House/Business Checks Haskins Police House/Business Check Homeowner / Property Information Address * Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip Code Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombi Comoros Congo (Brazzaville) Congo Costa Rica Cote d\'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (Timor Timur) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepa Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe Country Start Date *This is the date you will be leaving, and that you will want Officers to start checking your property. End Date *This is the date you will be returning to your property and Officers will no longer check the property. Homeowner Name * Homeowner Contact Phone *A phone number that an Officer can reach you in the event of an issue with your property. Special Instructions for Officers Anything you would like officers to know about your property (ex: The backyard fence doesn't latch so it may be open upon arrival). Emergency Contacts Emergency Contact First emergency contact to reach in case of an issue with your property Emergency Contact Phone Does the Emergency contact have a key to the property? Yes No Vehicles Being Left on Property All vehicles left on property while you are gone (Include: Make, Model, Color, License Plate #) Do you have an alarm system? Yes No Alarm Company Are there any broken windows/screens? Yes No If there are broken windows/screens, where are they? Will there be any lights left on? This includes lamps, fish tanks, etc. Yes No Where will the lights be on at? Will the lights be on a timer? Yes No Are there any pets being left on property? Yes No What types of pets and where will they be left? (Ex: Dog will be in back bedroom, or cat roams the house) Will your mail/paper delivery be stopped? Yes No Verification Please enter any two digits *Example: 12 This box is for spam protection - please leave it blank:
