Washtenaw County Sheriff's Office House Watch

This Portion Must Be Completed for Security/Vacation Checks

Responsible party

Phone

Address

Has keys?

Yes
No

Responsible party

Phone

Address

Has keys?

Yes
No

Will there be vehicles on the premises during your absence?

Yes
No

Vehicle description(s) (year, make, model, license plate number)

Do you wish to be notified in case of emergency?

Yes
No

Telephone number

I request a security check be made of my premises and agree to notify the Sheriff's Office promptly upon my return.

Signed (Required)

Please type name