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Police Department | Vacation House Check Request Form

Date of Request Territory Car #
Name
Address
Dates: Start End
Time: Start End

Notifiy us 'immediately' if dates and/or times change.
Persons authorized on property (relatives/lawn care/pet care, etc)
Name Phone
Name Phone
Name Phone
Vehicles left on property
Year Make Model Color License #
Year Make Model Color License #
Year Make Model Color License #
Vehicle Alarms
I hereby request the Topeka Police Department to place the above location on their vacation watch list, for checking by the area car or VIPS patrol when possible. I understand the department cannot guarantee to check this location every hour or even every day, but that they will attempt to check this location as frequently as time permit. I understand and agree that the Topeka Police Department, the City of Topeka, and their agents and employees are released from any liability in connection with this gratuitous service. I will notify the department when I return to cancel this request.
Requested by
Address/Phone
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Last Updated: Tuesday August 09 2011