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Transfer Request
Supervisor Portal
Incident Report
(Solomon Elementary
School
)
41 Abbott St Plains, PA 18705
Please take a moment to fill out the form.
Date (MM/DD/YYYY)
*
required
Time (00:00am/pm)
Location of incident
Incident Type
Choose an incident type
If you selected Others
Report prepared by (ENTER YOUR FIRST AND LAST NAME)
Name of Victims/Subject/Suspect
Name of the SSCI Officers
Department/Agency
Name of Emergency Personnel (i.e PD. Officer Smith)
What took place (Who, what, where, when, why and how?) PLEASE PUT IN DETAILS WHAT HAPPENED IN 3RD PERSON?
Other Pertinent Information:
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