Harwood Union Issued Device Incident Report
Use this form as soon as possible to report lost, stolen, or damaged devices.
Name of Person Filling Out this Form
Your answer
Student First Name
Your answer
Student Last Name
Your answer
What kind of device is it?
HU Device #
Look for the asset tag # from Harwood.
Your answer
TA Teacher
Your answer
Who was the first adult you reported this to?
Your answer
When did you first know of this problem?
Tell us the date and time if you can.
MM
/
DD
/
YYYY
Time
:
Lost, Stolen or Broken
Describe in detail what has happened and/or what the problem is.
If lost/stolen, tell us when & where the last time it was in your hands and if the power was on.
Your answer
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