Form Center

2. Name
3. Phone:
5. Address:
6. Email:
8. Watch Start Date:
9. Watch End Date:
11. Lights

    Inside

    1. Yes

    1. No

    1. On Timer

    1. Constant
13. Lights

    Outside:

    1. Yes

    1. No

    1. On Timer

    1. Constant
15. Alarm System

    1. No

    1. Yes
16. Company:
17. Phone Number:
19. Cars on Property

    1. No

    1. Yes
20. Location:

    1. In Garage
    2. On Driveway

    1. On Street
22. Make:
23. Model:
24. Color:
25. Tag Number:
27. Make:
28. Model:
29. Color:
30. Tag Number:
32. Make:
33. Model:
34. Color:
35. Tag Number:
37. Is there someone who has a key to the house?

    1. Yes

    1. No
39. Name:
40. Phone Number:
42. Address:
44. Name:
45. Phone Number:
47. Address:
49. Will anyone be working on or have access to the premises while you are gone?

    1. Yes

    1. No
51. Name:
52. Phone Number:
53. Relation:
55. Name:
56. Phone Number:
57. Relation:
59. If anything unusual is observed do you want someone, besides yourself, contacted?

    1. Yes

    1. No
61. Name:
62. Phone Number:
64. Address:
66. Where can you be reached while this house is unoccupied?
68. Address:
69. Phone Number:
71. Is there anything else the El Dorado Police Department should know?

    1. Yes

    1. No
73. Details:
75. I request a house check be made of my premises.

    I understand that the vacation watch is a voluntary service provided by the El Dorado Police Department and that the frequency of the checks will depend on the workload of the officers assigned to the area.

77. Date
78. Signature
Leave This Blank:


80. 1. Receive an email copy of this form.
81. Email address

    This field is not part of the form submission.

82. Submit

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