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?


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