CCS 1286 (03/19)
Page 1 of 2
Marketing and Public Relations
SECURITY INCIDENT REPORT
SECURITY USE ONLY
Spokane Community College Spokane Falls Community College OTHER
Date
Security case number
Male
Female
Visitor/Guest
Student
Staff
Employee
Contractor/Vendor
Last name
First
CCS mailing address or official residence
City
State
ZIP
Primary Phone
Secondary
Last name
First
Primary Phone
Secondary
Campus
Building
Room
Other
Occurred between
Time
Date
/
Time
Date
Were police notified?
Yes No
Date
SPD crime file number
Spokane Police Department
Spokane County Sheriff's Department
Other police agency
Serial #:
State Tag #:
Market value of item:
Report completed by
Phone
CCS 1286 (03/19)
Page 2 of 2
Marketing and Public Relations
Last name
First
Mailing address or official residence
City
State
ZIP
Home phone
Work phone
Male Female
Physical description:
Height
Weight
Hair (color)
Eyes (color)
Additional comments (clothing, etc.)
Make
Model
Year
Color
License no.
Additional comments