Police Security Check Request

 ZIP Code*

Phone Number*

Email*

Start Date*

End Date*

Type of Premises*     Residence     Business     Other

Would you like officers to walk around your property?*   Yes   No

Reason for Extra Patrol*   Vacation  Other (Explain below)

If Other above, please explain

Protected by an Alarm System?*   Yes   No

If Yes above, please share the type of alarm, company name and phone number?
Name:

Lights on?     Yes     No     On timer   

Keys left with anyone?   Yes   No

If Yes, please share the name, phone number and address of this person(s)

Others who may have access to property (neighbors, relatives, pet caretakers, etc.)? Please share names and phone numbers.

Animals present?     Yes     No

If Yes above, what type of animal and location in home?

Vehicles that may be left in driveway (List make, model, color, license plate and owner name)

NOTICE

This security check will self cancel on the ending date stated above. You may call (330) 468-3515 for an extension if necessary using the request number given to you at the time you applied.

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