BELLAIRE POLICE DEPARTMENT

VACATION WATCH FORM

The Bellaire Police Department needs the following information so we can watch over your property when you go on Vacation.  Please fill out the form completely.

We will leave on vacation on __________________________________________________

We will return on or about_____________________________________________________

In case of Emergency contact:  ________________________________________________

__________________________________Phone #________________________________

[  ]  We will turn off all lights in the house or business

[  ]  We will leave the following lights on:  __________________________________________

Name: ___________________________________________________________________

Address__________________________________Phone___________________________

Special Notes:_____________________________________________________________

________________________________________________________________________

E-mail address to contact you if necessary:_______________________________________

Please drop off or mail this form to 202 Bridge Street, Bellaire, MI  49615