Unoccupied Building or
Vacation Home Check Form

Name of Owner/Occupant*

Email*

Phone*

Address*

Dates Unoccupied*

Key Contact/Number*

Will anyone be at the home for any reason? (e.g. cat-sitter, house check, etc.)*
YesNo

If YES, Name & Phone

Specific Instructions

I request that a security check be made of my property/building. I understand that a security check conducted by the Jackson Police Department in no way guarantees that my property will be safe from vandalism or burglary, but merely provides the police department with information of my whereabouts if a crime should occur.

Please type your full name below as an electronic signature.