This form is to be used by staff to record information about problem or unusual incidents in the library or on library grounds. Types of problem incidents may include cases of intentionally excessive noise or raucous behavior, loitering, public intoxication, sexually related overtures, vandalism, fires, theft, physical violence or the threat of physical violence or any other disturbances. Unusual incidents may include accidents or illness, police or fire department activities, bomb threats, car accidents or towing. Fill in as much of the form as appropriate.

Nature of Incident

Offender

Affected Patron

Action Taken

Witness