Plano ISD Benefits and Risk Management Department Loss Report Form

Instructions:   Losses must be reported as soon as possible.  Fill out a separate form for each item involved.  This original report detailing the loss will be used for police and insurance reporting.  It is very important that all pertinent facts concerning the loss be included and all items below completed.

Loss Report

 
 
  Click to Open Calendar. The Date format is MM/DD/YYYY
 
 
  Click to Open Calendar. The Date format is MM/DD/YYYY
 
 
 
 
 
  Click to Open Calendar. The Date format is MM/DD/YYYY
 
 
 
 
Type of loss: (this a required field)
 
 
 
 
   

You will be able to submit this form AFTER you click the Submit/Preview button.