CSA Form Use

This form is used to gather statistical information to aid the University in compiling required statistics related to crimes that occur on campus and other University owned or controlled property. The collection of this information is required by the Higher Education Act and the Clery Act. This is NOT a report for the purposes of initiating a criminal investigation. However, University Safety personnel will review this information to evaluate crime trends and to determine whether the circumstances reported require the issuance of a campus-wide warning.

CSA Contact Info
Person completing this form.
Name Name * First Last
Phone Phone * - ### - ### ####
Email *
Your Department
Date Incident Occurred
Please provide the date the crime occurred. If the date is not known, please provide a time frame.
Date Known?

Date Known? Yes No
If an exact date is not known, please provide an approximate time frame. (example: Spring 2024)
Reporting party does not wish to provide this information
Date Incident Reported or Became Known to CSA. Date Incident Reported or Became Known to CSA. * / MM / DD YYYY

Date the victim/witness reported this incident to you or that you became aware of the incident.
Incident Information
Brief description of the incident. *
Has this incident been reported to another University office?

Has this incident been reported to another University office? Yes No, not to my knowledge. I do not know.

This report is for use by the Clery Compliance Coordinator and will be used to provide annual statistical information in accordance with the federal Clery Act.
Check the best answer to the following questions:

Clery statistics group incidents based on the location where the event occurred. Locations are categorized as follows: On campus; On campus student housing; On public property (state roads or sidewalks running through campus), and on non-campus property (property that is owned or controlled by the University but not part of the main campus).
Location of Incident *
Pick the choice that best describes the location where the incident occurred. *

Pick the choice that best describes the location where the incident occurred. On Campus in a Building (Not a residence hall) Inside a Student Housing Facility (Residence Hall) On Campus - On the Street (in the actual roadway) On Campus - On the Sidewalk On Campus - NOT inside any building Off Campus at a non-University location Off Campus at a location owned or controlled by the University do not know Other Other
Location Description

If you are unsure how to classify the location using the above choices, please provide your best description of the location.
Did the crime occur on property owned, controlled, or leased by the University or University affiliated organization?* *

Did the crime occur on property owned, controlled, or leased by the University or University affiliated organization?* Yes No i do not know Other
Did the crime occur at a University-sponsored activity or event? *

Did the crime occur at a University-sponsored activity or event? Yes No I do not know Other
Classification
Please choose the best classification based on your knowledge of the incident. Definitions of the listed incidents can be found below.
Clery Act Offenses (Definitions below) *

Clery Act Offenses (Definitions below) Murder/Non-Negligent Manslaughter Manslaughter by Negligence Robbery Aggravated Assault Burglary Motor Vehicle Theft Arson Weapon Law Violations Drug Abuse Violations Liquor Law Violations None of the above
Sex Offenses (Definitions below) *

Sex Offenses (Definitions below) Rape Fondling Incest Statutory Rape None of the above
Hate Crimes *

Hate Crimes Larceny Vandalism Intimidation Simple Assault None of the above

A hate crime is any of the above listed crimes that include some evidence that the offender was motivated by bias or hate toward a particular class of person or people. The type of bias should be indicated below.
Other Offenses *

Other Offenses Dating Violence Domestic Violence Stalking None of the above
Was the victim that told they can report this incident to the EIU Police?

Was the victim that told they can report this incident to the EIU Police? Yes No The police are already involved
Does the victim wish to have police involvement? *

Does the victim wish to have police involvement? No, they do not want police involvement Yes, they would like police involvement The police have already been notified or are already involved I do not know
Does the victim understand that they may contact the EIU Police Department at any time if they change their mind?

Does the victim understand that they may contact the EIU Police Department at any time if they change their mind? Yes No The police are already working with the victim I don't know
Addtitional Information

If there are any other details about this event you would like to share, you may do so here.
Clery Crime Definitions

Clery Crime Definitions
Murder/Non-Negligent Manslaughter: the willful (non-negligent) killing of one human being by another. NOTE: Deaths caused by negligence, attempts to kill, assaults to kill, suicides, accidental deaths, and justifiable homicides are excluded.

Manslaughter by Negligence: the killing of another person through gross negligence.

Robbery: the taking or attempting to take anything from value of the care, custody or control of a person or persons by force or threat of force or violence and/or by putting the victim in fear.

Aggravated Assault: an unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury. This type of assault usually is accompanied by the use of a weapon or by means likely to produce death or great bodily harm. It is not necessary that injury result from an aggravated assault when a gun, knife or other weapon is used which could or probably would result in a serious potential injury if the crime were successfully completed.

Burglary: The unlawful entry of a structure to commit a felony or a theft. For reporting purposes this definition includes: unlawful entry with intent to commit a larceny or a felony; breaking and entering with intent to commit a larceny; housebreaking; safecracking; and all attempts to commit any of the aforementioned.

Motor Vehicle Theft: The theft or attempted theft of a motor vehicle. (Classify as motor vehicle theft all cases where automobiles are taken by persons not having lawful access, even though the vehicles are later abandoned - including joy riding)

Arson: The willful or malicious burning or attempt to burn, with or without intent to defraud, a dwelling house, public building, motor vehicle or aircraft, or personal property of another kind.

Weapon Law Violations: The violation of laws or ordinances dealing with weapon offenses, regulatory in nature, such as: manufacture, sale, or possession of deadly weapons; carrying deadly weapons, concealed or openly; furnishing deadly weapons to minors; aliens possessing deadly weapons; all attempts to commit any of the aforementioned.

Drug Abuse Violations: Violations of state and local laws relating to the unlawful possession, sale, use, growing, manufacturing, and making of narcotic drugs. The relevant substances include: opium or cocaine and their derivatives (morphine, heroin, codeine); marijuana; synthetic narcotics (Demerol, methadones); and dangerous non-narcotic drugs (barbiturates, Benzedrine).

Liquor Law Violations: The violation of laws or ordinance prohibiting: the manufacture, sale, transporting, furnishing, possessing of intoxicating liquor; maintaining unlawful drinking places; bootlegging; operating a still; furnishing liquor to minor or intemperate person; using a vehicle for illegal transportation of liquor; drinking on a train or public conveyance; all attempts to commit any of the aforementioned. (Drunkenness and driving under the influence are not included in this definition.)

Sex Offenses
Any sexual act directed against another person, without the consent of the victim, including instances where the victim is incapable of giving consent.

Rape: The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim, including instances in which the victim is incapable of giving consent.

Fondling: The touching of the private body parts of another person for the purpose of sexual gratification, forcibly and/or against that person’s will; or, not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental incapacity.

Incest: Nonforcible sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law.

Statutory Rape: Nonforcible sexual intercourse with a person who is under the statutory age of consent.

NOTE: The above listed crime definitions from the Uniform Crime Reporting Handbook, 2013 Revised UCR definition of Rape, as prescribed by 2014 VAWA Negotiated Rulemaking Final Consensus Language.

HATE CRIMES
The University of Connecticut is also required to report statistics for hate (bias) related crimes by the type of bias as defined below for the following classifications: murder/non-negligent manslaughter, negligent manslaughter, sex offenses (forcible and non-forcible), robbery, aggravated assault, burglary, motor vehicle theft, arson (see definitions above) and larceny, vandalism, intimidation, and simple assault (see definitions below).

Larceny: The unlawful taking, carrying, leading, or riding away of property from the possession or constructive possession of another.

Vandalism: To willfully or maliciously destroy, injure, disfigure, or deface any public or private property, real or personal, without the consent of the owner or person having custody or control by cutting, tearing, breaking, marking, painting, drawing, covering with filth, or any other such means as may be specified by local law.

Intimidation: To unlawfully place another person in reasonable fear of bodily harm through the use of threatening words and/or other conduct, but without displaying a weapon or subjecting the victim to actual physical attack.

Simple Assault: An unlawful physical attack by one person upon another where neither the offender displays a weapon, nor the victim suffers obvious severe or aggravated bodily injury involving apparent broken bones, loss of teeth, possible internal injury, severe laceration or loss of consciousness.

If a hate crime occurs where there is an incident involving intimidation, vandalism, larceny, simple assault or other bodily injury, the law requires that the statistic be reported as a hate crime even though there is no requirement to report the crime classification in any other area of the compliance document.

A hate or bias related crime is not a separate, distinct crime, but is the commission of a criminal offense which was motivated by the offender's bias. For example, a subject assaults a victim, which is a crime. If the facts of the case indicate that the offender was motivated to commit the offense because of his bias against the victim's race, sexual orientation, etc... the assault is then also classified as a hate/bias crime.

Other Offenses

Dating Violence: Violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim.
(1) The existence of such a relationship shall be determined based on the reporting party’s statement and with consideration of the length of the relationship, the type of relationship, and the frequency of interaction between the persons involved in the relationship.
(2) For the purpose of this definition, dating violence includes but is not limited to, sexual or physical abuse or the threat of such abuse and does not include acts covered under the definition of domestic violence.

Domestic Violence: A felony or misdemeanor crime of violence committed
(1) By a current or former spouse or intimate partner of the victim.
(2) By a person with whom the victim shares a child in common.
(3) By a person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner.
(4) By a person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction in which the crime of violence occurred.
(5) By any other person against an adult or youth victim who is protected from that person’s acts under the domestic or family violence laws of the jurisdiction in which the crime of violence occurred.

Stalking: Engaging in a course of conduct directed at a specific person that would cause a reasonable person to
(1) Fear for the person’s safety or the safety of others; or
(2) Suffer substantial emotional distress.
(3) For the purpose of this definition, Course of conduct means two or more acts, including, but not limited to, acts in which the stalker directly, indirectly, or through third parties, by any action, method device, or means follows, monitors, observes, surveils, threatens, or communicates to or about, a person, or interferes with a person’s property. Substantial emotional distress means significant mental suffering or anguish that may, but does not necessarily, require medical or other professional treatment or counseling. Reasonable person means a reasonable person under similar circumstances and with similar identities to the victim.
(4) Report the location as where a perpetrator engaged in the stalking course of conduct or where a victim first became aware of the stalking.
(5) Report any additional behaviors that meet the above definition of Stalking if they occur or continue to occur after an official intervention has been put in place, including, but not limited to, an institutional disciplinary action or the issuance of a no contact order, restraining order or any warning by the institution or a court.

Thank you for taking the time to provide this information. If you have any questions regarding this submission, please contact the Clery Compliance Manager at 217-581-3212 or by email at police@eiu.edu .

CSA Form Use

CSA Form Use

CSA Contact Info Person completing this form.

Date Incident Occurred Please provide the date the crime occurred. If the date is not known, please provide a time frame.

Incident Information

Check the best answer to the following questions:

Classification Please choose the best classification based on your knowledge of the incident. Definitions of the listed incidents can be found below.

Clery Crime Definitions

CSA Contact Info
Person completing this form.

Date Incident Occurred
Please provide the date the crime occurred. If the date is not known, please provide a time frame.

Classification
Please choose the best classification based on your knowledge of the incident. Definitions of the listed incidents can be found below.