2. Residents may request to have an officer check their home and surrounding area for suspicious activity at random times, as time and call load permits. If the resident returns early, please contact the police department and advise them. Increased Patrols can be requested by an occupant of a location and consists of a drive-by inspection at random times, as time and call load permits.The request must be in relation to a reported crime or suspicious activity.
4. REQUEST:

   1. Increase Patrol

   1. House Watch
6. First Name
7. Last Name
9. Address
11. City
12. State
13. Zip
15. Telephone # (Primary):
16. Telephone # (Secondary):
18. Type:

    1. Premises

    1. Residence

    1. Business

    1. Other (define below)
20. Reason for Requesting Increase Patrol/House Watch:
22. Location for Increased Patrol/House Watch:
24. City
25. State
26. Zip
28. FROM Date / Time:
    FROM Date / Time:

    FROM Date / Time:
29. TO Date / Time:
    TO Date / Time:

    TO Date / Time:
31. If Increase Patrol request, stop here and submit below. If House Watch request, continue below:
33. Probable Route of Travel (in case of emergency):
35. Have keys been left with anyone?

    1. Yes

    1. No
36. If Yes, Name:
38. Address:
39. Telephone #:
41. Will anyone be working about or have access to premises during your absence?

    1. Yes

    1. No
42. If Yes, Name:
44. Address:
45. Telephone #:
47. In case of an emergency, how do you wish to be notified?

    1. Call

    1. Email

    1. Text message
49. Email Address:
50. Cell phone #:
52. LIGHTS:

    1. Motion Activated
    2. Solar/Twilight

    1. On Timer
    2. Off Timer
53. Time On:
54. Time Off:
56. If lights will be on, please indicate which rooms in the house or property:
58. Downstairs lighting:

    1. Hallway
    2. Bedroom
    3. Living Room
    4. Bathroom
59. Upstairs lighting:

    1. Hallway
    2. Bedroom
    3. Bathroom
60. Outside lighting:

    1. Front Yard
    2. Back Yard
    3. Side Yard
    4. Garage
62. Is there an alarm system on the premises?

    1. Yes

    1. No
64. Name of Alarm Company:
65. Phone #:
67. Pets/animals on the premises?

    1. Yes
    2. No
68. If so, describe type of animal, where they are kept and if contained:
70. Vehicles Left:

    1. In Driveway

    1. In Garage

    1. On Street

    1. Other (define below)
72. Vehicle Information:
74. Completed By:
75. Date/Time:
    Date/Time:

    Date/Time:
Leave This Blank:


77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

* indicates a required field