Dear Home Owner,

     In recent years the police department has kept logs of people who are leaving town and would like the department to monitor the property for inappropriate activity or emergencies. For years we have taken this information via the telephone. We are now proud to be able to provide this service on-line.
    Please fill out all of the information below.
    If anything changes during the period you specify, or if you are returning early or later, please notify us @ 859-441-6562.

(No information provided by you will be released to anyone in the public.)

Owner's Name:
Address:

Suite, Condo or Apt #:	Residence Telephone: Resident's Cell Phone:
Date Leaving:	Date Returning:

List 3 persons in order of contact importance in the event of an emergency:
Name & Relation:		Address:		Telephone:
1.)
2.)
3.)
Alarm:  Yes	No	Type:  Burglar	Panic	Fire
Alarm is:	Silent	Audible
Alarm Company:			Telephone:
After Hour Lighting: Be as specific as need be I.E. Timers, Sensors, Spot Lights etc.
Neighbors are notified:        Yes     No
Miscellaneous Information or Instructions: (This includes people checking the house or taking care of pets or plants)

Your Email Address: