Scribd
Upload
3K views

Property Damage Incident Report Sample

This property damage incident report summarizes damage that occurred at a property on a specific date and time. It details the items damaged, who witnessed and photographed the damage. It also indicates the location where the incident took place and includes details from any witnesses. Finally, it lists what emergency services were contacted about the incident and the actions taken in response.

Uploaded by

Honey Grace Lagura
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
3K views

Property Damage Incident Report Sample

This property damage incident report summarizes damage that occurred at a property on a specific date and time. It details the items damaged, who witnessed and photographed the damage. It also indicates the location where the incident took place and includes details from any witnesses. Finally, it lists what emergency services were contacted about the incident and the actions taken in response.

Uploaded by

Honey Grace Lagura
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

Risk Management Department

Property Management Workforce


152 Elm Street
New York, NY 10283
(888) 888-8888

PROPERTY DAMAGE INCIDENT REPORT


PROPERTY__________________________________________________ Date and Time Reported ___/___/____
________am/pm
Exact location _________________________________________________________________________________________________
Date of Incident _____________________ Time of Incident ________________________ Day of Week __________________________
Incident Reported by __________________________________ Incident Reported to ________________________________________
Time Incident Location Inspected ________________________ Inspected by _____________________________________________

PROPERTY DAMAGE DETAILS


Items Damaged_____________________________________________________________________________
Detailes:___________________________________________________________________________________
Viewed by:_________________________________________________________________________________

Photographed and by Whom_________________________________________________________________


LOCATION OF INCIDENT Please tick appropriate box.

Kitchen
Bathroom
Laundry
Dining Room
Living Room
Bedroom
Stairs
Deck
Garage
Pathway
Lawn
Other: (Please specify.)________________________________________________________

WITNESS DETAILS
Name of Witness to Account
__________________________________________________________________________
Surname Given Names
Witness Address:___________________________________________________________________________
Telephone # Home _________________________Business
_______________________Mobile______________________
Type of Witness
Witness
Eye Witness
Circumstantial
Relationship to the injured person:
__________________________________________________________________________________________
_
REPORTED TO

Police Department - Station ___________________ Officers Name _______________________


Report # _____________________
Details:
___________________________________________________________________________________
________
Fire Department - Station ___________________ Officers Name _______________________
Report # ______________________

Details

ACTION CHECKLIST

Potential Danger Immediate action required.


Security Risk Immediate action required.
Urgent and Important Action within 1 hour.
Important but not Urgent Action within 3 hours.

Provide details of specific actions taken:

REPORTER INFORMATION
Name: __________________________________________

Designation: _____________________________________

Department: _____________________________________

Additional Notes:

You might also like