CSA Reporting Form

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CSA Reporting Form

Campus Security Authorities (CSAs) can use this form to report incidents. This form is not for general student use, it is intended for trained Campus Security Authorities.

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
  • Reporting Party (R/P) or Victim Contact Information

  • 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.
  • Incident Information

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

  • 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.