E-Gov Services City of Milford

WARNING! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. If your issue is an emergency, please use the telephone and dial 911.

Vacation House Check

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Purpose. This form is used to request that police officers periodically check your residence or premises while you are away on vacation.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
* Email:
* Daytime Phone:	() –
Fax:	() –
Address:
City:
State:
ZIP:

* What are the dates that you will be away from your residence or premises?

Who has keys to your residence or premises? (Please provide contact information)

Who may occupy your residence or premises while you are away?

Will any lights be left on?

Yes

If so, where?

Is there an alarm?

Yes

If so, please provide the name and phone number.

Please provide the name(s) and phone number(s) of whom to call in the event of an emergency:

Attach a Picture or File (max size: 30MB):

Add Another FIle

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* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.