Facility Unauthorized Entry Incident Report
Report and document incidents of unauthorized entry at your facility. Please provide as much detail as possible to assist with follow-up and investigation.
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Incident (Building, Room, Area)
*
Type of Unauthorized Entry
*
Please Select
Forced Entry
Tailgating/Piggybacking
Propped Door
Lost/Stolen Access Card
Unknown
Other
Full Name of Reporting Party
*
First Name
Last Name
Contact Email of Reporting Party
*
example@example.com
Contact Phone Number of Reporting Party
Please enter a valid phone number.
Format: (000) 000-0000.
Detailed Description of the Incident (what happened, how it was discovered, etc.)
*
Were any individuals observed or suspected?
*
Yes
No
If yes, provide names or descriptions of individuals involved (if known)
Were there any witnesses?
*
Yes
No
If yes, provide witness names and contact information
Actions Taken After the Incident (e.g., notified security, called police, secured area)
*
Upload any supporting files (photos, documents, etc.)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature of Reporting Party
*
Submit Report
Submit Report
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