UM-Flint Campus Security Authority (CSA) Clery Act Crime Reporting Form
Regardless of your status (CSA or non-CSA), all community members are encouraged to promptly report all criminal incidents and other public safety related emergencies without delay to Public Safety at (810) 762-3333.

The following is a sample of what you can tell a reporting party who comes to you to report a crime:

"As part of my position on campus, I am a federally mandated Clery Act crime reporter for the University. I am required to report this incident to Public Safety for data gathering. If you request confidentiality, the CSA Reporting Form will not include personally identifiable information. My report will contain only the information you provide. Do you have any questions? Would you like to help me fill it out?"
Email address *
Name of the CSA completing this form: *
Your answer
Date the CSA is completing this form: *
MM
/
DD
/
YYYY
If applicable, Housing & Residential Life Incident Report Number:
Your answer
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