Vacation Check Request

Complete the following information and the police department will drive by your property while you are on vacation.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email
Date Leaving*
MM slash DD slash YYYY
Date Returning*
MM slash DD slash YYYY
Do you have any lights on?
- Yes
- No
Location of the Lights
Any vehicles in the driveway?
- Yes
- No
Vehicle(s) Description
Emergency Contact Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Does Emergency Contact have a Key?*
- Yes
- No
Miscellaneous information

Emergency Contact Information