RICHFIELD TOWNSHIP POLICE DEPARTMENT

VACATION CHECK

HOME OWNERS NAME:
HOME ADDRESS:
HOME OWNERS PHONE:
DATE LEAVING:
DATE RETURNING:
LOCAL EMERGENCY CONTACT (NEIGHBOR, RELATIVE, ETC.):
NAME:
PHONE:
NAME:
PHONE:
VEHICLES LEFT AT RESIDENCE (IN DRIVEWAY OR YARD):
(1)
(2)
(3)
INSIDE LIGHTS AN/OR TIMERS:
YARD MOTION/MERCURY LIGHTS:
PEOPLE AND/OR VEHICLES PERMITTED ON PROPERTY:
ALARM SYSTEM:
ADDITIONAL INFORMATION:
 
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