WILLOW PARK POLICE DEPARTMENT

VACATION CHECK

Vacation checks entail a visual check of structures and property, ensuring that vehicles, gates, lighting and the general security of the home is intact and in accordance with the request.

 

Request Date:     Date Leaving:     Date Returning:

RESIDENT

Resident:

Address: ER Contact #:

E-Mail Address:

DESTINATION

Destination:

In Case of Emergency, Notify: Phone #:

RESIDENCE

Outside Lights: Yes No    Timer: Yes No     Times:

Inside Lights: Yes No    Timer: Yes No     Times:

Alarm: Yes No    Timer: Yes No     Audible: Yes No    Silent: Yes No

Alarm Company:     Phone #:

VEHICLES LEFT ON PREMISES

Make:     Model:     Year:     Body:     L/P:

Make:     Model:     Year:     Body:     L/P:

Make:     Model:     Year:     Body:     L/P:

PERSONS ALLOWED ON PREMISES

Name:     Phone #:

Name:     Phone #:

Name:     Phone #:

MISCELLANEOUS INFO

Resident Signature: Date:

Willow Park Police Department
Copyright © 2009 [City of Willow Park]. All rights reserved.
Revised: 09/11/09