Date Hate Crime Reported: 

Hate Crime Reported By: 

Type of Hate Crime (classification as defined below):

Type of Hate Crime (classification as defined below):

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

Type of Bias:

Date incident occurred:

Did the crime occur in a building or on the street?

Did the crime occur in a building or on the street?

Did the crime occur on school owned, controlled, or leased property?

Did the crime occur on school owned, controlled, or leased property?

Did the crime occur at a University-sponsored activity or event?

Did the crime occur at a University-sponsored activity or event?

Location of Incident (building name or address):

Brief description of the incident: 

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