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House Check Form

  1. Niceville Police Department House Check / Extra Patrol

  2. Reason for Extra Patrol:*

  3. Keys left with anyone?*

  4. Do you wish to be contacted collect?*

  5. Animals left of premises?*

  6. Any vehicle left in boat/yard?*

  7. Protected by alarm system?*

  8. Lights?*

  9. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  10. I request a security check be made of my premises during the dates listed above and will notify you upon my return.

  11. Leave This Blank:

  12. This field is not part of the form submission.