Report a past off-site crime or incident - Administration and Finance

If this is an emergency, call Public Safety at (585) 275-3333.

Satellite report

Complete this form to report crimes or incidents occurring off-site or at a satellite location, even if no loss results. Employees should use their work address and phone number. After completing this form, you will receive an email confirmation and copy of the report. If you have access to RL Solutions, please fill out that report and check the “PUBLIC SAFETY” box.

You may also download, print, and complete the form [ADD HYPERLINK TO PAPER FORM]. Fax the completed form to University Public Safety at (585) 275-0344.

If you have questions or concerns about this form or the crime or incidence you are reporting, contact Public Safety at (585) 275-3333.

Your information

Name(Required)

First Last

Email(Required)

After you submit, a completed copy of the form will be emailed to this address.

Phone

Incident details

Nature of offense/incident(Required)

Please explain the nature of the offense/incident

Date of occurrence(Required)

Time of occurrence(Required)

Date reported(Required)

Time reported(Required)

Location

Name of off-site/satellite location(Required)

Specific location of incident(Required)

(BLDG., ROOM#, DEPT., ETC.)

Address of off-site/satellite location(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Property involved

Property stolen(Required)

Item

(Make, Model, Serial #, Etc.)

EPHI

PHI

Item value

Property damaged(Required)

Property damaged value

Persons involved

Name

Sex

Code

Address

Name

Sex

Code

Address

Name

Sex

Code

Address

Suspect information

Suspect #1 Name

Sex

Code

Address

Suspect #2 Name

Sex

Code

Address

Suspect description

If you only have suspect(s) description, please explain

Incident narrative

Describe the incident that took place

Law enforcement

Law enforcement agency involved

Law enforcement report number

Person completing report

Phone number

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Internal information

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Case number

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