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Property Check Form

2. I understand that by completing this form I am agreeing to allow officers of the Anacortes PD, as well as members of the Citizens Auxiliary Patrol, to perform physical checks on the property that I have listed. I understand that these checks may include checking windows and doors to make certain they are secured and may include walking around any structures that are on the property. I understand that property checks will not be done in inaccessible areas beyond fences or gates. I also understand that neither the City of Anacortes nor the Citizens Auxiliary Patrol assume any liability for the listed property. This form does not imply that any property checks will be performed.
   Property Checks will be performed for a maximum of 150 days and not on homes that are for sale.

   Property Checks will be performed for a maximum of 150 days and not on homes that are for sale.

4. Date
   Date

6. First Name

7. Last Name

9. Address

11. City

12. State

13. Zip Code

15. Phone Number

16. Alternate Phone Number

18. Email Address

20. House Color

21. Nearest Cross Street

23. Persons with access to my property while I am away, including phone number (neighbors, gardeners, etc.)

25. The following vehicles will be left on the property while I am away
    Provide make, model, and license plate number

    Provide make, model, and license plate number

27. Garage

29. Driveway

31. Street

33. A spare key will be left with

35. First Name

36. Last Name

38. Address

40. City

41. State

42. Zip Code

44. Phone Number

46. Is your property alarmed?

    1. Yes
    2. No

47. Alarm Company

49. Will any lights be on?

    1. Yes
    2. No

50. If lights will be left on, provide time and location

52. Address is posted on

    1. Curb
    2. House
    3. Mailbox

54. Please check listed property from
    Please check listed property from Start Date

    Please check listed property from Start Time

    —

    Please check listed property from End Date

    Please check listed property from End Time

56. Upon return to Anacortes, please remember to call 360-293-4684 and let us know you have returned.

58. APD Property Check Number

59. Cancelled on
    Cancelled on

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