CSAR Form You must have JavaScript enabled to use this form. Prepared By: Name Title Date Was this crime reported to any Law Enforcement Agency? Yes No If "Yes", to which Agency? SUNY Potsdam University Police Police Village Police Department Other Does the Reporter wish to file a formal complaint? Yes No Filing Complaint **Filing a complaint is Optional Enter any text supported by available text formats. If "yes" If 'Yes': Complainant Name Address Phone The following crime was reported: Aggravated Assault Arson Burglary Dating Violence Domestic Violence Drug Law Violations Fondling Hate Crimes Incest Liquor Law Violations Motor Vehicle Theft Murder Negligent Manslaughter Non-Negligent Manslaughter Rape Robbery Stalking Statutory Rape Weapon Law Violations Was the crime reported a hate crime? Yes No If "Yes", identify the category of prejudice Disability Ethnicity Gender Gender Identity National Origin Race Religion Sexual Orientation Please provide a brief description for this determination Crime Occurred Crime Occured: Date of Crime Time of Crime Location of Crime Give a brief description of the incident
