Weekly Residence Watch Form

Property Owner:

Checkboxes

30 Day Watch

60 Day Watch

90 Day Watch

Unit & Lot

Phone

Alternate Phone

Email

Your Physical Address

City

State/Province

Zip/Postal

Your Physical Address

Departure Date

Expected Return Date

Reason for Request

Emergency Contact Phone

Is there a key holder for the property?

Yes

No

Key Holder Phone Number

Is your residence equipped with an alarm?

Yes

No

Alarm Company & Phone Number

Have lights been left on at residence?

Yes

No

In which rooms are lights on?

Vehicles on property (locations)

Additional Information:

I hereby request that a special residence watch be made of my premises and agree to notify the Department of Safety promptly upon my return.