Step 1 of 8 12% Organisation Name*Name of person completing the form* Full name Position*Email*PhoneWork base address* Street Address Address Line 2 City County Postcode Was the equipment lost or stolen?*LostStolenAddress/location at which items lost or stolen* Street Address Address Line 2 City County Postcode Type of equipment/device*LaptopMobile PhoneTabletPCOtherIf other type of equipment please give details*Make*Manufacturer of deviceModel*Model number and or name of deviceSerial numberAsset numbere.g. PC Number if DCC PC or Laptop Name of person to which device was assigned* First Last Describe any personal data held on the equipment*information about individualsDescribe any other type of information that was on the device*e.g. business information Provide a description of the incident*Who was in the building at the time of the incident?* Date equipment was last seen/used* DD MM YYYY Time equipment was last seen/used* HH : MM AM PM Approximate value of item*Names of any witnessesIf anyone saw anything suspicious on that day or previous day, give details How did the thief gain access to the equipment?*Give 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?YesNoWhat is needed to secure the site?*e.g. Replace glass, change locks, change passwords?Roughly, 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?*YesNoDate Police Notified* DD MM YYYY 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?*Date form completed* DD MM YYYY Consent* I agree to the privacy notice. CAPTCHA