Day & Date :

Time Report :
By :

LOSS PROPERTIES FORM

Name Guest :…………………………………………………………………………… .Age :………..

Retreats/Villa :………………………………………………………………………………..Nationaly:…………

Permanent Address : ……………………………………………………………………………… Sex : M/F

Date Arrival : ……./……./……… Expected Departure:…../…./…

DESCRIPTION OF LOSS ITEM

Description : (Estimate Cost) : Date of purchase :..../...../......

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Please Indicate where and when the properties was loss ?

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Special remark
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When did you last see those properties

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Did you have any Visitor during your stay before this incident?

Name :............................................................................................................................................................

Address : ...........................................................................................................................................................

Time :...........................................................................................................................................................

How many person :............................................................................................................................................................

Is The Police Action required ? Yes/No

Report by, Received by, Witness by,

Name : Name: Name:

Guest Signature Security Duty Manager