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Security Incident Report Description:____________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Other Ministries/People Involved: Safety Name________________________________ Children's Name___________________________ Usher Name________________________________ Parking Name ____________________________ Staff Member Name__________________________ Greeter Name_____________________________ Other Ministry Name_________________________ Person A-Victim/Witness/Suspect Information (Statement information on back): Name:___________________________________ Address:_________________________________ Phone:__________________________________ ________________________________________ Description:______________________________ Person B-Victim/Witness/Suspect Information (Statement information on back): Name:___________________________________ Address:_________________________________ Phone:__________________________________ ________________________________________ Description:______________________________ Report #_____________ Date________________ Security Team Member: _____________________ Nehemiah 4:9 “But we prayed to our God and posted a guard day and night to meet this threat.” Other_______... Suspect Witness Victim Other_______... Suspect Witness Victim Other__________________ Threat Suspicious Activity Vandalism Disruption Theft Injury

Security incident report

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Page 1: Security incident report

Security Incident Report

Description:____________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Other Ministries/People Involved:

Safety Name________________________________ Children's Name___________________________

Usher Name________________________________ Parking Name ____________________________

Staff Member Name__________________________ Greeter Name_____________________________

Other Ministry Name_________________________

Person A-Victim/Witness/Suspect Information (Statement information on back):

Name:___________________________________

Address:_________________________________ Phone:__________________________________

________________________________________ Description:______________________________

Person B-Victim/Witness/Suspect Information (Statement information on back):

Name:___________________________________

Address:_________________________________ Phone:__________________________________

________________________________________ Description:______________________________

Report #_____________

Date________________

Security Team Member:

_____________________

Nehemiah 4:9 “But we prayed to our God and posted a guard day and night to meet this threat.”

Other_______...SuspectWitnessVictim

Other_______...SuspectWitnessVictim

Other__________________ThreatSuspicious ActivityVandalismDisruptionTheftInjury

Page 2: Security incident report

Person C-Victim/Witness/Suspect Information (Statement information on back):

Name:___________________________________

Address:_________________________________ Phone:__________________________________

________________________________________ Description:______________________________

Person A Statement:_____________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Person B Statement:_____________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Person C Statement:_____________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Other Comments:________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

__________________________________ ________________________________

Name/Signature, STM Name/Signature, Security Team Chief

Other_______...SuspectWitnessVictim


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