## Sheet1
Government of the U.S. Virgin Islands
MISSING OR STOLEN PROPERTY REPORT										Report No.
Department/Agency/Bureau								Date VIPD Notified				VIPD Report No.
Location								VIPD Officer
City				Island				Departmental Accountable Officer
Date of Occurence				Time				Phone No.				Extension
Asset ID No.		Federal / Local		Description of Property                                       (Include Make & Model)				Serial Number			Estimated     Value		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.
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.
		Signature							Date
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