Vacation Watch Form

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Dates

Beginning Date *

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Ending Date *

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Resident Information

Resident's Name *

Street Address *

Phone Number *

Email Address *

Emergency Contact Information (other than resident)

Contact Name *

Contact Address *

Contact Phone Number *

Second Contact Name

Second Contact Address

Second Contact Phone Number

Other

Alarm Company Information (if applicable)

Interior Lights *

Off

Exterior Lights *

Off

Did you stop your mail and newspaper deliveries? *

Yes

Vehicles *

Animals *

If vacation date(s) change and/or you arrive home early, please contact Lebanon Police Department at (541) 258.4339. Vacation checks will not be extended past 30 days.

Vacation Watch Form

Contact Information

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