This form is to be used by individuals identified as a “Campus Security Authority” who are required under the federal Clery Act to report information they receive about crimes. The information collected from these forms will be used to compile statistics to be included in the campus’ Annual Security Report.  You may not get enough information to complete the entire form, which is alright.  You should fill out as much information as you have.

Butler University urges all crime victims and witnesses to report criminal acts to the university police, and to report university policy violations to the appropriate office (e.g., student conduct violations to the Student Conduct Office (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.

The Butler University Police Department will use the information submitted to determine the appropriate category for the crime in the Annual Security Report and Daily Crime Log. After clicking on the Submit button, forms will be automatically forwarded to Butler University Police Department and the Butler University Title IX Coordinator at the same time.

For more information about Campus Security Authority responsibilities and the crime reporting process, please contact Lt. Jeffrey L. Wager at jlwager@buter.edu.