QUINLAN ENTERPRISES

480 Calit-Calit, San Juan, Batangas

Company Property Loss/ Damage Form

QUINLAN Enterprises employees are required to report any damage, loss or theft of QUINLAN Enterprises owned
materials as soon as possible and submit a completed copy of this form within 24 hours of the incident.

Please note that where an injury occurs as a result of any damage, loss or theft of QUINLAN Enterprises owned and
operated equipment, employees are required to report the incident immediately, and submit a completed Incident
Report and Investigation Form.
Damage / Loss - Reported By
Employee Name: Employee Number:

Position/Title: Department:

Incident Information

Reported on: ___/___/___ Time Reported (24 hour clock):

Supervisor: Specific Location:

Equipment Information
List of Equipment Damaged / Lost
(Please Specify)

Equipment Damage/ Lost Location

Description of Damage Company Property

Estimated Cost of Repair / Replacement

Action/s Taken:

Prepared by: Lovely B. Salimo

Administrative Officer

Acknowledgement & Agreement

Supervisor: ____________________________________________

Signature: ____________________________________________

Date: ____________________________________________