Internal Theft Incident Report v2

• Interview Date

  Date

• Employee / Person Full Name / Store Code / Location Name

• Prepared by

AMERICAN APPAREL - THEFT INCIDENT REPORT

GENERAL INFORMATION

• Incident Case #

• Name of Investigator Completing Theft Incident Report

• Investigator E-Mail and Telephone Number

• Date and Start Time of Interview

  Date

• Date and End Time of Interview

  Date

• Store Code and Location Name

• Name of Manager on Duty

• Incident Type

  Select Merchandise Theft Register Cash Theft Deposit Cash Theft Unauthorized Discounts Fraudulent Returns Unauthorized Commissions Time Card Manipulation Falsify Expense Report Inappropriate Use of Petty Cash Allowance Violation On-Line Sale Through Merchandise Theft Sale to Used Clothing Store Through Merchandise Theft Other (operational)

  • Merchandise Theft
  • Register Cash Theft
  • Deposit Cash Theft
  • Unauthorized Discounts
  • Fraudulent Returns
  • Unauthorized Commissions
  • Time Card Manipulation
  • Falsify Expense Report
  • Inappropriate Use of Petty Cash
  • Allowance Violation
  • On-Line Sale Through Merchandise Theft
  • Sale to Used Clothing Store Through Merchandise Theft
  • Other (operational)

• Case $ Value (based on admission)

• Internal Case Generated By

  Select Exception Report Covert Camera Video Surveillance Tip by Asset Protection Investigator Tip by Management Tip by Employee Audit Store Visit Rollover from Ongoing Investigation Anonymous Tip

  • Exception Report
  • Covert Camera
  • Video Surveillance
  • Tip by Asset Protection Investigator
  • Tip by Management
  • Tip by Employee
  • Audit
  • Store Visit
  • Rollover from Ongoing Investigation
  • Anonymous Tip

• Video Available?

  Yes

  No

  N/A

• Date and Time of Video (if applicable)

  Date

• Disposition of Investigation

  Select Booked by Law Enforcement Terminated Suspended Pending HR Review Return to Work Employee Resigned

  • Booked by Law Enforcement
  • Terminated
  • Suspended Pending HR Review
  • Return to Work
  • Employee Resigned

• Date and Time Police Contacted

  Date

• Date and Time Police Took Employee into Custody

  Date

• Name and Telephone Number of Police Agency Contacted

• Officer Name and Badge Number

• Employee Booked

  Yes

  No

  N/A

• Police Agency Case Number (if applicable)

EMPLOYEE INFORMATION

• Employee Full Name (as it appears on file)

• Street Address (include APT number, if applicable)

• City and State

• Zip Code

• Residence Telephone Number (N/A if not available)

• Mobile Number (N/A if not available)

• State Identification Number (N/A if not available)

• Adult or Minor

  Adult

  Minor

• Was the parent of the minor contacted

  Yes

  No

  N/A

• First & Last Name of Parent Contacted

• Employee D.O.B.

• Age of Employee

• Employee ID Number

• Employment Status

  Select Full Time Part Time Seasonal

  • Full Time
  • Part Time
  • Seasonal

• Hire Date

• Position

  Select Store Manager Assistant Manager Key Holder Cashier Sales Person Back Stock / Inventory Control District Sales Manager District Back Stock / Inventory Control Merchandiser Factory Employee Maintenance Fresh Air Janitor Sewing Packing Shipping Cutting temp

  • Store Manager
  • Assistant Manager
  • Key Holder
  • Cashier
  • Sales Person
  • Back Stock / Inventory Control
  • District Sales Manager
  • District Back Stock / Inventory Control
  • Merchandiser
  • Factory Employee
  • Maintenance
  • Fresh Air
  • Janitor
  • Sewing
  • Packing
  • Shipping
  • Cutting
  • temp

INCIDENT REPORT (document details of the incident and interview with employee)

• Incident Report part 1

• Incident Report part 2

• First & Last Name of Witness (if applicable)

• Witness Employee ID #

• Witness Job Title

• Witness D.O.B.

• Witness E-mail and Telephone Number

• Witness Statement part 1

• Witness Statement part 2

• Employees Involved (if applicable)

• Property List (list any items by their style code for merchandise theft cases)

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• List Style Code and Description, Quantity and Retail Price

• Employee Statement (upload statement here)

  Media

• Promissory Note Signed (if applicable)

  Yes

  No

  N/A

• Promissory Note (upload document here)

  Media

• Investigation Notes / Evidence (upload document(s) here)

  Media