House Watch Request Form (Alsip PD)

Alsip Police Department
House Watch Request Form

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Address*

Name*

Request Made By*

Phone*

Reason for extra patrol*

Type Premises*

Protected by alarm system*

If yes type alarm

Lights on*

Constant*

Automatic*

Keys left with anyone*

If yes, name

Address

Phone

Other persons that will have access to the premises

(Relatives, workers, neighbors, employees)

In case of emergency do you wish to be notified by collect call?*

C/o name

Address

Phone

I request that a security check be made of my premises from*

Date of departure

to*

Date of return

and will notify upon my return.

Signed*

Date of request*