House Check

Please complete all applicable questions of this on-line form and click the submit button when finished. Once your request is received, you will be contacted by the department to confirm your information within 24 hours.

If you would rather submit your request in person, you can forward the form after completing all areas in RED and checking the contact request box. We will take the needed information from you by phone or at the station.

Please feel free to contact the department with your questions, Monday through Friday, 8-4pm, at 815-624-8881.

Departure Date: Return Date: Location Type:

Address:

Home Phone: Work Phone:

Will you be leaving inside lights on?

Comments:

Locations:

1. Timer? Time?

2. Timer? Time?

Will you be leaving outside lights on?

Comments:

1. Timer? Time?

2. Timer? Time?

Paper stopped? Mail stopped?

Alarm system?

Company/Phone:

Snow Removal?

Company/Phone:

Lawn Care?

Company/Phone:

Other Workers?

Company/Phone:

Comments:

Have keys been left with anyone?

Name/City/Phone: 1.

Name/City/Phone: 2.

In case of problem ,who do we call?

Are cars or other vehicles being left in driveway or elsewhere on property?

1. Make/Model/Color: License:

2. Make/Model/Color: License:

Enter any other information that you feel would be helpful:

Tell us how to get in touch with you:

Resident Name
Resident Email
Vacation Address
Vacation Telephone
Resident's Cell Phone
Resident's Pager

Please contact me as soon as possible regarding this matter.