Siena College Campus Security Authority Crime & Incident Report Form

Introduction As part of the federal Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (20 USC ยง 1092(f)), otherwise known as the Clery Act, qualifying incidents reported to Public Safety, from various sources, including Campus Security Authorities (CSA), are required to be published in an Annual Security Report and made available to the campus community. One purpose of the Clery Act is to encourage the reporting and collection of accurate campus crime statistics to promote crime awareness and enhance campus safety. The information collected from these forms will be used to compile statistics to be included in the Annual Security and Fire Report that Siena College publishes and distributes each fall. CSA's are obligated under statute to report Clery Act qualifying crimes and furthermore, are expected by the College to report all crimes/incidents reported to them to Public Safety as soon as they become aware. For additional information on the Clery Act and CSA responsibilities, visit the Campus Security Authority training web page or contact the Clery Act Coordinator at 518-783-2376. INCIDENT REPORT FORM The CSA is to document as much of the requested information on the form as s/he knows, excluding identity if confidentiality is requested. It is the policy of Siena College to ensure that the victims and witnesses to crime are aware of their right to report criminal acts to the police and to report policy violations to the appropriate office (e.g. Student Affairs, Public Safety, Residence Life, etc.). However, if a reporting person requests anonymity, this request must be honored to the extent permitted by law. Based on information received, Public Safety will determine the category of the crime or incident and the location under which the incident should be reported in the Annual Security and Fire Report. PLEASE FILL OUT ALL RELEVANT FIELDS. (* - required field)
* Required







Arrest for a Liquor Law Violation (underage possession or consumption or distribution to minors)
Student Conduct Referral for a Liquor Law Violation (underage possession or consumption or distribution to minors)
Arrest for a Drug Law Violation (use, possession or distribution of controlled substances or possession of drug paraphernalia)
Student Conduct Referral for a Drug Law Violation (use, possession or distribution of controlled substances or possession of drug paraphernalia)
Arrest for a Weapon Law Violation (possession or use of an illegal weapon)
Student Conduct Referral for a Weapon Law Violation (possession or use of an illegal weapon











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