Vacation Home Security Check Form
Home Details
Address
Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Departure Date
-
Month
-
Day
Year
Date
Return Date
-
Month
-
Day
Year
Date
Type of Premise
Residence
Business
Other
Type of Premise - Other (specify)
Access and Security
Keys left with anyone?
Yes
No
Who?
Will anyone have access to your home during your absence?
Yes
No
Names
Lights left on?
Yes
No
Where are the lights left on?
Timer?
Yes
No
Vehicles, Animals, and Hazards
Any cars left on premises?
Yes
No
If yes, provide make, model, color, and tag number
Any animals left in house or in yard?
Yes
No
If yes, type of animals
Any known hazards on property?
Yes
No
If yes, explain hazards
Emergency Contact and Destination Contact
Emergency Contact Name
Emergency Contact Address
Emergency Contact Phone (Home)
Please enter a valid phone number.
Format: (000) 000-0000.
Number you can be contacted at your destination
Submit
Should be Empty: