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Crime Incident Report Form
This form should be completed by those individuals identified as “campus security authorities”
who are required to report information they receive about specified crimes (described below)
pursuant to the federal Clery Act. The information collected from these forms will be used to
prepare a compilation of statistical crime information that will be included in the campus’ Annual
Security Report.
It is the policy of the SWOSU to ensure that victims and witnesses to crime are aware of their
right to report criminal acts to the police, and to report University policy violations to the
appropriate office (e.g., student conduct violations to the Office of Dean of Students). However,
if a reporting person requests anonymity, this request must be honored to the extent permitted by
law. Accordingly, no information should be included on this form that would personally identify
the victim without his/her consent.
SWOSU Campus Police will use this form to determine the c