CAMPUS SECURITY AUTHORITY REPORT FORM

Campus Security Authority (CSA) Reporting Form

A CSA  (Campus Security Authority) is someone who has been recognized by the Clery Act as a federally mandated reporter of any Clery Act crimes occurring on campus and campus owned or controlled property.

The CSA Reporting Form is intended to provide CSAs with a method of reporting Clery crimes ONLY to Public Safety for inclusion in the College’s annual compilation of Clery statistics.

The CSA Report is NOT a method of notifying police of an emergency, dangerous situation, or other hazard.  The submission of this report will NOT prompt a security investigation or generate an official report or case number.  Public Safety will evaluate each CSA Report to determine if the incident reported requires the publication of a Timely Warning Notice or Emergency Notification to the campus community. 

CSAs please follow the directions outlined:
 
Option 1 (No Incidents to Report):
if no Clery crimes were reported to you, please complete the section below titled "No Incidents to Report (Option 1)."
 
 
Option 2 (Incident and Disciplinary Referral Form):
If you have an incident to report, please complete the section below titled "Incident and Disciplinary Referral Form (Option 2)."
 
 
Option 3 (Reporting Fires):
Please report any and all incidents of fire to the Director of Public Safety.  A fire is defined of "any instance of open flame or other burning in a place not intended to contain the burning or in an uncontrolled manner."
PS Director: Timothy W. Allen
twallen@ranken.edu
(314) 286-3394
Please select Option below.
*Note: for Option 3 follow contact instructions above *

- OPTION 1 - NO INCIDENTS TO REPORT -

This portion of the form is used to document that no Clery crimes were reported to you.  If no Clery crimes were reported to you, please complete the information below.  
Reporting Month(s): *
Please confirm *
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Incident and Disciplinary Referral Form -

CSA - Please complete this form in its entirety and mark applicable boxes.  This form must be completed for Each Clery reportable crime or incident reported to you. 
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If the incident was reported to any other campus resource, please check the corresponding box:
 

- Location -

Location of Occurrence: Please be specific *
 

- Agency Notified -

If, to your knowledge, a law enforcement agency was notified please enter the name of the agency.
Does the victim want the incident reported to law enforcement agency?
Does the victim understand they may contact the police department at any time even if they change their mind.

- Incident Crime -

Please see below for definition of offenses (Please check offense that applies). *
Hate Crime: Is there evidence that this crime was motivated by bias (requires one or more of the following biases).

- Referrals -

Disciplinary Referrals (Briefly explain the violation the person is being referred for).

- Narrative/Description -


- 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.
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Manslaughter by Negligence: the killing of another person through gross negligence.
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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.
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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).
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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.
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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)
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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.
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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.
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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, methadone’s); and dangerous non-narcotic drugs (barbiturates, Benzedrine).
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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.)
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Illegal Weapons Violation: The violation of laws and ordinances prohibiting the manufacture, sale, purchase, transportation, possession, concealment, or use of firearms, cutting instruments, explosives, incendiary devices, or other deadly weapons.
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Sex Offenses Forcible:  Any sexual act directed against another person, without the consent of the victim, including instances where the victim is incapable of giving consent.
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Forcible Rape: Carnal knowledge of a person forcibly and/or against the person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her temporary or permanent mental or physical incapacity (or because of his/her youth).
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Forcible Sodomy: oral or anal sexual intercourse with another person, forcibly and/or against that person’s will; or not forcibly and/or against that 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 or physical incapacity.
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Sexual Assault with an Object:  Use of an object or instrument to unlawfully penetrate, however slightly, the genital or anal opening of the body of another person, 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 or physical incapacity.
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Forcible 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.
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Sex Offense Non-Forcible:  Unlawful, non-forcible sexual intercourse.
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Incest: Is non-forcible sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law.
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Statutory Rape: Is non-forcible sexual intercourse with a person who is under the statutory age of consent.
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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; and where the existence of such a relationship shall be determined based on a consideration of the following factors:
  • the length of the relationship
  • the type of the relationship
  • the frequency of interaction between the persons involved in the relationship
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Domestic Violence: Felony or misdemeanor crimes of violence committed by a current or former spouse or intimate partner of the victim, by a person with whom the victim shares a child in common, by a person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner, by a person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction…or 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.
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Stalking: Engaging in a course of conduct directed at a specific person that would cause a reasonable person to fear for his or her safety or the safety of others or suffer substantial emotional distress.
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Arrest: Persons processed by arrest, citation, or summons. 
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Referred for Disciplinary:  The referral of any person to any official who initiates a disciplinary action of which a record is kept, and which may result in the imposition of a sanction. 
 

- Geography -

On Campus - Any building or property owned or controlled by an institution within the same reasonably contiguous geographic area and used by the institution in direct support of, or in a manner related to, the institution’s educational purposes, including residence halls; and

Any building or property that is within or reasonably contiguous to the area identified in paragraph (1) of this definition, that is owned by the institution but controlled by another person, is frequently used by students, and supports institutional purposes (such as food or other retail vendors)
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Non-Campus Building or Property -  Any building or property owned or controlled by a student organization that is officially recognized by the institution; or

Any building or property owned or controlled by an institution that is used in direct support of, or in relation to, the institution’s educational purposes, is frequently used by students, and is not within the same reasonably contiguous geographic area of the institution.
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Public Property - All public property, including thoroughfares, streets, sidewalks, and parking facilities, that is within the campus, or immediately adjacent to and accessible from the campus.

- Exempt Disclosure -

Certain individuals who have significant responsibility for student and campus activities are exempted from disclosing information.
 
Pastoral Counselor: A person who is associated with a religious order or denomination, is recognized by that religious order or denomination as someone who provides confidential counseling and is functiong within the scope of that recognition as a pastoral counselor.
 
Professional Counselor:  A person whose official responsibilities include providing mental health counseling to members of the institution's community and who is functioning within the scope of his or her license or certification.  (This definition applies to professional counselors who are not employees of the institution but are under contract to provide counseling at the institution.) 
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