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Incident Report
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Your name:
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Today's Date:
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Date of Occurrence:
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Time of occurrence:
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Explanation: (Submit a separate page and turn it in if your text will not fit here)
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Persons involved: (names and phone numbers)
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Employees present:
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Were the police notified?
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Was the supervisor/director notified
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Damage or loss: List items stolen, lost, broken and their value.
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Individual(s) description: Information needed for future follow up by police or staff.
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Signature: Your supervisor will have you sign a copy this report.
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COVID-19
Citizens
Utilities
Government
In Our Community
How do I...?
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