SUSU Incident Report Form Individual(s) Involved: Type/Nature of ...

If police called, give name of station and crime number if applicable.
University Security Called? Yes No
If yes, give name of officer:
CCTV Tape requested? Yes No
Evidence Taken (please take as much evidence as possible. E. G photos)
Yes No
If yes, please state type of evidence received … … … … … … … … … … … … … … …
… … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … …
Was anyone injured? Yes No
If yes, please complete and attach an accident form
Was there any damage to property? Yes No
If yes, please give details:
Owner: ……………………………………………………………………………………………
Damage: …………………………………………………………………………………………
Property: …………………………………………………………………………………………
Description of Incident:
Describe the events leading up to during and after the incident
Witnesses: (Please list the names, addresses, union card numbers, etc
including any security staff)