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TIMELY WARNING REPORT (TWR) Decision Matrix

Instructions: You are required by the US Department of Education to follow your policy for the determination of whether to issue a warning and its distribution methods. The text in red is related only to crimes of gender violence.

Date/Time of incident (per Reporting Party): Date/Time Public Safety became aware of the incident:

1. Name of reporting party:

2. Is this incident accurately recorded in the Daily Crime Log? Entry Number:

3. Type of Clery defined crime (indicate by checking all that apply):a. Murder or Non-negligent manslaughterb. Negligent manslaughter

c. Sex offense:

i. Rape

ii. Fondling

iii. Incest

iv. Statutory Rape

d. Robbery

Aggravated Assault

Burglary

Motor Vehicle Theft

Arson

Domestic Violence

4. Address of the crime (as specifically as known):

Did the incident occur in Clery geography?

5. Factors to consider when determining a “serious or continuing” threat to students and employees.

Select One Select One

j. Dating Violencek. Stalkingl. Hate Crimes

i. Indicate which of the previous offenses (there may be more than one crime indicated):

1. Vandalism2. Intimidation3. Theft4. Assault5. Other bodily injury crimes

ii. Indicate category of bias:1. Race2. Gender3. Gender Identity, Religion, Sexual Orientation, Ethnicity, National Origin, Disability

On Campus (Residence Hall:______________________________________)Non-Campus property that College/University owns, leases, or controls (Includes locations such as fraternities, athletic travel or study trip where there is extended or repeated use)Public Property within or immediately adjacent to campus

Yes / No Yes / No

16. List the victim’s visible or invisible injuries (beyond those identified and recorded through a sexual assault forensics exam):

17. Do the previous factors increase or decrease the need for a TWR? Explain How:

a) Is the suspect(s) known to the victim?

b) Are there multiple suspects?

c) Does the act involve a student organization or sports

team?

d) Does the suspect have a student conduct record for

similar incidents?

e) Does the suspect have a criminal record for similar

incidents?

f) Has the suspect(s) been arrested?

If yes, is suspect still in custody?

g) Has the campus issued a no-contact or stay-awayadministrative notice to the suspect?

h) Has the institution enacted any Interim Measures?If yes, what are they?

i) Has the Title IX Coordinator been notified?

j) The victim is a (check all that apply):

Student Employee 3rd Party

k) The suspect(s) is a (check all that apply):Student Employee 3rd Party

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18. Do you believe, to a reasonable degree of certainty, that the incident represents a serious or continuing threat to students and employees?(Note: This means that after a Clery crime is reported, you should consider whether students and employees are at risk of becoming victims of a similar crime. For example, if a robbery is reported on campus and the alleged perpetrator has not been caught, the risk is there. If the alleged perpetrator was apprehended, there may be no continuing risk if the perpetrator acted alone. Does a criminal incident appear to be a one-time occurrence or does it fall into a pattern of reported crimes? For example, if your students set some posters on fire after your school’s team lost the homecoming football game, the arsons are probably a one-night event. If an unknown person were randomly setting fires, this would pose a continuing threat.)

• A serial crime that targets certain campus populations such as sex crimes or race-based crimes in which the perpetrator has not beenapprehended;

• A crime in which there is no apparent connection between perpetrator and victim and the perpetrator has not been apprehended.

Examples of crimes that may not constitute a continuing threat include, but are not limited to: • Crimes in which the perpetrator has been apprehended, thereby neutralizing the threat;• Crimes in which an identified perpetrator targets specific individuals to the exclusion of others, such as domestic violence.

Timely Warning Issued: _____________________ date/time of issuance

The Timely Warning should include: a. A brief statement of the incident.b. Possible connection to previous incidents, if applicable.c. Physical description of the suspect.d. Composite drawing of the suspect, if available.e. Date and time the warning was released.f. Other relevant and important information including prevention tips.g. Include methods to contact LEA for people with information in TWR

If a Timely Warning has been issued, please check all of the resources used to disseminate: College/University WebsitePolice/Public Safety WebsiteVocal (intercoms/loudspeakers/etc.)

Attach copy of Timely Warning Notification to the incident report Attach a copy of this form to the incident report

__________________________________________________________________

__________________________________________________________________

Posters/Fliers Mass Email Text Alert Media (radio/television/newspaper(s))

Other: __________________________________

Supervisor Approval:

_____________________________________ Print Rank/Name

_____________________________________ Signature

_____________________________________ Badge #

_____________________________________ Date/Time

Completed By:

_____________________________________ Print Rank/Name

_____________________________________ Signature

_____________________________________ Badge #

_____________________________________ Date/Time

Yes No

Justify your reasoning for this determination:

Examples of crimes that could constitute a continuing threat include, but are not limited to:

Yes No Will issuing a TWR jeopardize the safety of the victim?

If yes, provide an explanation why:

Provide an explanation of what steps are being taken to ensure the victim's safety: