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2. 

4. The purpose of reporting a house check with the Webster Police Department is two-fold:

   1.  By completing this report, the Police Department will have a telephone number to contact you in case of emergency when you are out of town.

   2.  If there is a problem in your neighborhood, the Police Department can check your house to make sure it is secure.  

   
   

   The Webster Police Department does not physically check each residence while the homeowner is away, but uses the house check as a tool if the need arises. In addtion, only residents residing within the Town or Village of Webster may use this form.

6. 
   
8. First name*
9. Last Name*
11. Street Address*
13. City*
14. ST
15. Zip Code*
17. Date leaving*
18. Date Returning*
20. Home Phone*
21. Contact Phone
23. Where will you be staying and is there a phone number other than your contact number to contact you if needed?
25. Have you left your house keys with a neighbor or relative?*
    -- Select One --YesNo
27. If yes, who is the key holder?
29. Key Holders phone number
31. Are your neighbors aware that you will be away?*
    -- Select One --YesNo
33. Have you left any lights on in the house?
    -- Select One --YesNo
35. Which lights have you left on?
37. If you have left any vehicles at home please list the License Plate Number, Make, Model and color of the vehicle(s).
39. Have you left any firearms in the house?
    -- Select One --YesNo
41. Where are the firearms located in the house?
43. Has the mail been stopped?
    -- Select One --YesNo
44. Has the paper been stopped?
    -- Select One --YesNo
45. Is the house alarmed?
    -- Select One --YesNo
47. Additional Comments

49. 
    

    Thank you for completing this form.  

    Please select the SUBMIT button below to complete this process. 

    
    

    Thank you!

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51. 1. Receive an email copy of this form.
52. Email address

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