VACATION HOUSE CHECK

Name Address Phone Reason for Extra Patrol-Vacant or other (if other state) Type of Premises-Residence or Business Protected by Alarm-Yes or No If Alarm-What Company Lights On- Yes or No If Lights On-Constant or Automatic Keys Left With Anyone-Yes or No If Keys Left-Name, Address, Phone Other Persons That Will Have Access In Case of an Emergency, Do you wish to be notified by collect call? Yes or No If yes, phone number Date you will leave Date you will return Comments