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Home Phone
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MM slash DD slash YYYY
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Is Anyone Checking the Residence?
(Required)
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No
Do you have an alarm system?
(Required)
Yes
No
Are any of your lights on a timer?
(Required)
Yes
No
Are there any vehicles at the residence?
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Yes
No
Are the doors and windows locked?
(Required)
Yes
No
Any pets at the residence?
(Required)
Yes
No
Are the mail and newspaper stopped?
(Required)
Yes
No
Additional Information
Consent
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I agree to the privacy policy.
Release Agreement:
Please read the following statement before submitting this form: The Montrose Township Police Department, per your request, will attempt to check your residence periodically. Neither Montrose Township, nor the Montrose Township Police Department, assume any liability in the event of theft, loss or damage to personal or real property in or around your residence. By submitting this form, it is understood and agreed that neither Montrose Township or the Montrose Township Police Department assumes any liability with the "Vacation House Check." The resident, by accepting the "Vacation House Check," and by execution of this request understands and agrees to the provisions of this release.
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