Services » Permits and Forms » Police Forms » Vacation/House Check

Vacation/House Check

I request a vacation house watch be made of my premises and agree to notify you of my return.

Note: Red asterisks indicate required fields.

General Information:

Name

Street Address

City

State

Zip Code

Phone

Departure Date and Time

Return Date and Time

Vacation house check requests will be accepted for a period of no longer than 30 days. If a resident would like house checks to contunue after the 30 day period they must contact the Police Department.

Emergency Contact:

Emergency Contact Name

Emergency Contact Address

Emergency Contact Phone

Vehicles Left on Premises:

Vehicle 1 Color and License Plate

Vehicle 2 Color and License Plate

Vehicle 3 Color and License Plate

Keyholder Information:

Keyholder Name

Keyholder Phone

In Case of an Emergency:

In case of an emergency, do you wish to be notified?

Notify in Case of Emergency

YesNo

If yes, please list location and phone number to notify:

Location and Phone Number

Additional Helpful Information:

Please list any additional information that may be helpful to our officers. Include information such as broken windows, missing screens, lights on timers, etc.:

Additional Information

AUTHORIZATION: By clicking "submit" on this form I hereby authorize the action requested and/or police use of the information supplied. I certify that all information as entered is true and correct. I am aware that by submitting this form, my Internet IP address will become available to the Wethersfield Police Department. This IP address can and will be traced if this form is submitted unlawfully.

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