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Residence Vacation Check Request

2. 
3. City of Edgewood
   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.
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.
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

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