Form Center

Residence Vacation Check Request

2. 

3. City of Edgewood
   2224 104th Avenue East, Edgewood, WA 98372-1513<br> City Hall Phone: 253-952-3299 | Police Department Phone: 253-952-0275

   2224 104th Avenue East, Edgewood, WA 98372-1513
   City Hall Phone: 253-952-3299 | Police Department Phone: 253-952-0275

7. Residence Vacation Check Request
   If you are an Edgewood resident, are planning to be away from home, and would like the Edgewood Police to perform residence check on your home in your absence, please complete this form and return to the Police Department at the address provided.

   If you are an Edgewood resident, are planning to be away from home, and would like the Edgewood Police to perform residence check on your home in your absence, please complete this form and return to the Police Department at the address provided.

9. Name

11. Address

13. City

14. State

15. Zip Code

17. Dates Gone

19. Alarm Company

20. Phone #

22. Names & Phone Number of Anyone Coming to Residence

    Anyone getting mail, watering/feeding animals, etc.

24. Vehicles at Residence
    Include any that will be at residence for any reason.

    Include any that will be at residence for any reason.

26. Make

27. Model

28. Lic #

30. Make

31. Model

32. Lic #

34. Make

35. Model

36. Lic #

38. Animals at Residence - Farm or Domestic

40. Anything Unusual Police Deputies Should Be Aware of

42. Emergency Contact

44. Name

45. Phone

47. Signature

48. Date
    Date

Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field