University of California, Santa Cruz
Campus Security Authority Annual Crime Report Notification
This form is to be used by identified "campus security authorities" who
are required under the federal Clery Act to report information they receive
about crimes. The information collected from these forms will be used
to compile statistics to be included in the UCSC Annual Report. For more
information about Campus Security Authority responsibilities and the
crime reporting process, please see PowerPoint presentation at http://www2.ucsc.edu/judicial/clery/ppt/
The University of California urges all crime victims and witnesses to
report criminal acts to the police, and to report University policy violations
to the appropriate office (e.g., student conduct violations to the Office
of Student Judicial Affairs at 831-459-4447). However, if a reporting
person requests anonymity, this request must be honored to the extent
permitted by law. Accordingly, no information should be included on this
form that would personally identify the victim without his/her consent.
Campus Police will use the information submitted to determine the appropriate
category for the crime in the Annual Security Report. Please forward
completed forms to Sgt. Mike Kimura, UCPD, mtkimura@ucsc.edu,
or by fax to 831-458-5021.
Campus Security Authority name: 
Campus Security Authority Position: 
Phone number: 
  E-mail: 
I have no crimes to report for calendar year 2008 (If you have no
crimes to report, please click submit to return the form to mtkimura@ucsc.edu).
I received reports of
crime(s) in calendar year 2008.  A separate Crime Report Form
has been completed for each of these crimes. To complete
a Crime Report Form,  click
here
Comments or Message for Sgt. Kimura:
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