• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Date and time of incident

  • Date and time incident was reported.

  • Additional Information on Time of Theft

  • To whom was the incident reported?

  • Location of incident.

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


  • Name

  • Address

  • Phone:

  • Email address


  • Describe of items stolen

  • Detail of location and additional information

  • Detailed description of theft (Include environmental conditions at time of incident)

  • Property Damage:

  • Photo of damage.

  • Estimated cost of damage:

Police Call

  • Time Police Called

  • Additional Information


  • Select date

  • Customers Signature

  • Select date

  • Security Managers 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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.