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Use this form to certify that you have fulfulled your obligation to report Clery Act offenses occurring during the period specified below.

[ Name of the individual submitting this form ]

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FOR PERIOD: 1/1/2014 - 3/31/2014

GROUP A OFFENSES - Murder, Non-negligent Manslaughter, Negligent Manslaughter, Forcible Rape, Forcible Sodomy, Sexual Assault with an Object, Forcible Fondling, Incest, Statutory Rape, Robbery, Aggravated Assault, Burglary, Motor Vehicle Theft, and Arson.

GROUP B OFFENSES - Larceny/Theft, Simple Assault, Intimidation, Destruction/Damage/Vandalism of Property (but only when the circumstances of the incident are bias-motivated)

MISCELLANOUS OFFENSES - Liquor Law Violation, Drug Law Violation, Weapons Violation