Form # DPP-ASMA-005-2024
Approved  4-15-2024
Condition
            
Please check one.
Our investigation of the circumstances surrounding the property listed herein indicates reasonable
cause to determine that the loss of this property was through the negligence of the person(s) charged 
with the care and custody of this property.
Our investigation of the circumstances surrounding the property listed herein indicates reasonable 
cause to determine that the loss of this property was not through the negligence of the person(s) 
charged with the care and custody of this property.
Government of the U.S. Virgin Islands
Departmental Accountable Officer
VIPD Officer
Date VIPD Notified
VIPD Report No.
Department/Agency/Bureau
Report No.
             MISSING OR STOLEN PROPERTY REPORT
Date of Occurence
Time
Location
City 
Island
Asset ID No.
Phone No.
Extension
Federal / Local
Description of Property
(Include Make & Model)
Serial Number
Estimated 
Value
This form should be signed and dated by the Department/Agency Head or designated representative. If a designated representative completes this form, the rank of that individual should be greater    than 
that of the Accountable Officer.
Print
Title
Signature
 Date 
SIGN