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pdf1-700 (Rev. 05-14-12)
OMB No. 1110-0015
QUARTERLY HATE CRIME REPORT
Offenses Known to Law Enforcement
City
County
State
Name of Agency
Originating Agency Identifier (ORI)
Name and Title of Preparer
Area Code & Telephone Number of Preparer
E-mail Address of Preparer
Quarter and Year of Report:
January - March
April - June
July - September
October - December
Year
Total number of hate crime incidents reported in this quarter
(If your agency is reporting a bias motivated incident, please attach this report to the Hate Crime Incident
Report. The number of hate crime incidents reported should agree with the actual number of Hate Crime
Incident Reports submitted.)
If there were no hate crime incidents in this quarter, check this box.
Incidents to be Deleted: This section should be used to delete a hate crime incident(s) previously reported,
which further investigation has determined was not bias motivated. Please provide the Incident Number and
Date of the Incident for each incident to be deleted.
Incident Number
Date of the Incident
/
Month
/
/
Month
/
Day
/
Month
Year
/
Year
Day
/
Month
Year
Day
/
Day
Year
This report is authorized by Title 28, Section 534, U.S. Code, and the Hate Crime Statistics Act of 1990. Even though
you are not required to respond, your cooperation in using this form to report hate crimes known to law enforcement
during the quarter will assist the FBI in compiling timely, comprehensive, and accurate data regarding the incidence
and prevalence of hate crime throughout the Nation. Please submit this report quarterly, by the 15th day after the
close of the quarter, and any questions to the FBI, Criminal Justice Information Services Division, Attention:
Uniform Crime Reports/Module E-3, 1000 Custer Hollow Road, Clarksburg, West Virginia 26306; telephone 304-6254830, facsimile 304-625-3566. Under the Paperwork Reduction Act, you are not required to complete this form
unless it contains a valid OMB control number. The form takes approximately 7 minutes to complete. Instructions
for preparing the form appear below.
GENERAL
This report is separate from and in addition to the traditional Summary Reporting System submission. In hate
crime reporting, there is no Hierarchy Rule. Offense data (not just arrest data) for Intimidation and
Destruction/Damage/Vandalism of Property should be reported. On this form, all reportable bias motivated
offenses should be included regardless of whether arrests have taken place. Please refer to the publication
Hate Crime Data Collection Guidelines and Training Manual for additional information.
QUARTERLY HATE CRIME REPORT
At the end of each calendar quarter, each reporting agency should submit a single Quarterly Hate Crime
Report, together with an individual Hate Crime Incident Report for each bias motivated incident identified
during the quarter (if any). If no hate crimes occurred during the quarter, the agency should submit only the
Quarterly Hate Crime Report.
The Quarterly Hate Crime Report should be used to identify your agency, to state the number of bias
motivated incidents being reported for the calendar quarter, and to delete any incidents previously reported
that have been determined during the reporting period not to have been motivated by bias.
HATE CRIME INCIDENT REPORT
The Incident Report should be used to report a bias motivated incident or to adjust information in a previously
reported incident. Include additional information on separate paper if you feel it will add clarity to the report.
Instructions for preparing the Hate Crime Incident Report
Administrative Information
Report Type: (Required.) Indicate the type of report as Initial or Adjustment.
Initial-To report a hate crime incident.
Adjustment-To update a hate crime incident previously reported. (Note: This will delete the
information already on file and insert the information provided in this report.)
ORI Number: (Required.) Enter the nine-character Originating Agency Identifier assigned to your agency.
Date of Incident: (Required for Initial or Adjustment Reports.) Provide the date of the hate crime
incident in the format of MMDDYYYY.
Incident Number: (Required for Initial or Adjustment Reports.) Provide an identifying incident
number, preferably your case or file number. The number can be up to 12 characters in length. Valid
characters include: A through Z, 0 through 9, hyphens, and/or blanks.
Page
of
entry into this portion.
of same incident: If additional Incident Reports are used, make an appropriate
Offense Information
Offense Code: Enter the two-digit offense code for each bias motivated offense. The offense codes that are
specific to hate crime are: 01 Murder, 02 Rape, 03 Robbery, 04 Aggravated Assault, 05 Burglary, 06
Larceny-theft, 07 Motor Vehicle Theft, 08 Arson, 09 Simple Assault, 10 Intimidation, and 11
Destruction/Damage/Vandalism.
Number of Victims: Enter the number of victims for each bias motivated offense. The field allows for up
to a three-digit number to be entered. Number of victims are inclusive of Individual, Business, Financial
Institution, Government, Religious Organization, Other, and Unknown.
Location Information
Offense #1 Location: Check one location for Offense #1.
Additional Offense Locations: Enter a two-digit location code for each additional offense that has a
different location than Offense #1.
Bias Motivation Information
Offense #1 Bias Motivation: Check up to five bias motivations for Offense #1.
Additional Offense Bias Motivations: Enter up to five two-digit bias motivation codes for each additional
offense that has a different bias motivation than Offense #1.
Victim Information
Victim Type: Check all applicable victim types identified within the incident.
Number of Victims: When victim type is individual enter the total number of individuals (persons) who
were victims in the incident. Enter the total number of individuals (persons) who were victims in the
incident that are 18 and over. Enter the total number of individuals (persons) who were victims in the
incident that are under the age of 18.
Offender Information
Number of Offenders: Enter the total number of individuals (persons) who were offenders in the incident.
If unknown, enter 00 in the two-digit field. Enter the total number of individuals (persons) who were
offenders in the incident that were 18 and over. If unknown, enter 00 in the two-digit field. Enter the total
number of individuals (persons) who were offenders in the incident that were under the age of 18. If
unknown, enter 00 in the two-digit field. Incidents involving multiple offenders must not be coded as
Unknown Offender. Indicate an Unknown Offender when nothing is known about the offender including the
offender's race. When the Race of Offender(s) has been identified, indicate at least one offender.
Race and Ethnicity of Offender or Offender Group
Race: Check one race for the offender. If there was more than one offender, provide the race of the group as
a whole. If the number of offenders is entered as Unknown Offender, then the offender's race must also be
indicated as Unknown.
Ethnicity: Check one ethnicity for the offender. If there was more than one offender, provide the ethnicity
of the group as a whole. If the number of offenders is entered as Unknown Offender, then the offender's
ethnicity must also be indicated as Unknown.
File Type | application/pdf |
File Title | 1-700 07-07-11.xls |
Author | pshanning |
File Modified | 2012-06-20 |
File Created | 2012-06-20 |