This form is used to notify the Police Department of your upcoming vacation or a period of time that you may be out of town and would like extra patrol around your residence. The police department can not guarantee that we will be able to check your residence at specific times or dated, but we will make every effort to make as many checks on your residence as time and workload allow.

Fitzgerald Police Department Vacation Watch Request Form

Notify us immediately if departure or return times change at 229-426-5000.

Resident Information: * Indicates required information

Email:(If none, leave blank)

* Name:

* Fitzgerald Address:

* Zip Code:

* Phone Number:

* Away Phone:

(Phone number where you can be reached while away)

* Date & Time of Departure:

* Date & Time of Return:

Local Emergency Contact:

(Page 2)

Name:

Address:

Phone:

Do they have a key?

Persons Authorized on Property (Lawn/Pet Care, Etc.):

Name:

Name:

Name:

Name:

Vehicles Left on Property (Do not include vehicles in garage):

Year:

Make:

Model:

Color:

License # and State:

Year:

Make:

Model:

Color:

License # and State:

(Page 3)

Please Answer Yes or No to the Following:

Alarm System:

Alarm Company & Phone Number:

Broken Windows & Screens:

Where:

Lights Left On:

Where:

Pets in Yard:

What Type:

How Many:

Paper/Mail Stopped:

Member of Neighborhood Crime Watch:

Additional Information: