STRATHAM, NH POLICE DEPARTMENT
HOUSE CHECK REQUEST
Name: Phone #: Cell Phone:
Address:
Email:
Night Lights/Timers:
Vehicles and Plate #s:
Date & Time Leaving: Date & Time Returning:
Other:
Emergency Contact (Family member/neighbor): Please list in order of who to contact first, second, third, etc.
1.
2.
3.
For Police Department Use Only:
DATE CHECKED TIME CHECKED OFFICER RESULTS
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