Police Department Forms - Rochester, Illinois

Name

Phone

E-mail

Full Address

Departure Date

Return Date

Are you leaving lights on in your home while you are away? Yes No

Will you be using a timer to turn lights on in the evening? Yes No

If Yes, please briefly explain the location in your home where the constant/automatic lights are located

If you have an alarm system installed, please let us know the security company that monitors your system.

Emergency Contact #1 with Phone Number

Emergency Contact #2 with Phone Number

If vehicles will be parked in your driveway or on the street in front of your house while you’re away, please provide the following information.

Vehicle #1 Description and Plate

Vehicle #2 Description and Plate

Vehicle #3 Description and Plate

Please list any additional notes that you might have

Vacation Watch Form