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House Watch Request

2. Please make sure to enter information in every line of the form. If its not applicable - enter n/a in the form.

4. Resident Information

6. Requestor's Name*

7. Business Name

9. Email

10. Address*

12. Date of Departure*
    Date of Departure

13. Date of Return*
    Date of Return

14. Telephone Number Where You Can Be Reached*

18. Vehicles Left at Residence

    (Include make, model, color, license plate number and state)

    (Include make, model, color, license plate number and state)

20. Vehicle Number 1

21. Location

    1. Driveway
    2. Garage
    3. Street

23. Vehicle Number 2

24. Location

    1. Driveway
    2. Garage
    3. Street

26. Vehicle Number 3

27. Location

    1. Driveway
    2. Garage
    3. Street

31. Premise Information

    This information is used for emergency contacts and emergency access to your residence if necessary.

    This information is used for emergency contacts and emergency access to your residence if necessary.

33. Who has keys to residence?*

34. Address

36. Telephone Numbers*

38. Additional People with Keys

39. Address

41. Telephone Numbers

45. Authorized Visitors

    Examples: Relatives, lawn care workers, house keepers, pool workers, person(s) feeding animals, etc.

    Examples: Relatives, lawn care workers, house keepers, pool workers, person(s) feeding animals, etc.

47. Names

49. Addresses

51. Telephone Numbers

55. Animals

    Are you leaving any animals at the residence we need to be aware of?

    Are you leaving any animals at the residence we need to be aware of?

57. Type of Animals

59. Number of Animals

60. Location of Animals

    1. In the House
    2. In a Kennel
    3. In the Yard

64. Security

    Security precautions we need to know.

    Security precautions we need to know.

66. Do you have a security alarm?

    1. Yes
    2. No

67. If you have a security alarm, is it monitored?

    1. Yes
    2. No

69. Please describe any lights you are leaving on.

71. Is there any damage to your residence now?

    1. Yes
    2. No

72. If yes, please describe.

74. Have you had any recent problems we should be aware of?

    1. Yes
    2. No
    3. I am not sure

75. If yes, please describe.

77. Is there any additional information you think we might need to know?

79. Acknowledgement

    I understand that this vacation house check request is not valid until I am contacted personally by the Fayette County Sheriff's Office.

    1. Yes
    2. No
Leave This Blank:


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

    This field is not part of the form submission.

83. Submit

* indicates a required field