Cash Handling Incident Report
Please use this form to report any cash handling discrepancies, losses, or irregularities. Provide detailed information to assist with investigation and resolution.
Reporter Full Name
*
First Name
Last Name
Reporter Email Address
*
example@example.com
Reporter Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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
*
Type of Incident
*
Please Select
Cash Shortage
Cash Overage
Theft/Suspected Theft
Counterfeit Currency
Lost Cash
Other
Amount Involved (USD)
*
Names of Other Individuals Involved (if any)
Detailed Description of the Incident
*
Immediate Actions Taken
*
Was a supervisor/manager notified?
*
Yes
No
Upload Supporting Evidence (photos, receipts, documents, etc.)
Upload a File
Drag and drop files here
Choose a file
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of
Follow-up or Investigation Notes (for office use)
Signature (to verify accuracy of report)
*
Submit Report
Submit Report
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