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Form Section 1

Vacation House Check Request

Personal Information

Vacation Start Date *
Vacation End Date *

Residence Information

Is there a dog on the premises *
Is there a house alarm? *
Will the officer have access to the backyard? *
Will all doors, windows and garage entries be locked? If no, please explain* *
Will there be vehicles in the driveway? If yes, please describe vehicle(s)** *

Emergency Contact Information

Does this person have a key to the premises? *