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2. First Name
3. Last Name
5. Type of Watch*

   1. Property / Vacation Check
   2. Other
6. If other, please explain
8. Address to be checked*
10. Township / Village*

    If your city/township does not appear below, please contact Washtenaw Metro Dispatch at 734-994-2911 for an appropriate response.

    1. Ann Arbor Township
    2. Barton Hills Village
    3. Dexter Township
    4. Dexter City

    1. Lodi Township
    2. Manchester Village
    3. Salem Township
    4. Scio Township

    1. Superior Township
    2. Webster Township
    3. York Township
    4. Ypsilanti Township
12. Type of Property*

    1. Business
    2. Residential
    3. Other
13. If other, please explain
15. Beginning and Ending Date*
    Beginning and Ending Date Start Date

    —

    Beginning and Ending Date End Date
17. Property Owner's Name*
18. Phone*
20. Email Address
22. Will there be any vehicles on the property during your absence?

    1. Yes
    2. No
23. Vehicle(s) description(s) i.e., year, make, model, color, license plate(s)
25. Location of Vehicle(s) remaining on property during absence i.e., driveway, garage, barn, etc.
27. Lighting Information: Check all that apply

    1. Timed Lights - Indoors
    2. Timed Lights - Outdoors
    3. Constant Lighting - Indoors
    4. Constant Lighting - Outdoors
    5. None
28. Do you have security cameras, e.g. NestCam, Ring Doorbell, etc.?

    1. Yes
    2. No
30. Does the property have an alarm system?

    1. Yes
    2. No
31. If yes, please specify what alarm company and the alarm company's phone number.
33. Are there any pets in the home?

    1. Yes
    2. No
34. If yes, please list name and type of each pet.
36. Will anyone else be doing property checks?

    1. Yes
    2. No
38. If someone else will be doing property checks, please provide their name, phone number and vehicle description in the fields below.
40. First Name
41. Last Name
42. Phone Number
44. Vehicle Description (make, model, color) of person other than WCSO completing property checks.
46. In case of emergency, who should be contacted other than or in addition to you?
48. Emergency Contact #1 Name
49. Emergency Contact #1 Phone Number
51. Does emergency contact #1 have keys to property?

    1. Yes
    2. No
53. Emergency Contact #2 Name
54. Emergency Contact #2 Phone Number
56. Does emergency contact #2 have keys to property?

    1. Yes
    2. No
58. Additional Comments
60. I request a security check be made of my property during my absence and agree to notify the Sheriff's Office promptly upon my return. By submitting this online form, I understand the Sheriff’s Office will contact me in the event of an emergency.
62. Signed*
    Please type name
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field