, street name with cross streets or close address, or
nearby buildings if it occurred outside. Consult Clery Reportable Geography and Clery map as
necessary
Location Classification
o
On-Campus
o
On-Campus Residence Halls
o
Non-Campus (University Leased Or Controlled Off-Campus Property))
o
Public Property (Within Or Immediately Adjacent To On-Campus Property)
o
Off-Campus
Section E: Reported Crime
Check The Box That Best Indicates The Crime You Are Reporting. As Needed, Please
Refer To Clery Reportable Crimes For Crime Definitions.
o
Murder
o
Manslaughter
o
Robbery
o
Burglary
o
Motor Vehicle Theft
o
Aggravated Assault
o
Sex Offense (Rape or Fondling)
o
Sex Offense (Incest or Statutory rape)
o
Arson
o
Dating Violence
o
Domestic Violence
o
Stalking
o
Other:
The following crimes need only be reported if the victim(s) of the reported crime was/were
targeted specifically because of bias/prejudice against the victim.
o
Simple Assault
o
Larceny
o
Intimidation
o
Vandalism
o
Any other crime involving Bodily Injury
Number of Crime Victims
Please provide a brief description of the reported crime (what happened) to help us
classify it.
Section F: Hate Crime Reporting
Was the crime reported in Section E motivated by bias (was the victim specifically targeted
because of prejudice i.e. a Hate Crime)?
Hate Crime
o
Yes
o
No
Section G: Referrals
Certain student and employee violations referred to the Office of Student Accountability and
Restorative Justice, Human Resources, Office of Residence Life etc. must be reported. These
reportable law violations include:
o
Liquor Law Violation
o
Drug Law Violation
o
Weapon Law Violation
If A Liquor, Drug, or Weapon Law Violation Referral Is Reported, the Corresponding
Number of Persons Referred Must Be Entered
Case Number
If Known