Kippa Ring Security Incident Report

At 20.18 Women customer complain me about Kippa fresh fruit vege cover is very dangerous and her daughter fall down last time she was at shopping centre .

• Gurtejpal Singh

• 04/08/14

  Date

• What kind of incident are you investigating?

  Select Motor Vehicle Theft Major Retail Theft over $150 Minor Retail Theft under $150 Steal From Person Drug Use Alcohol Consumption Unruly Anti Social Behaviour Assault Fraud Unsecured Shop First Aid Assist

  • Motor Vehicle Theft
  • Major Retail Theft over $150
  • Minor Retail Theft under $150
  • Steal From Person
  • Drug Use
  • Alcohol Consumption
  • Unruly Anti Social Behaviour
  • Assault
  • Fraud
  • Unsecured Shop
  • First Aid Assist

• Name of Police Officer and QP Number.

Incident Details

• Name of person (if any)

• Address and Phone Number
  Address

• Select date

  Date

• Describe in detail what happened?

• Describe in detail the items taken if applicable.

• Please add as many images as you can that relate to the incident.

  Media

Witness Statement 1

• Please interview all witnesses and ask for signatures

• Name Address and Phone Number

• Statement

  Yes

  No

  N/A

• I confirm that the information I have provided in relation to this incident is accurate.

  Sign

Witness Statement 2

• Please interview all witnesses and ask for signatures

• Name

• Address and Phone Number
  Address

• I confirm that the information I have provided in relation to this incident is accurate.

  Sign

• Select date

  Date

Exclusion Notice to be issued

• Was a 24hr verbal exclusion given?

• Is a longer exclusion notice to be issued by Centre Management?

• How many months is the offender to be excluded for?

Incident Reporting

• Are you required to notify Centre Management of this incident immediately?

  Yes

  No

Authorisation

• I agree that all information provided by me in this report is accurate.

• Gurtejpal Singh

  Sign