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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)
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.
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.
47. Names
49. Addresses
51. Telephone Numbers
55. Animals
    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.
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