Form Information:

As a crime prevention measure and community relations service, we provide home security checks for vacationing residents. Complete this form with as much information as possible. We require resident's to provide contact information so they can be notified if an incident occurs on their property.

*** House checks will be made as time permits. ***
*** Residents are asked to notify the Police Department 513-922-0060 if they should return early. ***
*** No house checks on vacant properties will be made under this program. ***

Home Resident Address

House Number: *

Street Name: *

Vacation Dates

Departure:*

Return: *

Your Contact Information

First and Last Name*

Email Address: *

Phone Number: *

Additional Identifying Details

Will any lights be left on? *

Yes, Exterior Lights Yes, Interior Lights

No

Are the lights on timers? *

Yes, Exterior Lights Yes, Interior Lights

No

If you are leaving any lights on, please provide a description of their location.

Do you have an alarm system? *

Yes

No

If you have an alarm system, please provide the Company Name and Phone Number.

Will there be any pets at the residence? *

Yes, Exterior Pet Yes, Interior Pet

No

If you have pets left at the residence, please provide what type. If someone will be checking on your pets, please provide their Name and Phone Number.

Will there be any vehicles left in the driveway? *

Yes

No

If you will have vehicles left in driveway, please provide Make, Model, Color and License Plate Number if possible.

Will there be anyone checking on your residence? *

Yes

No

If you plan to have others checking on your house, please provide their Names, Addresses and Phone Numbers.

Are there any keyholders to your residence? *

Yes

No

If there are keyholders, please provide their Names, Addresses and Phone Numbers.

Photo / File Upload

Photograph: (Must be GIF, JPG, JPEG, or PNG file)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Photograph: (Must be GIF, JPG, JPEG, or PNG file)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Photograph: (Must be GIF, JPG, JPEG, or PNG file)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)