I am assuming you want to be reimbursed for things that have been lost or stolen from you. How about . . . .
To Whom It May Concern,
On (date), the following articles were (lost , stolen) from (location or place where itmes went missing.) I undertand that I am eligible for reimbursement from (your company or agency) for the value of these articles.
The items are valued at (state value in money terms OR list separate and total)