Bias-Motivated Incident Data Collection Form
The Hindu American Foundation urges that if you or someone you know has been harassed, assaulted or threatened with harm on the basis of your identity (e.g., race, religion, disability, ethnic origin, or sexual orientation), please do not stay silent. Report the incident to law enforcement immediately. Similarly, please report any incidents involving vandalism, hateful graffiti, desecration, arson, or violence directed towards temples or other properties.

We also request that you help us in tracking incidents of identity-based or bias-motivated intimidation, threats, harassment, and violence being experienced in our communities. The more data we have about such incidents, the better we will be able to work with the appropriate authorities, agencies, civil rights advocates, and other stakeholders to identify areas of particular concern and ensure the safety and security of the community. Please be aware that HAF is unable to offer individual legal assistance or counsel.

Email address *
PERSONAL INFORMATION
Who experienced this incident? If the incident involved a temple or other property, please include the name/phone/email of the primary contact person.
First and Last Name *
Your answer
Phone Number *
Your answer
INCIDENT
In filling out the description of the incident, please be as thorough as possible. Please include a description of the perpetrator(s), as well as exactly what was said or written by the perpetrator(s), if anything.
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Location of Incident *
Please provide city and state.
Your answer
Nature of Incident *
Required
Detailed Description of Incident *
Your answer
Was the incident reported to law enforcement? *
If yes, what law enforcement agency?
Please include contact details for the representative of the law enforcement agency.
Your answer
Was the incident reported to the media and/or community organization(s)? *
If yes, what media outlet(s) and/or community organization(s)?
Please include contact details for the representative from the media outlet or community organization.
Your answer
A copy of your responses will be emailed to the address you provided.
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