Damaged, Missing or Stolen University Items

Your Safety Matters

First Name
Last Name
Banner ID #
Driver’s License (state/#)
Email Address
Phone #
Home Address
Campus Department
Date and Time Last Seen
Date
MM slash DD slash YYYY
Time

: HH

MM

AM/PM
Date and time noticed missing or damaged
Is there any personal identifiable information on the electronic device(s)
For Example: Social Security number, health records, banking information, PIN numbers etc…
If Yes, please explain in detail.
Please DO NOT SEND us your social security number
Date
MM slash DD slash YYYY
Time

: HH

MM

AM/PM
Detailed Description of item(s)
Image Upload
Please send photographs of damages
Max. file size: 128 MB.
Name
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