AAPI Hate Incident Reporting Form

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Hate incidents include any acts of hostility or violence, physical or verbal, motivated by bias against race or ethnicity, national origin, religion, gender identity, sexuality, or disability. One example of bias would be assuming that an AAPI individual is infected with COVID-19, or that person’s ethnic group is responsible for creating or spreading COVID-19. Even if you are not 100% sure that the incident you experienced was motivated by one of these biases, you should still file a report.

Filing a report with the Asian American Commission will help advocacy organizations nationwide fight for the civil rights of all AAPIs. There is no obligation for you to disclose your name, gender, ethnicity, or contact information. If you do not want to disclose this information, please state “Anonymous” or “N/A” when appropriate.

You are not required to file a report with any law enforcement agency. However, AAC encourages you to report to law enforcement independently, if possible.

Date of incident *

YYYY

Location of incident *

What type of incident are you reporting? *

Racial Profiling

Physical Harassment

Verbal Harassment

Bullying

Threats of Violence

Hoax calls, abusive phone or text messages, hate mail

Online Abuse

Discriminatory literature or posters

Harm or damage to personal items

Graffiti

Arson

Malicious Complaints

Required

Please describe the incident (In detail): *

Did you contact local authorities? *

Yes

Planning to

Name (optional)

Email (in case we want to follow up)

Ethnicity *

Age

Gender identity

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