CHEVY CHASE VILLAGE HOUSE CHECK
Routine House Check
Resident Name:
Address:
Date and Time Leaving:
Date and Time Returning:
Emergency Number:
Emergency Number:
EMERGENCY CONTACTS
Car parked in front or left in the driveway?
Yes No
Description of vehicle ____________________
______________________________________
______________________________________
Are the house lights on timers?
Yes No
Location of timed lights or lights left on
__________________________________________
__________________________________________
Anyone residing, visiting or working at the
residence? (Circle one)
Yes No
Information regarding occupancy
__________________________________________
__________________________________________
__________________________________________
Does the house have an alarm system?
Yes No
Alarm Company and if available phone number
__________________________________________
__________________________________________
Pick up Newspapers? Yes No
Relocate on Property Recycle
Disposition _______________________________
__________________________________________
Pick up Mail? Yes No
Pick up Packages? Yes
No
Disposition________________________________
__________________________________________
Received by:
Date: Time: