Title Page

  • Conducted by:

  • Security Special Services @ Double Tree Hotel

  • Address: 39900 Balentine Drive, Newark, Ca 94560

  • Date:

  • Day / Shift Hours:

  • When an incident occurs, guards must complete an Incident Report. Attach any documents, photographs, and other pertinent evidence to this IR as necessary. Additionally, make sure all required notifications are made. This is not to be given out to anyone outside the organization. This report is ONLY for internal Security Special Services Management and the client management if requested.

Report

WERE THERE ANY?

  • Nature Of The Incident

  • Location of Incident

  • Approximate Date / Time of incident

  • Day of Week

  • Date / Time Incident was reported / Discovered

  • Day of Week

  • Was Police / Sheriff / 911 called?

  • Officer's Department, Name and Badge #

  • Case or Incident Report #

  • Weather Conditions

  • Were photographs taken?

Complainant Information

  • Name: Last, First MI

  • Address (Include City, State and Zip)

  • Phone / email

  • DOB / Sex

  • Is Complainant a registered guest? If so, hotel room #

  • Witnesses
  • Witness#1 Name, address, phone number

  • Witness #2 Name, address, phone number

  • Witness #3 Name, address, phone number

  • Property involved
  • Style, Size, Color, Condition, Approx value, Serial number if available

  • Description of Vehicle if applicable (Color, year, make/model, license plate, state)

  • Vehicle Registered owner name, address and phone number

  • Vehicle owned by:

Damages (If applicable)

  • undefined

NARRATIVE (Brief synopsis of incident)

  • undefined

Sign Off: This report is true and accurate to the best of my knowledge. Email report to Ulysses, Lee Jackson and Hotel Management. This report is required for record in anticipation of possible litigation.

  • Officer Name:

  • Supervisor:

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