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Vacation Check Request

Vacation Check Request

Request for Vacation Check

Location of Check: 

 

Departure Date:      Return Date: 

Destination: 

Requesting Persons Information

Name: 

Address: 

People Allowed on Property During Your Absence

Name: 

Name: 

Name: 

Name: 

 

Pets on PropertyYes    No

    Animal types and demeanor (Friendly, aggressive, protective, etc.)

 

Alarm System InstalledYes    No   Alarm Company & Phone #

 

Vehicles on Property

Color/Year/Make/Model/License: 

Color/Year/Make/Model/License: 

Color/Year/Make/Model/License: 

Color/Year/Make/Model/License: 

 

Local Emergency Contact / Keyholders

Name/Address/Phone # 

Name/Address/Phone # 

 

Disclaimer

The Escalon Police Department assumes no liability should theft or damage occur to your property. Security/Vacation Checks are performed as a courtesy and only as time permits. You should have mail and newspapers picked up or stopped while on vacation; as well has having someone take care of pets, lawn, gardening, etc.

    I have read and agree to the above:

 

I request a security check be made of my premises and agree to notify the Escalon Police Department of my return. I have read and understand the above. 

Signature (Type Name): 

Date: 

 



Security Measure