Fillable 900-1-2F3 - 900.1.2 [F3] _Adopted 06-08-10_

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900-1-2F3 - 900.1.2 [F3] _Adopted 06-08-10_

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900.1.2 [F3]
Adopted: 06/08/10
Page 1 of 2
ELIZABETH CITY STATE UNIVERSITY
(CONFIDENTIAL)
Administrative Investigation Report Form
Conducted by: ___________________________, Title _________________________
Date: _______________________________
Elizabeth City State University (ECSU) conducted an administrative investigation in response to
allegations lodged by __________________________________________, Complainant, against
______________________________________________________________, Alleged Harasser.
SCOPE OF INVESTIGATION
(Set forth the scope of the investigation by identifying all witnesses interviewed including complainant,
alleged harasser and others and all documents examined, if any). Add additional sheet(s) if necessary.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
FINDINGS
(Summarize findings in accordance with ECSU Policy 900.1.2 Section 3.B.i). Add additional
sheet(s) if necessary.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
900.1.2 [F3]
Adopted: 06/08/10
Page 2 of 2
ELIZABETH CITY STATE UNIVERSITY
(CONFIDENTIAL)
Administrative Investigation Report Form
Conducted by: ___________________________, Title _________________________
Date: _______________________________
OTHER COMPLAINTS OF SEXUAL HARASSMENT
(Indicate whether or not there were prior reported incidents of sexual harassment involving either
complainant or alleged harasser). Add additional sheet(s) if necessary.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
ADMINISTRATIVE RESOLUTION
(Indicate how the complaint will be resolved or the recommendation for resolution). Add additional
sheet(s) if necessary.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
____________________________________
Investigator’s Signature
The Complainant and the Accused have fourteen (14) calendar days from receipt of this
report to submit written comments to the investigator which may be attached to the report.
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900-1-2F3 - 900.1.2 F3 _Adopted 06-08-10_

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Completed 10 December 2019

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