NEIGHBORHOOD CHECK FORM

Your neighbor has applied to work in Public Safety. Please help us determine their suitability. This is a State requirement for applicants seeking a position of public trust.

Thinking about the neighbor and family in question, please check your response, and comment if needed. Comments will not be shared with the applicant.

The investigators name? *

On door hanger or business card

Applicant's Address*

We do not reveal names or the position applied

Your name*

We will never sell your information

Your email address*

We will never sell your information

Your phone number*

Sometimes we need to follow-up for clarity

Your street address *

Street number and name

How long have you lived in the neighborhood?*

Neighbor Questions

Rows	Yes	No
Does the neighbor keep the home well-maintained?
Is it a pleasure to walk by the neighbor’s home?
Does the neighbor maintain their yard?
Is the neighbor friendly?
Any annoyances from the neighbor’s home?
Any unpleasant smells coming from the neighbor’s home?
Have you ever heard the neighbors yelling and screaming?
If there are children, are they quiet and respectful?
Are the neighbor’s cars parked properly?
When the neighbor have friends over, it is a respectful event.

Questions

Rows	Yes	No
Are the neighbor’s pets quiet and behaved?
If you were ever in the applicant’s home, did you see anything illegal or unusual?
Do you often see people coming and going from the neighbor’s home at all hours of the day and night?
Has the neighbor exhibited problems with other neighbors, had a noise complaint, or have police been called to the home in an official capacity?

Your answers will NOT be shared with the applicant. Please give details of any answers above that are concerning.

Please give any additional information you think may be helpful in considering this applicant for Public Safety:

Please verify that you are human*

We appreciate your help. Please click on submit at the bottom to send your responses.

Please DO NOT give this questionnaire to the applicant.
Email us with questions:
G2-docs@guardianbgi.com

P.O. Box 2393
Lodi, CA 95241-2393
State License# PI 188266

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