Can this be signed electronically

Yes. Electronic signatures are generally enforceable under ESIGN and state electronic signature laws when they demonstrate intent, consent, attribution, and retention.

Do I need a police report

Most insurers require a police report to process a claim. File with the responding agency promptly and reference the report number in the agreement.

Is notarization required

Not typically for incident documentation, but some jurisdictions or insurers may request notarized attestations for high-value claims or disputed facts.

What if a signer disputes facts later

Maintaining photos, timestamps, witness statements, and an audit trail reduces disputes; correct errors by executing a dated amendment signed by all parties.

How long should records be kept

Retain signed agreements for at least three years after resolution; retain longer if required by insurer, state law, or HIPAA when health information is involved.

Who should receive copies

Provide final signed copies to the insurer, the responding police agency if requested, property manager, tenant, and retained vendor records for repairs.

Electronic Signature
Templates
Miscellaneous
Burglary Incident Agreement

Burglary Incident Agreement

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BURGLARY INCIDENT AGREEMENT

This Burglary Incident Agreement (Agreement) is entered into by and between Property Owner: , Address: and Service Provider: , Address: . The parties agree to the terms set forth below concerning the burglary incident described herein.

RECITALS

WHEREAS, on or about at the premises located at (Premises), a burglary occurred resulting in damage and loss of property; and

WHEREAS, Service Provider represents that it is experienced in securing premises, documenting losses, coordinating temporary repairs and assisting with claims and restoration related to burglary incidents; and

WHEREAS, Property Owner desires to retain Service Provider to perform the services set forth below and Service Provider agrees to perform such services under the terms and conditions of this Agreement.

SCOPE OF WORK

Services to be performed

POLICE REPORT & INCIDENT DETAILS

Law enforcement agency Police report number Description of stolen or damaged property Estimated total loss amount Insurance claim filed?

Yes — Insurer name:

PAYMENT TERMS

The Property Owner agrees to pay Service Provider the agreed fee for services as follows:

Total fee Payment schedule / milestones Late payment fee

TERM AND TERMINATION

This Agreement commences on Start Date: and, unless earlier terminated in accordance with this Agreement, continues through End Date: .

Required notice for termination

Either party may terminate this Agreement for material breach if the breaching party fails to cure the breach within the notice period specified above. Termination shall not relieve the Property Owner of obligations to pay fees for services performed through the effective date of termination.

CONFIDENTIALITY

Service Provider shall maintain in confidence all non-public information provided by Property Owner concerning the incident, personal property inventories and claim information and shall not disclose such information except (a) to law enforcement or insurance carriers as necessary to pursue claims, (b) to subcontractors engaged to perform services under this Agreement who are bound by confidentiality obligations, or (c) as required by law. This obligation survives termination of this Agreement for a period of three years.

INDEMNIFICATION; LIMITATION OF LIABILITY

Property Owner shall indemnify, defend and hold harmless Service Provider and its agents from and against all claims, liabilities and expenses arising from the incident to the extent attributable to the condition of the Premises, Property Owner's negligence, or any false statements regarding the loss. Service Provider's liability for direct damages under this Agreement shall be limited to the total fees paid by Property Owner to Service Provider under this Agreement. Neither party shall be liable for consequential, incidental, punitive or special damages except for liability resulting from willful misconduct or gross negligence.

INSURANCE; RELATION TO INSURER

Service Provider is not an insurer and carries insurance as required by law or contract. It is the responsibility of Property Owner to file insurance claims directly with their insurer. Payment obligations under this Agreement are independent of the outcome of any insurance claim.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to choice-of-law principles.

ENTIRE AGREEMENT

This Agreement constitutes the entire understanding between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether oral or written. No amendment or waiver of any provision of this Agreement will be effective unless made in writing and signed by both parties.

REPRESENTATIONS AND CERTIFICATIONS

Each party represents and warrants that the information provided in this Agreement is true and complete to the best of its knowledge, that it has the authority to enter into this Agreement, and that execution of this Agreement will not violate any other agreement or applicable law.

Property Owner:

By:

Date:

Service Provider:

By:

Date:

What a Burglary Incident Agreement Covers

A Burglary Incident Agreement is a written record that documents the facts, parties, property, and immediate remedies following a reported burglary. It collects incident details, witness statements, inventory of stolen or damaged items, and authorizations needed to process repairs, insurance claims, or temporary relocation. The form can serve as an operational record for property managers, a supporting document for an insurance claim, and an evidence log for internal or legal review. When executed by involved parties, it creates a dated and attributable record of what occurred and what actions are authorized next.

Why documenting the burglary in a formal agreement matters

A formal agreement centralizes facts, preserves evidence, and clarifies responsibilities for repairs, insurance claims, and occupant relocation. A clear, signed record reduces disputes, speeds insurer review, and provides an auditable timeline that supports claim resolution and any required legal actions.

Who typically completes a Burglary Incident Agreement

Use the form with the police report and insurer claim paperwork to create a complete, consistent record across all stakeholders.

Property managers and landlords responsible for documenting damage and coordinating repairs.
Tenants or occupants providing statements, itemized loss lists, and consents for entry or repairs.
Insurance adjusters or claims representatives using it to verify coverage and authorize payments.

Primary signer roles

Property Owner

The owner certifies property details, authorizes repair vendors and insurance claim filings, and confirms the inventory of stolen or damaged items. Their signature establishes ownership interests and grant of access for remediation work.

Tenant / Occupant

The tenant provides a contemporaneous statement of events, lists missing or damaged property, consents to temporary relocation or repairs when required, and attests to the accuracy of submitted information under penalty of law if false.

Essential components of a professional Burglary Incident Agreement

A complete agreement groups core evidence, parties, authorizations, and next steps so insurers, vendors, and legal advisors can act without ambiguity.

Incident Details

Date, time, location, and concise narrative of what occurred including entry point and observable damage documented in neutral language.

Police Report Reference

Official police report number, responding agency, officer name/badge, and the date/time report was filed to link official records.

Witness Statements

Names, contact information, and short signed statements from witnesses or neighbors who observed the incident or provided corroborating details.

Property Inventory

Line-item list of stolen or damaged items with estimated values, serial numbers when available, and photographic evidence attachments.

Authorizations

Permissions for repairs, temporary occupancy changes, vendor access, and release of information to insurers or investigators.

Signatures & Attestation

Signature blocks for involved parties, dates, printed names, and a statement confirming the accuracy and completeness of the information provided.

Required data elements at a glance

Incident Date: MM/DD/YYYY

Location: Street, city, state, ZIP

Police Report: Agency and report number

Party Names: Full legal names

Inventory: Itemized list with values

Signatures: Signer name and date

Step-by-step: completing and executing the agreement

Follow this sequence to collect facts, secure approvals, and produce a signed, auditable record for claims and repairs.

01

Collect facts: Record date, time, and location immediately.
02

Notify police: File an official police report as early as possible.
03

Inventory items: List damaged/stolen property with photos.
04

Sign and distribute: Have all parties sign and provide copies to insurer.

How to configure an online workflow for this agreement

Set up a digital workflow that automates collection, signing order, and distribution to key recipients.

Field	Configuration
Signer Order	Owner first \| Tenant second
Required Attachments	Photographs \| Police report
Authentication	Email + SMS code recommended
Delivery	PDF copy to insurer and parties

Where to send the completed agreement

After signatures, route the final document to all stakeholders and retain a secure copy for recordkeeping.

Insurance Company: Attach to claim submission or upload to carrier portal.
Police Department: Provide report reference and copies when requested.
Property Manager: Maintain on file for repairs and tenant communication.
Repair Vendor: Share authorizations and scope for scheduling work.

Digital signing and secure eSubmission requirements

Ensure the platform used can export a complete certificate of completion and store signed copies in encrypted format for retention.

Audit Trail: Capture IP, timestamp, and signer metadata
Authentication: Email plus SMS code or stronger
File Formats: PDF and DOCX support recommended

Key reporting and processing timelines

Timely actions preserve evidence, protect coverage, and meet contractual or statutory notice requirements.

Report to Police:

Within 24–72 hours of discovery

Notify Insurer:

Typically within 24–72 hours—check policy

Preserve Evidence:

Do not alter scene until cleared

Complete Agreement:

Finalize and sign within 30 days

Submit Supporting Docs:

Send photos and receipts with claim

Processing milestones from incident to resolution

A sequential view of stages helps teams track progress and prevent missed steps.

01

Stage One: Incident Logged

Document initial facts and file police report.

02

Stage Two: Parties Notified

Inform insurer, property manager, and tenant.

03

Stage Three: Evidence Collected

Take photos, secure inventory, preserve scene.

04

Stage Four: Authorizations Issued

Sign repairs and vendor access authorizations.

Common mistakes to avoid when preparing the agreement

Delaying documentation: waiting to record details leads to inconsistent accounts and weaker proof.
Incomplete inventory: vague descriptions or missing serial numbers hinder insurer valuation and recovery efforts.
Missing police report linkage: omitting report reference delays claim validation and may force supplemental requests.
Improper signatures: unsigned or initial-only acknowledgments can create disputes over consent and authorization.

Risks and consequences of errors or omissions

Claim Denial: Inaccurate detail risk

Delayed Payment: Incomplete evidence causes hold

Criminal Liability: False statements risk prosecution

Contract Disputes: Ambiguous authorizations cause conflicts

Vendor Refusal: No authorization halts repairs

Record Rejection: Unsigned records lack enforceability

Realistic use examples of the agreement

Two representative scenarios show how the agreement supports prompt remediation and claims.

Apartment Break-In Example

A tenant discovers forced entry and reports to police immediately.

The property manager documents damage and gathers photos.
The signed agreement plus the police report allowed the insurer to authorize temporary relocation and approve contractor estimates within days.

Retail Store Theft Example

A store manager records missing inventory and security footage timestamps.

An inspector and insurer review the inventory list and evidence.
Clear authorizations in the agreement permitted fast remedial boarding and a vendor to secure the premises the same day.

How this agreement differs from related documents

Compare the Burglary Incident Agreement with other documents you may encounter after a burglary.

Document	Primary Use	Who Prepares
Burglary Incident Agreement	record facts	owner/manager
Police Report	official record	police
Insurance Proof of Loss	claims basis	policyholder
Repair Authorization	vendor work order	owner/manager

eSignature provider comparison for executing the agreement

Representative vendor pricing and feature rows to consider when choosing an eSignature solution for secure execution.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	Yes, 7-day trial	Yes	Yes	Yes	Yes
Bulk Send	Yes (premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
Envelope Cap	No cap	100 envelopes/user/year	No cap	No cap	No cap

Frequently asked questions about the Burglary Incident Agreement

Answers to common questions about completing, signing, and using the agreement in claims and repairs.

Need help? Contact support

Can this be signed electronically
Yes. Electronic signatures are generally enforceable under ESIGN and state electronic signature laws when they demonstrate intent, consent, attribution, and retention.
Do I need a police report
Most insurers require a police report to process a claim. File with the responding agency promptly and reference the report number in the agreement.
Is notarization required
Not typically for incident documentation, but some jurisdictions or insurers may request notarized attestations for high-value claims or disputed facts.
What if a signer disputes facts later
Maintaining photos, timestamps, witness statements, and an audit trail reduces disputes; correct errors by executing a dated amendment signed by all parties.
How long should records be kept
Retain signed agreements for at least three years after resolution; retain longer if required by insurer, state law, or HIPAA when health information is involved.
Who should receive copies
Provide final signed copies to the insurer, the responding police agency if requested, property manager, tenant, and retained vendor records for repairs.

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