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Workplace Violence Incident Report - The College at Brockport

It is a crime, punishable as a Class A misdemeanor, under the laws of New York State, for a person, in a written instrument, to knowingly make a false statement which such person does not believe to be true.

  • 1Individual Information> 2Incident Information> 3Assailant Information> 4Incident Results>5Review Your Entry
  • 1. Name of individual - victim/potential victim 1. Name of individual - victim/potential victim
  • 5. Work Phone Number 5. Work Phone Number - -
  • 6. Alternate Phone Number 6. Alternate Phone Number - -

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