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Property Loss Report

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Property Loss Report Powered By Docstoc
					Property Loss Report
Department__________________________________________ Date ______________ Completed by ________________________________________ Date ______________

Cause of Loss  Theft  Vandalism  Burgl ry a  Tools and Equipment  Fire/Arson  Accident Damage —  Unexplained

Type of Loss  Property Damage  Inventory  Money/Cash  Tools and Equipment  Employee Time  Business Interruption  Other: _________________________________________ ___________________________________________ _____

 Ot er: h _______________________________________ _______________________________________

Date and time loss occurred _______________________________________________________ Date and time loss reported _______________________________________________________  Police report made Report ID # ___________________________________________ List police department contacts and notes ____________________________________________ ______________________________________________________________________________ Besides the property loss, were there any other consequences of the loss? __________________ ______________________________________________________________________________ ______________________________________________________________________________ Could this loss have been avoided?  Yes  No If yes, how? ___________________________________________________________________ ______________________________________________________________________________ Other comments, notes: __________________________________________________________

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posted:12/27/2007
language:English
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