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Vacation Check Submission Form
Germantown, TN Police Department
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Residents who are going away for at least four days or for as long as a month, are eligible for the service. Due to the dangers involved, only unoccupied homes will be checked. This service is not available for vacant houses or new houses under construction.
Name: *
Address: *
Primary Phone Number: *
Secondary Phone Number:
(Optional)
Email Address: *
Date Leaving: *
MM
/
DD
/
YYYY
Time Leaving: *
Time
:
Date Returning: *
MM
/
DD
/
YYYY
Time Returning: *
Time
:
Will a friend or family member nearby have a key to the residence? *
(If yes, please list name and phone number below.)
Key left with:
(First and last name)
Phone number of keyholder:
Any lights left on? *
Any vehicles left at the residence? *
Vehicle Descriptions:
(If yes, please list year, make, model, and vehicle plate number and state below. Example: 2005 Toyota Camry - 465LMJ - TN)
Animals left in the yard? *
(If yes, please describe quantity and type/breed of animals below)
Brief description of the Animal(s):
Do you have an alarm at the residence? *
Person(s) who may to be on property during absence:
(Friends/Family, housekeeping, pool service, yard service, contractors, etc.)
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