By following these steps, you can be sure that the NYS security incident report is completed thoroughly and accurately, providing a reliable document for incident management and response.
1. Identifying Information
At the top of the form, write the date and time of the incident. This information sets the timeline for the reported events, so make sure it is precise.
2. Location of the Incident
Specify the exact location where the incident occurred. Include relevant details, such as the facility's room number, building, or area. For incidents that span multiple locations, describe the starting point and any subsequent locations separately.
3. Details of Individuals Involved
Record the names, addresses, and contact information of all individuals involved in the incident. If applicable, include their roles (e.g., staff, visitor, student) and other identifiers that could assist further inquiries.
4. Incident Description
Provide a detailed description of the incident. This should include what happened, the sequence of events, and any actions the involved parties took. Be as descriptive as possible to give a clear and complete picture of the situation.
5. Witness Information
If there were any witnesses to the incident, list their names and contact information. Include a brief note on their perspective of the incident if it has been shared when filling out the form.
6. Law Enforcement Interaction
Indicate whether law enforcement was contacted regarding the incident. Include details such as the agency involved, the officers' names, and any report or case numbers issued. If law enforcement was not contacted, note this explicitly on the form.
7. Follow-Up Actions
Document any immediate actions taken in response to the incident, such as medical care provided, evacuations, or security measures implemented. Also, note any planned follow-up actions to address the incident's consequences or to prevent future occurrences.
8. Signature and Verification
The person filling out the form should sign and date it at the bottom, verifying that the information provided is accurate to the best of their knowledge.
Who Needs to File an Incident Report
All licensed security guard companies and contract security firms regulated under New York General Business Law must file an incident report following any qualifying event. Individual guards are required to cooperate in completing the documentation. For other security-related documentation, see our security guard daily report.
Common Questions about the Incident Report Form
What qualifies as a reportable security incident in New York?
A reportable incident includes physical altercations, thefts, property damage, medical emergencies requiring outside response, any use of force by a guard, or contact with law enforcement. Minor disputes resolved without intervention and without injury or property loss generally do not require a formal report filing.
Where do I submit the completed report?
Submit the completed form to the New York State Division of Criminal Justice Services, Office of Justice Information Services. Your company's license administrator should retain a copy and send the original within the reporting window required by your licensing agreement. For other New York law enforcement forms, see our printable police report form.
Can I complete the form online?
Yes. FormsPal provides a free PDF editor that lets you fill in the form directly in your browser. Complete all required fields, review your entries, and download the finished document as a PDF ready for printing and submission. For additional incident documentation forms, visit our child care incident report page.