Property Check Form

Date Leaving

Date Returning

Property Owner/s Information and Contact

First name

Last name

Phone

Property Information

Property Address

Color & Description of Property

Is this a Business

Is this a Residence

or Other type of property. If other please describe below.

Describe other type of property

Are the property lights left on?

YES

YES ( on a timer)

Dose the property have a security system?

YES

If yes, for the security system, please choose all that apply.

Burglar

Fire

Hvac

Name and contact information of Alarm Company.

Are pets left on or in the property

YES

If yes, pets are in or on the property. Please list them below: the type of pet, its name and contact information, and the person responsible for its well-being.

Key holder information responsible for property

Should anyone be on your property? If so, please list them.

In the case of EMERGENCY, who should be notified other than yourself?

Just me at the stated contact above

Include the following people listed below.

other people listed as EMERGENCY contacts for property

Will there be any vehicles left on the property? If yes, please list them below, including year, make, model, color, and registration.

Additional Comments

The undersigned grants and requests the Eastport Police Department to check the property listed above visually. You agree to hold the Eastport Point Police Department and its employees harmless for any claims for personal injury, loss, or damage to property that could occur through any action or lack thereof by a representative of the Eastport Point Police Department. Further, the undersigned understands and agrees that this is a voluntary, free service, does not create a special duty upon the Eastport Point Police Department, will be provided only as time is available, and no guarantee is made against loss, theft, or damage to premises.

City of Eastport

EASTPORT POLICE DEPARTMENT

EMERGENCY DIAL 9-1-1

Property Check Form