Homicide Survey - Incident Questionnaire: 2015 to 2016

Canadian Centre for Justice Statistics
Policing Services Program

Confidential when completed

Please provide information as of time of the incident for each victim.

See instructions on last page for items indicated with an asterisk ( * ) or refer to the "Scoring Guide for the Homicide Survey".

This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Completion of this questionnaire is a legal requirement under this act.

Objective

This survey collects essential data to produce statistics on the incidence and characteristics of homicide offences in Canada. The information is used by federal and provincial policymakers as well as public and private researchers. The data are also widely disseminated by the media for purposes of general public information. The information may also be used by Statistics Canada for other statistical and research purposes.

Confidentiality

Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes.

Record linkages

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada may combine the information you provide with other survey or administrative data sources.

Instructions

Please return this questionnaire by December 31st, "Collection Year". Questionnaires may be returned by mail (see address below) or through the Electronic File Transfer system.

Correspondence

Statistics Canada
ATTN: Central Reception
200 blvd. de la Technologie
Gatineau, QC J8Z 3H6
Phone: Toll free 1-888-659-8229
Fax: 1-888-883-7999
E-mail: homi-surv@statcan.gc.ca

Fax or e-mail transmission disclosure

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.

  1. Name of force / detachment where homicide occurred
  2. Respondent code
  3. Incident file number
  4. Number of homicide victims
  5. Number of chargeable homicide suspects
  6. Date of incident (i.e. date of attack – if exact date is unknown, estimate the date)
    • Year / Month / Day
  7. Report date (i.e. date upon which a homicide became known to police or upon which an incident was determined to be a homicide)
    • Year / Month / Day
  8. Time of incident (if exact time is unknown, estimate the time)
    • 1 From 00:01 to 04:00
    • 2 From 04:01 to 08:00
    • 3 From 08:01 to 12:00
    • 4 From 12:01 to 16:00
    • 5 From 16:01 to 20:00
    • 6 From 20:01 to 24:00
    • 9 Unknown
  9. Specific type of location of incident * (check one only)
    • 01 Single home, house, townhouse
    • 02 Other residential dwelling unit (e.g., rooming house, dormitory, seniors' residence)
    • 03 Apartment building
    • 04 Hotel, motel, bed & breakfast
    • 05 Convenience store - Go to Question 11
    • 06 Gas bar - Go to Question 11
    • 07 Bank, trust company - Go to Question 11
    • 08 Bar, restaurant, after-hours club - Go to Question 11
    • 09 Other commercial / corporate place - Go to Question 11
    • 10 Parking lot - Go to Question 11
    • 11 School (Primary / Secondary) * - Go to Question 11
    • 12 University / College - Go to Question 11
    • 13 Correctional institution - Go to Question 11
    • 14 Community group home / halfway house - Go to Question 11
    • 15 Public institution - Go to Question 11
    • 16 Privately owned vehicle - Go to Question 11
    • 17 Taxi, limousine - Go to Question 11
    • 18 Public transportation and / or connected facility - Go to Question 11
    • 19 Street, road, highway - Go to Question 11
    • 20 Open area * - Go to Question 11
    • 21 Other – specify - Go to Question 11
    • 99 Unknown - Go to Question 11
  10. Occupancy of the residence where the incident occurred
    • 1 Joint occupancy by one or more victims and one or more of the chargeable suspects
    • 2 Occupied by one or more victims
    • 3 Occupied by one or more of the chargeable suspects
    • 4 Neither any of the victims nor any of the chargeable suspects were occupants
    • 9 Unknown
  11. Location of incident (if rural, give section, township and range or distance to nearest town)
    • City – town – village
      County – Township – Rural Municipality
      Postal Code
  12. Most serious violation (indicate even if homicide is unsolved)
    • 1 Murder – 1st degree
    • 2 Murder – 2nd degree
    • 3 Manslaughter
    • 4 Infanticide
  13. Clearance status *
    • 1 Cleared by charge (laid or recommended)
    • 2 Cleared by suicide
    • 3 Cleared otherwise – specify
    • 4 Not cleared - Go to Question 15
  14. Clearance date
    • Year /Month /Day
  15. Associated or related offence committed by the chargeable suspect(s) that lead to this homicide * (e.g., robbery that ends in the death of the victim(s)) (check the most serious offence)
    • 88 No related offence
    • 1 Sexual assault
    • 2 Other assault
    • 3 Kidnapping, abduction, etc.
    • 4 Robbery – personal
    • 5 Robbery – bank, other commercial institution
    • 6 Criminal harassment (Stalking)
    • 7 Other violent crime
    • 8 Arson
    • 9 Break and enter
    • 10 Theft
    • 11 Other property crime
    • 12 Prostitution-related offence
    • 13 Other Criminal Code
    • 14 Controlled Drugs and Substances Act
    • 15 Other Federal / Provincial Statute
    • 99 Unknown
  16. Indicate type of drug involved if the homicide was related to the illegal drug trade * (i.e., drug trafficking or settling of drug accounts) (check the drug involved in the most serious CDSA offence)
    • 88 Not drug-related
    • 01 Cannabis
    • 02 Cocaine (includes crack)
    • 03 Heroin
    • 04 Other controlled drugs and Substances
    • 05 Evidence of drugs – type unknown
    • 99 Unknown
  17. Evidence that this incident was gang-related (involving organized crime or street gangs)
    • 0 Suspected
    • 1 Yes
    • 2 No
      9 Unknown
  18. Apparent motive related to the incident * (Check one only)
    • 01 Settling of accounts (e.g., drug / gang-related)
    • 02 Revenge
    • 03 Jealousy
    • 04 Concealment (e.g., killing newborn)
    • 05 Argument or quarrel
    • 06 Frustration, anger or despair
    • 07 Financial gain, protection of assets
    • 08 Personal protection (e.g., battered spouse)
    • 09 Hate crime *
    • 10 Fear of apprehension
    • 11 Terrorism, political cause
    • 12 Sexual violence
    • 13 Mercy killing / assisted suicide
    • 14 No apparent motive
    • 15 Other – specify
    • 99 Unknown
  19. Narrative * (Provide a summary of special or specific circumstances leading up to and surrounding the homicide incident)

Authorization

This authorizes the Chief Statistician to disseminate aggregated information reported on these questionnaires, excluding personal identifiers (e.g., name, date of birth, FPS number) to the public.

  • Name of Official (please print)
  • Name of Police Service / Detachment
  • Signature
  • Date
  • Telephone Number (Area code before number)

Instructions

The Investigating Officer is the ideal person to complete this form.

9. School (primary / secondary) – Includes outside parking lots and playgrounds during and after regular school hours when used for education (e.g. adult night school), school sanctioned extra-curricular activities (e.g. sporting events, school dances, etc.) and other events (e.g. scout meetings, gymnasium rental, etc.) Homicides occurring on school grounds after the school is closed should be scored as "20 - Open area".

Open area – Includes areas to which the public has access such as bodies of water, parks and playgrounds, bush areas, and pleasure boats not being used as temporary residences.

13. Clearance status – When incidents are cleared by charge, suicide or otherwise, submit charged/suspect chargeable forms to the Homicide Project, Canadian Centre for Justice Statistics.

15. Associated or related offence - If the intent of the accused was to commit another offence which then led to the homicide, then an associated offence should be scored. If police can determine that the intent of the perpetrator was to commit homicide from the outset, then no associated or related offence can occur.

16. Illegal drug trade – Includes all homicides that occur as a result of either the accused or the victim being involved in the illegal drug business (e.g. drug dealing, settling of drug-related accounts or debts and drug trafficking disputes) including importing, trafficking and possessing drugs. This question does not refer to whether the accused and/or victim were under the influence of drugs at the time of the incident.

18. Hate crime – Includes all homicides where the accused person's primary motive was hate, prejudice or bias based on race, national or ethnic origin, language, colour, religion, sex, age, mental or physical disability, sexual orientation or any other similar factor.

19. Narrative – In your own words, provide greater detail of the motives and the events leading up to the homicide. Omitting important details about the homicide and/or scoring "unknown" without sufficient explanation will result in CCJS contacting the investigating officer to obtain clarification.

Thank you for your co-operation

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