Download - … · Web viewLocal Person Cell Number: Lights Left On: Timer: Alarm System: Vehicles in Driveway: Note: Special note area, i.e. front porch light is motion sensor, etc.: Author

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Page 1: … · Web viewLocal Person Cell Number: Lights Left On: Timer: Alarm System: Vehicles in Driveway: Note: Special note area, i.e. front porch light is motion sensor, etc.: Author

Edgar Police Department224 South Third Avenue Edgar, WI 54426

Phone: 715-352-2891Chief Jeanette Stankowski

Vacant House Check Form

Address:Resident Name:Home Number:Cell Number:Date Vacating:Date Returning:Name of Local Person in Case of Emergency:Local Person Home Number:Local Person Cell Number:Lights Left On:Timer:Alarm System:Vehicles in Driveway:Note: Special note area, i.e. front porch light is motion sensor, etc.: