Vacation Home Check Form

    Vacation home checks are performed as a service to the community to help insure peace of mind while your family is on vacation.  Please fill out the following form to be submitted to our staff.  If we have any questions, we will contact you at the provided phone number.  Please submit the form at least 10 days prior to your departure.  In addition, please contact our department upon your return.

Name:     Township: 

Address: 

Phone Number:     

Date Leaving:     Date of Expected Return: 

Lights left on:  Timer:    What times: 

Location of the lights:

Cars left on property:    Where left: 

Description of Vehicles: 

Alarm:    Company Name: 

Emergency Contact Person: 

Does the emergency contact have a key?

Contact Person Address: 

Contact Person Phone: 

Will this person be checking?    Times: 

Miscellaneous Information: