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(S4) Property/Equipment Loss Report Form

  1. Campbell County Public Safety Document Header
  2. Property/Equipment Loss Report Form
  3. Name and Address of Person Filing Report
  4. Equipment Returned?
  5. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that: 

    • 1) your submission will not be signed in the sense of a traditional paper document;
    • 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature; and 
    • 3) you may still be required to provide a traditional signature at a later date.
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  7. This field is not part of the form submission.