theft loss damage report

SOMERVILLE EXTENDED PROTECTION THEFT, LOSS or DAMAGE REPORT FORM

The issue of this form does not constitute an admission of liability on the part of Somerville. This form must be completed by the School or the Parent before the claim is considered.

This section must be completed for all claims
If "YES" please complete these details
ACCIDENTAL DAMAGE (For Loss and Theft Claims please proceed to next page)
If "YES" please complete these details
If "YES" please complete these details

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