Property Report Form

    Date of Occurrence:

    Address of Occurrence:

    Staff Name Reporting Accident:

    Contact Phone:

    Description of Occurrence:

    List Property Damage:

    Estimates Obtained?

    Temporary Repairs Started?

    Who is performing Temporary Repairs?

    Witnesses:

    Police Called (Department, Case Number:

    Photos Obtained?

    Additional Information:


    Privacy Policy Confirmation

     I agree to be contacted by Alera Group in accordance to their Privacy Policy as described below.

    By submitting this form, I agree I want to receive additional information from Alera Group, including by email, phone, and mail to the contact information I am submitting. I consent to Alera Group, its subsidiaries, and its service providers, processing my personal information for these purposes and as described in the Privacy Notice. I understand that I can withdraw my consent at any time.
     

    Report within 24 hours