Vacant / Vacation House Check Request

When you leave town you may submit a form asking the Melbourne Beach Police Department to check on your house for you while you are gone.

Please ensure you understand the following house check guidelines:

• Officers will not check houses that are for sale/rent/vacant or if someone is staying at the residence
• The house check program has a 60 day limit
• Homeowner must have an available keyholder who can respond within 30 minutes
• It is very important that homeowners secure all windows and doors in the residence before leaving the area
• If there are any changes to the information on this form, the homeowner is responsible for notifying the Department at the non-emergency number (321) 723-4343 to ensure that officers do not respond to activity at the household that has been authorized by the homeowner
• The homeowner is responsible for cancelling housewatch upon return to town

Please complete the form below and submit to notify the Department of your request.

Completing this form does NOT guarantee your property will be placed under a permanent surveillance. The Melbourne Beach Police Department will check your property as calls for service permit. There is a sixty (60) day limit for the house watch program. When you return, please call the Police Department at 321-723-4343 so we can cancel your house watch. NO abandoned, for sale, or under construction houses.

Name * (required)

Address * (required)

Telephone # * (required)

Email Address * (required)

Date Leaving * (required)Date Leaving * (required)

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Date Returning * (required)Date Returning * (required)

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Destination * (required)

Destination Telephone # * (required)

IN CASE OF AN EMERGENCY, MY LOCAL CONTACT IS

Name * (required)

Telephone # * (required)

Address * (required)

Local contact has a key? * (required)

Yes

No

Newspaper/mail has been stopped? * (required)

Yes

No

Any pets left at the property? * (required)

Yes

No

Is your home alarmed? * (required)

Yes

No

Can your local contact reset the alarm? * (required)

Yes

No

Is your yard fenced? * (required)

Yes

No

Do you have a swimming pool? * (required)

Yes

No

If you have a shed, is it locked? * (required)

Yes

No

N/A

What rooms (if any) will have lights on or set on timers? * (required)

Persons working/checking the property other than the above contact? (Pest control, pool or lawn care, etc.) Please provide name(s) and reason(s). * (required)

Vehicles left in view? Please provide year/make/model, color, and tag number. * (required)

Type the characters you see in the image below * (Required)

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