Request a Property Vacation Check from the Elmwood Park Police Department

First Name

Last Name

Email Address

Street Address

Apartment No., Unit No., or Floor (if applicable)

City or Town

State

Zip Code

Primary Phone Number

Additional Phone Number

Date and Approximate Time of Departure

Date and Approximate Time of Return

Will anyone be having access to the property? Yes No

If your answer to the foregoing question was "yes", who is it?

Their Phone Number

Will there be lights left on or on a timer? Yes No

If your answer to the foregoing question was "yes", during what hours?

Is there an alarm installed? Yes No

Will there be any vehicles left on the property in your absence? Yes No

If your answer to the foregoing question was "yes", please provide the make, model, color, and year of each vehicle. (250 chars left)

Local Emergency Contact Person

Their Address

Their City or Town

Their State

Their Zip Code

Their Phone Number

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