Vacation Check Request

Dayton Police Dept Vacation/Security Check Request

By completing this form, you are notifying the police department that you will be away from your property for a period of time (such as vacation or business trip). This information will be used to help us locate areas of the city in need of increased patrol, and to help us contact you in case of an emergency at your property.

Date of request(Required)

Date to begin check(Required)

Date to end check(Required)

Owner/Resident(Required)

First Last

Address(Required)

Street Address

Does anyone have permission to be on the premises?(Required)

Name of allowed persons (if applicable)

First Last

Relationship to Owner

Name of allowed persons (if applicable)

First Last

Relationship to Owner

Name of allowed persons (if applicable)

First Last

Relationship to Owner

Will the lights be left on?(Required)

Will a vehicle be left at the address(Required)

Make (Vehicle 1)

Model

Color

License Plate Number

State of License Plate

Make (Vehicle 2)

Model

Color

License Plate Number

State of License Plate

Emergency Contact

Emergency Contact Phone

Emergency Contact Email (optional)