PLEASE READ THE FOLLOWING DISCLAIMER: Requesting a vacation house check does not guarantee that a burglary or other crime will not occur at your residence, and it is only intended to be a request for the Urbandale Police Department to check your home periodically, based upon the availability of an officer. No vacation checks while the homeowner is gone from the home are guaranteed. No additional police response or protection is being guaranteed by requesting a vacation check, other than normal police services and protection which is provided to the general public. Consequently, it is recommended that you make every effort to safeguard against losses including securing of high value property, using proper locking devices, alarm systems, etc.

PLEASE READ AND AFFIRM:

The Urbandale Police Department does not conduct vacation house checks on homes that are under the care of a 3rd party or if a person is infrequently or routinely checking on your home. This could pose a safety risk to the officer and the 3rd party or person. By affirming with your initials, you do not have a 3rd party or person at your home either infrequently or routinely during this vacation house check request. *

PLEASE READ AND AFFIRM:

The Urbandale Police Department does not conduct vacation house checks on homes that are monitored by an active alarm system. By affirming with your initials, you do not have an active alarm system at your home. *

Name:*

Property Location:

Street Number and Name:*

*

Address Line 2:

City:*

State:*

Zip Code:

Your Contact Information While Away

Phone Number:

Alternate Phone Number:

Email Address:

Preferred Contact Method:*

Do NOT contact me Email

Leaving Date:*

Returning Date:*

Has mail been stopped?

Please select an answer Yes No

Did you leave the lights on?

Did you leave any vehicles on the driveway?

Please select an answer Yes No

If yes, how many?

Does your home have an alarm system?*

Please select an answer Yes No

Do you have someone checking on the house while away?*

Please select an answer Yes No

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