Report a theft or loss of IT equipment - Devon Assurance Partnership

Organisation Name*

Please note, this form is intended for use by our client organisations to report a theft or loss of IT equipment. Any theft loss should also be reported as per the client organisations procedures.

Name of person completing the form*

Full name

Position*

Email*

Phone

Work base address*

Street Address Address Line 2 City County Postcode

Was the equipment lost or stolen?*

Address/location at which items lost or stolen*

Street Address Address Line 2 City County Postcode

Type of equipment/device*

If other type of IT equipment please give details*

Make*

Manufacturer of device

Model*

Model number and or name of device

Serial number

manufacturer serial number if known

Asset number

e.g. PC number if DCC Laptop

Name of person to which device was assigned*

Full name

Describe any personal data held on the equipment*

information about individuals

Describe any other type of information that was on the device*

e.g. business information

Provide a brief description of the incident*

Who was in the building, or present, at the time of the incident?*

Date equipment was last seen/used*

Time equipment was last seen/used*

:

Approximate value of item*

Names of any witnesses

200

If anyone saw anything suspicious on that day or previous day, give details

How did the thief gain access to the equipment?*

Provide details of any evidence of a break-in or damage to other equipment?*

Was anything else relating to the equipment stolen?*

e.g. manuals, carry case

Please give full details of security controls in operation at time of theft or loss*

Please give full details of security controls in situ, but not in operation at time of theft or loss*

Has the site been secured?

Yes

No

What is needed to secure the site?*

e.g. Replace glass, change locks, change passwords?

Approximately, what is the expected cost of clearing up and securing the site?*

What action could be taken to prevent re-occurrence?*

Have the police been informed?*

Date Police Notified*

By whom?*

Police station at which theft reported*

Name of police officer handling the case*

First Last

Crime reference number*

Are the police going to visit?*

Have you registered the theft/loss of the equipment on the National Property Register?*

Some of our client organisations require that the theft or loss of IT equipment is reported via the National Property Register, https://www.immobilise.com Please refer to your organisations guidance.

Date reported on the National Property Register*

Date form completed*

Consent*

I agree to the privacy notice.

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Email

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