if this is an emergency, contact 911

Vacation House Check Form

The Clear Creek County Sheriff’s Office will check your residence or business for up to 30 days while you are away. Please fill out the form 7 days in advance and leave a current contact name and telephone number should we need clarification prior to your departure.

 
*Home Owner Name:
*Address:
*Brief Description of House:
*Home Phone No.:
*How to Contact When Away:
*Phone No. When Away:
*Responsible Party Name:
*R.P. Phone No.:
*Date Leaving:
Morning Afternoon Evening Night
*Date Returning:
Morning Afternoon Evening Night
*Lights Left On? Yes No
If so, where?
*Vehicles Left? Yes No
If so, what?
*Animals Left? Yes No
If so, what?
*Current Contact Name and Phone No.:
*Date of Birth:
*E-Mail Address
(A copy of the submitted form will be sent to this address.):
*Confirm E-Mail Address:
Special Notes:
Enter the numbers and letters
(Anti-SPAM Verification)