The Cypress Police Department provides citizens with a free visual check of the exterior of your residence while you are away from home. Please fill out this form and submit at least one week prior to leaving on vacation. Make sure to lock all doors and windows prior to leaving and please notify the Cypress Police Department when you return.

 

This service is performed by Volunteers in Policing Members wearing identifying uniforms and driving a marked police department vehicle. If you have any questions about this form, call Police Records at (714) 229-6600.

1

Vacation information:

Vacation information:

Date leaving your home?

Date returning to your home?

Time leaving your home? (hour, am, pm)

Time returning to your home? (hour, am, pm)

2

Personal Information:

 *

Personal Information:

Name (Last, First)

Home Phone

Mobile Phone

3

Address:

 *

Address:

4

Person Responsible for Property in Your Absence:

Person Responsible for Property in Your Absence:

Contact Name

Home Phone

Mobile Phone

5

House Details:

 *

House Details:

Have you left any pets in residence or yard? (If YES, please list)

Lights/Radio on timers? (Provide location and type)

Vehicles left in driveway? (License #, Make, Model and Color)

Are all windows and doors locked and secured? (If NO, please explain)

Is anyone allowed to be inside the residence during your absence? (If YES, who/when?)

Do you have a lawn service? (Day of service?)

Do you have a pool service? (Day of service)

Is there access to the rear yard?

Any other comments?

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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