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Vodafone Partner Incident Notification Form (Confidential — For Internal Use Only)
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Email the completed report to: Fraud (VHA_Fraud@tpgtelecom.com.au) and Physical Security (physical.security@tpgtelecom.com.au).
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CC: Regional Manager and Retail Function Support (retailfunction.support@tpgtelecom.com.au).
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Submit within 4 hours of becoming aware of the incident.
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1. Dealer & Store Information
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Dealer Group Name:
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Store Name:
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Store Manager Name:
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Store Address & State:
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Location specifics (e.g., inside shopping centre, kiosk, street frontage):
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2. Reporter Information
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Name of person completing report:
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Position / Role:
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Contact Number:
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Email Address:
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Date & Time report completed:
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3. Incident/Hazard Details
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Date & Time of incident:
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Type of incident (Customer aggression, injury, safety hazard, burglary, shop theft, theft by employee, fraud, etc):
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Detailed description of the incident (sequence of events, actions taken, people involved):
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4. Offender Information (if applicable)
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Method of operation (how the offence was committed):
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Number of offenders:
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Description of offender(s) (approx. age, build, clothing, distinguishing features):
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5. Evidence Available
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CCTV footage or photos available? (Y/N) If yes, attach files:
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6. Stock, Asset & Financial Impact
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Was any stock stolen or damaged? (Y/N). If yes, list items and estimated value:
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Stolen device IMEI number(s):
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For eSIM devices — Secondary IMEI (available from Vodafone Logistics):
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Estimated total financial impact (stock/cash/damage/fraud):
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7. Damage & Store Operations Impact
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Nature of damage (describe):
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Estimated cost of repairs:
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Was the store required to close? (Y/N). If yes, duration and estimated lost revenue:
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8. Customer Impact
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Did the incident affect any customers? (Y/N). If yes, describe:
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Was any customer information lost, accessed, or stolen? (Y/N). If yes, provide details:
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9. Injury Information
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Were any staff, customers, or members of the public injured? (Y/N). If yes, describe and current status:
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Medical treament provided (Y/N). If yes, describe:
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Will injured staff member miss any scheduled work shifts (Y/N)? If yes, describe:
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10. Police & External Notifications
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Were police notified? (Y/N):
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Police station / attending officer name / case reference number:
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Police attended on site? (Y/N):
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Centre management notified? (Y/N). Details:
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11. Internal Response & Escalation
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Internal teams notified: Regional Manager / DP / BDM
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Any media interest (Y/N) –if yes, what outlet and link to article (if able)
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12. Staff Misconduct (if applicable)
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If a staff member was the offending party: Name, position, current status (suspended/terminated/stood down):
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Summary of interview (if completed):
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13. Preventative Measures & Observations
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What could have prevented this incident?
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Recommended actions to rectify, prevent reoccurance or reduce future risk (remove hazard, security upgrades, training, process changes):
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14. Additional Comments
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Additional information not covered above:
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