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PRIMECITADEL SECURITY AGENCY INC.

MANILA URBAN SETTLEMENT OFFICE


BINONDOMINIUM SECURITY DETACHMENT
Brgy. 272, Delpan St., City of Manila
FOR : MS RUBY VILLANUEVA
Admin Officer, Binondominium
MR EDGARDO MANALILI
Admin Officer, Binondominium
THRU : SO EDGAR MATUDAN JR, RCrim.
Officer-In-Charge, BTSD
SUBJECT : Information Report
Re: Damage Report Form

Location of Damage: ________________________________________________ Date: _____________


Description of Damage:
[ ] Broken Glass [ ] Broken Lock [ ] Canopy Damage
[ ] Graffiti [ ] Broken Window
[ ] Wall Damage [ ] Broken Door

[ ] Other:
_____________________________________________________________________________________
Description of Incident:
Description of Persons Involved (if known): Use back page if necessary.
Name: ___________________________________________________ Unit Number: ___________
Name: ___________________________________________________ Unit Number: ___________
Name: ___________________________________________________ Unit Number: ___________
Action Taken:
[ ] Photographs taken [ ] Police notified
[ ] Area secured [ ] Maintenance/Utility notified
[ ] Other(s):
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Prepared by:

Integrity. Loyalty. Competency.


____________________________
(Signature over Printed Name)

Integrity. Loyalty. Competency.


Integrity. Loyalty. Competency.

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