Property Damage Incident Report Sample

By | September 17, 2016

There is no actual format that you can follow when writing a property damage incident report. Every organization has its own format which can be tweaked to meet the requirements, according to the incident. Most reports of this sort are form-based – an authorized personnel needs to fill out a form, the information from which will be eventually used to gauge how much damage was done and what costs are involved.

Most organizations may not have a particular property damage incident report – instead, they will have a standard one in which you can detail if there was bodily injury involved, property damage or both. The form usually has all the information of the people involved in an incident, including the perpetrator who was responsible for damage to the said property, and witnesses if any.

A property damage incident report is usually filled out by the risk management department of an organization. It may be a complicated form or a very simple one, depending on the company’s own requirements. Here is a standard property damage incident report that you can take reference from:

Download: Property Damage Incident Report Sample


Property Damage Incident Report Sample

Risk Management Department
Property Management Workforce
152 Elm Street
New York, NY 10283
(000) 888-8888


Date and Time Reported: ___/___/____ am/pm ________
Exact location: ________________________________________
Date of Incident: _____  Time of Incident ______  Day of Week _____
Incident Reported by: _____________________
Incident Reported to: _________________
Time Incident Location Inspected:  ______________
Inspected by:  __________________


Items Damaged: ___________________________________________
Detailes: _________________________________________________
Viewed by: ________________________________________________
Photographed and by Whom: _________________________________

LOCATION OF INCIDENT – Please tick appropriate box.

        ☐ Kitchen
        ☐ Bathroom
        ☐ Laundry
        ☐ Dining Room
        ☐ Living Room
        ☐ Bedroom
        ☐ Stairs
        ☐ Deck
        ☐ Garage
        ☐ Pathway
        ☐ Lawn
        ☐ Other: (Please specify)_______________


Name of Witness to Account  _________________________

Surname: ___________   Given Names: ___________

Witness Address:_______________________________________

Telephone #:  Home ________  Business ________  Mobile___________

Type of Witness

☐ _______________________________________ Witness

☐ _______________________________________ Eye Witness

☐ _______________________________________ Circumstantial

Relationship to the injured person: ______________________


Police Department – Station:  ___________________
Officer’s Name: _______________________
Report #: _____________________
Details: _________________________________
Fire Department  –  Station:  ___________________
Officer’s Name: _______________________
Report #: ______________________
Details: ______________________


☐ Potential Danger – Immediate action required.
☐ Security Risk – Immediate action required.
☐ Urgent and Important – Action within 1 hour.
☐ Important but not Urgent – Action within 3 hours.

Provide details of specific actions taken:


Name: __________________________________________
Designation: _____________________________________
Department: _____________________________________

Additional Notes: