Section J 13C Form CSO-003 Court Facility Incident Report.pdf

UNCLASSIFIED // LES

Note: Completed forms containing personally identifiable information (PII) must be encrypted and include the appropriate marking (U/LES) in the SUBJECT line of the message prior to dissemination via email outside of USMS.

UNCLASSIFIED // LES Form CSO-003 Rev. 03/22 DISTRIBUTION: DISTRICT COR - 1 COPY / OCS - 1 COPYPAGE ____ OF ____

U.S. Department of Justice United States Marshals Service Court Facility Incident Report

1. DATE OF REPORT: 2. DATE OF INCIDENT: 3. TIME OF INCIDENT:

4. BUILDING NAME: 5. BUILDING ADDRESS:

6. WAS SUBJECT DETAINED? Yes No 7. REPORTING DISTRICT:

8. TYPE OF INCIDENT (Check applicable box):

Alarm Activation Assault & Battery (Including Attempts)

Completed Attempted

Bomb Threat Contraband Damage, Loss, & Vandalism Demonstration Disruptive Person Disturbance Hostage Illegal Weapon

Judicial Facility/Protective Facility Escort Incident

Malfunctioning Equipment Medical Emergency Missing Property Non-Compliance Physical Security Breach

Open/Unsecured Access Point Forced Entry Unauthorized Access Burglary Vehicle Break-In None of the Above

Suspicious Activity Inappropriate Communications (Incl. Threats)

Suspicious Individuals Suspicious Packages/Letters Suspicious Vehicles Unattended Packages Unmanned Aerial Vehicles

Use of Force Vehicle Break-Ins/Burglaries Other (Describe in Field #10)

9. CHECK APPLICABLE BOX:

Initial Report Follow-Up Report - Initial Report Dated:

10. INCIDENT DESCRIPTION (Details should cover who, what, where, when and how):

I hereby certify that the information stated herein is true, complete, and accurate to the best of my knowledge.

Reporting CSO Name: Reporting CSO ID #:

Signature - Reporting CSO Date Submitted Signature - USMS JSI / COR Date Submitted

Court Facility Incident Report (continued)

DATE OF INCIDENT:DATE OF REPORT:

Note: Completed forms containing personally identifiable information (PII) must be encrypted and include the appropriate marking (U/LES) in the SUBJECT line of the message prior to dissemination via email outside of USMS.

UNCLASSIFIED // LES Form CSO-003 Rev. 03/22 DISTRIBUTION: DISTRICT COR - 1 COPY / OCS - 1 COPYPAGE ____ OF ____

INCIDENT DESCRIPTION (Details should cover who, what, where, when and how) - CONTINUED:

UNCLASSIFIED // LES

Note: Completed forms containing personally identifiable information (PII) must be encrypted and include the appropriate marking (U/LES) in the SUBJECT line of the message prior to dissemination via email outside of USMS.

UNCLASSIFIED // LES

Form CSO-003 Rev. 03/22

DISTRIBUTION: DISTRICT COR - 1 COPY / OCS - 1 COPY

PAGE ____ OF ____

Court Facility Incident Report (continued) Note: Completed forms containing personally identifiable information (PII) must be encrypted and include the appropriate marking (U/LES) in the SUBJECT line of the message prior to dissemination via email outside of USMS.

UNCLASSIFIED // LES

Form CSO-003 Rev. 03/22

DISTRIBUTION: DISTRICT COR - 1 COPY / OCS - 1 COPY

PAGE ____ OF ____

U.S. Department of Justice United States Marshals Service Court Facility Incident Report

6. WAS SUBJECT DETAINED?

8. TYPE OF INCIDENT (Check applicable box):

9. CHECK APPLICABLE BOX:

I hereby certify that the information stated herein is true, complete, and accurate to the best of my knowledge.

9.0.0.2.20101008.1.734229