Burgettstown Form | Ssc Employee Portal

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Incident Report (Burgettstown)

104 Bavington Road Burgettstown, PA 15021

Please take a moment to fill out the form.

Date (MM/DD/YYYY)

Time (00:00am/pm)

Loation of Incident

Incident Type

If you selected Others

Report prepared by (ENTER YOUR FIRST AND LAST NAME)

Name of Victims/Subject/Suspect

Name of SSCI Officers

Department/Agency

Name of Emergency Personnel (i.e PD. Officer Smith)

What took place (Who, what, where, when, why and how?) PLAESE PUT IN DETAILS WHAT HAPPENED IN 3RD PERSON?

Other Pertinent Information:

Photo

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Thanks for submitting!

stadesse@sscsecurity.com

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