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Customer Occurrence ReportsReported by (name and position):National Restaurant Number:Note: If the customer is a minor, please provide the guardian information in the "describe the incident in more detail" section of this form.|Day Phone number (Please include Area Code):|Evening Phone number (Please include Area Code):|Cell or Other Phone number (Please include Area Code):|Foreign Object - Product Information|MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember/Day12345678910111213141516171819202122232425262728293031/Year2000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033010203040506070809101112:000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859ampmRaw Item(s) Involved (e.g. Lettuce):Is Object restaurant related?Where was the object found (e.g. embedded in product):If Yes, provide details below:Is surveillance available for this incident?All Video must be copied. If this is not possible, please provide a reason why it cannot be copied:Does Customer require follow-up?If YES, who will perform the follow-up?OwnerManagerConsultantInsurance AdjusterOtherDid the customer discuss or request compensation?If Yes, did you advise customer that compensation request must be investigated by our insurers, who will be the next point of contact:Did the customer threaten legal action?If Yes, did you provide customer with appropriate information (company and contact name, address, etc.)?Please describe the incident in greater detail:Please do not print until you press SUBMIT. After submitting your report, a printer friendly version will be available.|