Vacation House Check Request

Amity Township Police Department offers vacation security checks to residents. Officers will do a periodic check of the exterior of your home while you are away. Your house will be checked by an officer every other day, depending on the manpower and availablity of officers.

If your house check goes beyond 30 days, your house will be checked on a bi-weekly basis.

For the safety of our officers, house checks will not be conducted if walkways and pathways aon the property are not clear of snow and ice.

By signing below, you authorize the Amity Township Police Department to check your property and no guarantee is made or assurance given against loss, theft, or damage to the property.

The following information is need to assist us in checking your house:

Name:*

First NameLast Name

Property Street Address*

Phone #*

Area CodePhone Number

Emergency Contacts

Emergency Contact #1 Name:*

First NameLast Name

Emergency Contact #1 Phone Number*

Area CodePhone Number

Emergency Contact #1 Address*

Emergency Contact #2 Name:*

First NameLast Name

Emergency Contact #2 Phone Number*

Area CodePhone Number

Emergency Contact #2 Address*

Do the contacts listed above have access to the inside of the property?*

Is the property alarmed?*

Name of alarm company? - Type N/A if not applicable*

Lights left on?*

Where? - Type N/A if not applicable*

Timer?*

Any animals on the premises? - Type N/A if not applicable*

Person responsible for their care? - Type N/A if not applicable*

Phone Number*

Area CodePhone Number

Does your house have any of the following (check all that apply):*

Broken doors or windowsTorn window screensTimers on exterior lightsN/A or None

Any vehicles on the property?*

Make/Model/Color - Type N/A if not applicable*

License Plate(s) - Type N/A if not applicable*

Additional Information:

Date Leaving:*

Date Returning:*

Signature*

Date:*