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2. VACATION HOME REGISTRATION GUIDELINES

   The purpose of the Vacation Home Registration is to provide emergency contact information for the Police Department: 

   1. In the event police are called to the home for an emergency or suspicious activity while the owner or resident is out of town, and
   2. When no other person(s) will be present in the residence. Time permitting, police may drive by the residence and on occasion, may walk around the property to check for signs of a break-in; however, residents should not construe this as a guarantee of the safety and security of their property in any way. 

   Residents should include contact information for a local key holder in the event the interior of the home would need to be checked. The information should be provided at least three (3) days in advance of departure. Requests made during non-business hours will not be processed until the next business day. All contact information provided will be safeguarded.

   There is no additional charge for this service.

   Checks should generally not be submitted on homes unoccupied for 72 hours or less, that are being offered for sale by a realtor, or where a person has been engaged to live or work in the home while the owner is absent.

6. Name*
7. Email Address*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Number to be reached while away*
18. Date of Departure*
    Date of Departure
19. Date of Return*
    Date of Return

    Date of Return
21. Emergency Contact Name*
22. Emergency Contact Address
24. Emergency Contact Phone Number*
25. Is there a spare key?*

    1. Yes
    2. No
27. Are lights on a timer?*

    1. Yes
    2. No
28. Where?
30. Mail/Paper Stopped? *

    1. Yes
    2. No
    3. Being picked up
32. List vehicles that will be in the driveway:*
34. Anything else to note?
36. Electronic Signature Agreement*

    By submitting this form, I understand and acknowledge that a request for a house check pursuant to this program does not guarantee the safety or security of my property. I further acknowledge that neither Patton Township nor the Patton Township Police Department assume any liability for loss or damage to my property pursuant to this vacation home registration service.

    Please select I agree and type your full name to sign below. 

    1. I agree.
38. Electronic Signature
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field