Date of Incident:

-- mm/dd/yy

Time of Incident:

-- hh:mm:ss am/pm

Type of Incident:

ArsonAggravated AssaultSimple AssaultBriberyBurglary/B&EComputer TheftComputer Trespass (Cracking/Hacking)Internet Crime (Fraud/Hoaxes)E-Mail Harassment/ThreatsCounterfeiting/ForgeryDestruction/Damage/VandalismIntimidationObscene Phone CallsAnnoying Phone CallsThreatening Phone CallsDrugs/Narcotic ViolationsDrug Equipment ViolationEmbezzlementExtortion/BlackmailFalse PretensesCredit Card/ATM Card FraudImpersonationMurder/Non-negligentManslaughterNegligent ManslaughterKidnapping/AbductionPocket-PickingPurse-SnatchingShopliftingTheft from BuildingTheft from Coin MachineTheft from Motor VehicleTheft of Motor Vehicle PartsMotor Vehicle TheftObscene Material/PornographyProstitutionRobberyRapeSodomySexual Assault with ObjectFondling/Indecent Liberties/Child MolestationChild AbuseDomestic ViolenceLoiteringDisorderly ConductDriving Under the InfluencePublic DrunkenessPeeping TomRunawayTrespassConspiracyFirearms on CampusSpeeding VehiclesTraffic ViolationStalkingSuspicious ActivitySuspicious Person(s)Any Other Offense

Suspects Name and/or Description (If Available):

Suspect's Status Here at Reynolds:

Not sure...May be a student here...May be a faculty member here...May be a staff member here...May be an Administrator here...May be a Frequent Visitor here...

Please name or describe any other person(s) involved:

Please provide us with a description of the Incident:

Is someone's safety or your own safety at risk currently?

Yes
No
Not Sure

Please provide the following contact information:

Name
Phone Number	Please include area code
E-mail