USI logo
University of Southern Indiana
Directories
Contact
USI Home
google search
Security

Campus Crime and Security Report

Drug and Alcohol Policy
Emergency Phone Numbers
Escort Service
Mission Statement
Sexual Assault
Support Services
Vehicle and Parking Regulations
Vanderburgh County Sheriff's Department
Evansville Police Department
ISA Sex Offender Registry

Silent Witness Form

Vehicle Registration Form
New License Plate Information Form

Transportation and Parking Fee Information

Missing Artwork from the Health Professions Building

Missing Artwork from the University Center

 

 

SILENT WITNESS FORM

If you have witnessed a crime or have information about a crime or incident that occurred on campus, you may anonymously submit the form below. All information submitted will be kept strictly confidential.

This form is for:

  1. crimes or incidents occurring on USI campus property
  2. crimes or incidents occurring off campus that involve University of Southern Indiana students, faculty, or staff.

All other off-campus crimes should be reported to the Vanderburgh County Sheriff Department or call 911 for emergencies.

Silent Witness Form

IMPORTANT NOTE: Submission of this form will not result in an immediate emergency response from Campus Security.

If you require immediate assistance, call Campus Security at x.7777 or 812-464-1845 from any off-campus phone or cell phone.

Call 911 for all off-campus emergencies.

Only fields with an (*) are required.
Crime/Incident Description:
Location:*
(Where did the incident occur?)
campus map
Date: / / (mm/dd/yyyy)
Time of day:
(approximate okay) 		hr min am pm
Type of crime:*
(check all that apply)

Drugs
Vandalism
Fraud
Hate

Other:

Alcohol
Theft
Battery
Sexual Assault
 
How did you find out about this incident?:* Personal Witness
Personal Knowledge
  Other:
Please describe the incident:*
 
Suspect Information:
Pleave provide as much information as you can.
Suspect #1 name (if known):
(Approx. answers are acceptable)
Gender:
Age:
Height:
ft. in.
Weight:
lbs.
Race:
Complexion:
Hair color:
Eye color:
Other identifying characteristics and clothing at the time of the incident (i.e.: tattoos, piercings, facial hair, build, hats, logo/sports apparel):

Suspect #2 name (if known):
(Approx. answers are acceptable)
Gender:
Age:
Height:
ft. in.
Weight:
lbs.
Race:
Complexion:
Hair color:
Eye color:
Other identifying characteristics and clothing at the time of the incident (i.e.: tattoos, piercings, facial hair, build, hats, logo/sports apparel):

Suspect #3 name (if known):
(Approx. answers are acceptable)
Gender:
Age:
Height:
ft. in.
Weight:
lbs.
Race:
Complexion:
Hair color:
Eye color:
Other identifying characteristics and clothing at the time of the incident (ex: tattoos, piercings, facial hair, build, hats, logo/sports apparel):

   

If there are more than 3 suspects, please supply the information requested above for all additional suspects:

 
Vehicle Information:
(Approx. answers are acceptable)
License Plate #:
License Plate State:
Vehicle Make:
(ex: Ford, Toyota)
Vehicle Model:
(ex: Altima, Focus)
Vehicle Type:
(ex: car, truck, SUV)
Vehicle color :
Other identifying characteristics (ex: dents, stickers, spinners). If more than one vehicle was involved in the incident, please describe additional vehicles here, as well:

Witness Contact Information (optional) :
First Name:
Last Name:
Are you a USI student or employee?:
Phone Number:
Email:
ID Number:
 
Additional Information (optional) :
Is there anything else you'd like to add that has not been covered by this form?:

Security Code: cc8dg

   


Academics | Calendar | Athletics | Visitors | Events and News | Administration

8600 University Boulevard - Evansville, IN 47712-3596 - 812/464-8600

Copyright © 2008 University of Southern Indiana. All rights reserved.

EMBOSSED USI LOGO