Campus Security Authority Reporting Form
For Internal Reporting Use Only
If this is an emergency or there is an ongoing crime, contact University Police at 562-985-4101 or dial 9-1-1
One important purpose of the Clery Act is to encourage the accurate collection of campus crime statistics in order to promote and enhance campus crime awareness and campus safety through reliable statistical crime reporting. The purpose of this report form is to provide Campus Security Authorities (CSAs) with a uniform mechanism for documenting the (who, what, when, where) of crimes reported to them, especially, confidential reporting.
When anonymity is requested by the victim, do not include personal identifying information. The student status of the offender or victim is not a relevant fact when determining if a report should be submitted under Clery. All reports involving any of the listed crimes must be documented and reported to the University Police Department. Use a separate report form for every individual Clery reportable incident.
If you have questions, please visit the CSULB Clery webpage or contact the Clery Director at OEC@csulb.edu or 562-985-8256.