WFB_Form_Vacation_Security_Check

City of Ionia

Complete the following information and Public Safety will drive by your property while you are on vacation or the premises is vacant.

Contact Information

Contact Name

Address

City

State

Zip Code

Phone Number

With area code. No prefixes or dashes. Example: 6165274170

Email Address

Required. We can send you dates when the premises is checked.

Reason for Extra Patrol

Type of Premises

Business Residence Other

required

Vacation Information

Date Leaving

required

Date Returning

required

Any Lights On?

Yes No

Location of Lights

Vehicles in Driveway?

Yes No

Vehicle Descriptions

Alarm System Protection?

Yes No

Type of Alarm

Emergency Contact Information

Emergency Contact Name

Emergency Contact Address

Emergency Contact Phone

Does Emergency Contact Have Key?

Yes No

required

Additional Information

Notes