CSA Reporting Form

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CSA Reporting Form

Campus Security Authorities (CSAs) can use this form to report incidents.

For incidents requiring an immediate police response, contact the Taft Police Department at 661-763-3101 or by calling 911 if appropriate.

Complete this form as soon as possible but no later than the next business day after the incident was reported to you.

  • Header Information

  • MM slash DD slash YYYY
  • If multiple incidents were reported or if the date of occurrence is unknown, please note that in the Incident Information section below.
    MM slash DD slash YYYY
  • Name of Campus Security Authority
  • Reporting Party (R/P) or Victim Contact Information

  • Reported By:
  • R/P Name
  • If a third party (e.g. roommate, friend, parent) reported the crime to you, please enter the relationship of the third party to the victim:
  • Agency Notified

  • If, to your knowledge, a law enforcement agency was notified, please enter the name of that agency.
  • Does the victim want the incident reported to law enforcement?
  • Incident Information

  • Building name, street address, office number, room number, etc. (see location details below).
  • Please provide specific, detailed information.
  • Incident Classification

  • Incident Category
  • Is there any evidence this crime was motivated by bias?
  • If you answered "yes" to the Motivated by Bias question, please provide a brief summary of the evidence supporting a bias motivation:
  • What best describes the location of the crime? If the crime occurred in multiple places, check all that apply.