Information

  • Venue Number and Name

  • Conducted on

  • Prepared by: (Full Name)

  • Location
  • Key holder Name: (If present)

Incident

  • Type of Incident

  • Date and time incident occurred

  • To whom was incident reported?

  • Names of staff

  • Date and time incident was reported:

  • Were there staff on Duty

  • Was there any witness(es)? If yes, provide name(s).

  • Witness

  • Witness #
  • Name:

  • Add signature

Details of Entry

  • Was entry gained

  • Photo/s of entry point

  • Entry point#
  • Photo/s

  • Was the Staff Guard or Panic Button activated?

Details of Damage

  • Any Damage To The Venue?

  • Photos of damage

Cash Loss

  • Was there any cash loss?

  • Total cash Loss

  • Where were the keys being stored?

  • Were the keys to GeWete, ATMs, Safes locked in a timelock safe?

Offender Information

  • Were offenders apprehended

  • Details of offender

  • Offenders
  • Offender #1: Name & other information.

After Incident Actions Taken

  • Was Police called?

  • Police Officers Name:

  • From what police station:

  • Event Number:

  • Will officer require copy of report?

  • Did the Police request or take a copy of the CCTV evidence

  • Was the Area Manager called?

  • Area Manager Name

Analysis

  • Was site secure?

  • What action was taken:

  • Was Locksmith Required

  • Was a static guard required

  • Name of static guard placed on site

  • Time guard arrived on site

  • Security License#

  • Expiry Date

Auditor Findings

Incident Notes

  • Any Further Notes

  • Note/s

  • Note #
  • Notes by (Persons Name)

  • Note:

Recommendations

Follow Up Action - If required

Signature's

  • Auditors Signature

  • Area Manager Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.