Vacation Check Report VC #_______________
Resident:
Name: ______________________________ Phone #: (______) ______-_____________
Address: ____________________________ City: Gahanna
Zip: 43230
Leave Date:__________________________
Return Date: _________________________
Office:
Date Taken:__________Time:__________ Taken By:___________________________
Date Cancelled: ______________________ Cancelled By: ________________________
Description of House: __________________________________________________________________
Other Information that may be Helpful to Officer: ____________________________________________
_____________________________________________________________________________________
Key Holders:
Na
me Phone #
Others wh
o may be on Property (repair work, construction, house cleaning, mowing, etc.):
Name Phone #
Cars on Prop
erty:
Year Make Color License Plate # Location on
Property
Security:
Security System? ____________ Audible? ____________ Dialer? ___________________
Security Company: ____________________________ Phone #: (_______) _______-_______________
Lights:
Lights on for Security Purposes? ______
If yes:
On Timer? ______ On Time: __________ to __________ Off Time: __________ to __________
Outside? ______ Inside? ______ Rooms? ___________________________________________________
Explain if Necessary: ___________________________________________________________________
_____________________________________________________________________________________
Pets:
Pets on premise? ________ Type of Pet: _______ Will pet be of concern to officer? ____________
Please Explain if Yes: __________________________________________________________________
Person Feeding Pet(s): ____________________ Phone #: (_______) _______-_______________
City of Gahanna
Division of Police
JEFFREY SPENCE , CHIEF OF POLICE
460 ROCKY FORK BLVD
GAHANNA,OHIO 43230
614-342-4240
614-342-4300 (FAX)
