Securitas

Vacation Check Form:

For

ZONE:  _______

FAIRWOOD GREENS:

Name: _________________________                       Residential Check Number: _____(SECURITY ONLY)

Address: _______________________                        Phone Number: ________________

Date Departing: ________________                           Date Returning: _______________

Interior Lighting:  Yes or No                                         Timers/Motion:  Yes or No

Exterior Lighting:  Yes or No                                        Timers/Motion:  Yes or No

Cars or Equipment Outside:  Yes or No (Please provide description of car with licenses plate number and any equipment with location): ________________________________________________________

Residential Alarm Status

Is Residence Alarmed:  Yes or No    If yes, is Alarm Audible Outside:  Yes or No

Company that Monitors the Alarm: ___________________________________________

Is Alarm Auto Shut Off:  Yes or No

Person to Contact for Alarm Codes: __________________________________________

Phone Number: __________________________

Emergency Contact Person

Name: __________________________________________________________________

Phone Number #1:  (       )-_____-______________  Work or Home

Phone Number #2:  (       )-_____-______________  Work or Home

Does this Contact have keys to the Residence:  Yes or No

Will anyone be Visiting or Staying at the Residence:  Yes or No

Name of the Person or Company that will be Visiting or Staying: _________________

Phone Number of the Person or Company that will be visiting or staying:_____________

Special Instructions: _______________________________________________________

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