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2. Please Note

   Requests are only processed Monday through Friday between the hours of 8am and 4:30pm. Requests are not processed on observed holidays. Any requests submitted outside of the advertised days and times will not be processed until the next business day.

4. Your Name*
6. Home Phone Number
7. Cell Phone Number
9. E-mail Address
10. Home Address*
12. Color of House*
13. Cars in Driveway (description)*
15. Lights

    1. On
    2. Off
16. On Timers

    1. Yes
    2. No
17. When Are They On*
19. Alarm System

    1. Yes
    2. No
20. Name of Alarm Company
21. Alarm Company Phone Number
23. Pool In Yard*

    1. Yes
    2. No
24. Fence Around Yard*

    1. Yes
    2. No
25. Fence Locked

    1. Yes
    2. No
27. Responder's Name*
28. Responder's Phone Number*

    In case of emergency

30. Contact 1
32. Contact Name*
33. Contact Phone Number*
35. Contact 2
37. Contact Name
38. Contact Phone Number
40. Contact 3
42. Contact Name
43. Contact Phone Number
45. Other Comments

    Housewatch will not be performed beyond the "date returning".

47. Date Leaving*
    Date Leaving

    Date Leaving
48. Date Returning*
    Date Returning

    Date Returning
49. I Am The*

    1. Owner of this Property
    2. Person Responsible for this Property

51. Please note: The Vacant House Watch will end on the return date listed on the form. If your dates change or you return home early, it is incumbent upon you to contact the non-emergency number at 407-665-1017 and advise this information.

53. Permission

    If "I do give permission" is checked, you agree that:
    I give permission to the Lake Mary Police Department members to enter this house if they find it necessary. They also have my permission, for which I will file any required complaint, to make any necessary legal arrests in order to protect my home and security.

    1. I do give permission
    2. I do not give permission to the Lake Mary Police Department members to enter this house.
55. Consent

    By typing your name in the field, you are submitting via an electronic signature.

57. Signature*
58. Date*
    Date
60. Note

    If you will be gone for a longer time period than 3 months, please make arrangements to complete another form.

Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit

* indicates a required field