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Property Damage Report
Andrews University
Information about the property
1. Describe the property that was damaged or stolen.
2. Please provide estimated replacement or repair cost.
3. Who owns the property (university, department or you personally)?
Your name Daytime phone
Home address (if you own the property)
Information about the damage or theft
1. What were the date and time when the loss occurred?
2. Please describe what happened.
3. Was campus safety notified? If yes, what date were they notified?
If property was damaged:
1. Where did the damage occur (be as specific as you can).
2. Describe the damage that occurred.
3. Did anybody see it happen?
If so, provide their names and phone numbers.
Name Phone
Name Phone
Name Phone
Name Phone
If property was stolen:
1.Where was the property when it was stolen (be specific)?
2. Was the property behind a locked door when it was stolen?
3. Was there evidence of forcible entry? If yes, please describe
Your signature Date
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