2. Address and Contact Information
   Use this section to enter the address of the house you'd like checked along with your contact information.
4. Homeowner's Full Name:*
6. House Address:*
7. City
   San Mateo, CA
9. Home Phone Number:*
10. Cell Phone Number:*
11. Email Address:*
13. Vacation Phone Number:*
15. Vacation Start and End Dates
17. Departure Date:*
    Departure Date:

    Departure Date:
18. Return Date:*
    Return Date:

    Return Date:
20. What can we expect?
    Please use the section below to identify pets and/or people who may be at your home during your vacation.
22. Are there animals on premises?*

    1. YES
    2. NO
23. If there are animals on premises, please describe:
25. Vehicles left at home?*

    1. YES
    2. NO
26. If there are vehicles left at home, please include make/model/color and license plate number:
28. Location of lights and timers?
    If you have lights on timers, please indicate the room(s) and set times.
30. Alarm Company?*

    1. YES
    2. NO
31. Please provide name and contact phone number of alarm company:
33. Gardener?*

    1. YES
    2. NO
34. Please provide name and phone number of gardener:
36. Pool cleaner?*

    1. YES
    2. NO
37. Please provide name and phone number of pool cleaner:
39. Housekeeper?*

    1. YES
    2. NO
40. Please provide name and phone number of housekeeper along with date(s)/time(s) they will be at your address:
42. Have you left a spare key with a neighbor?*

    1. YES
    2. NO
43. Please provide the name and phone number of the neighbor:
45. Emergency Contact Information
47. Emergency Contact - Full Name*
49. Emergency Contact - Address*
51. Emergency Contact - Phone Number:*
53. I agree with and understand the following:
    NOTE: Please check each box below as confirmation that you have read and understand the following limitations:
55. For office/cadet safety, San Mateo Police will not provide a vacation house check if someone is staying on the premises*

    1. I understand
57. Vehicles left on city strees in axcess of 72 hours are subject to tow.*

    1. I understand
59. San Mateo Police Department will make every reasonable attempt to monitor your property during your vacation. However, circumstances may preclude us from performing this services on any day, any series of days, or perhaps, during the entire tenure of your vacation.*

    1. I understand
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit

* indicates a required field