Vacation Watch Information:

Name:

Telephone:

Address:

Phone number you can be reached at while on vacation:

Other person to contact:

Other person address:

Relationship:

Will you be leaving any lights on?
Yes No
If yes, give location:

Will they be on a timer?
Yes No
Will there be any vehicles left at the residence?
Yes No
If yes, provide license plate numbers and vehicle descriptions:

Leave Date:

Returning Date:

Will anyone else be checking on the residence?
Yes No
Remarks:

I do not hold the Troy Police Department or the City of Troy liable for any theft or damage to my property. I also understand that the police will not be able to check the above residence at all times. I agree to call the Troy Police Department upon returning home to my residence at (618) 667-6731