East Dundee Police Department House Watch Request

Start Date*Required
End Date *Required
Address *Required
Name*Required
Request Made By
Phone*Required
E-Mail Address: *Required


Reason for Extra Patrol:


Type Premise:

Protected By Alarm System?

Lights On?


Keys Left with Anyone?

Other Persons Who Will Have Access To Premises (relatives, workers, neighbors, employee, etc.)
Person 1:
Person 2:

In Case of Emergency, Who Do You Wish Us To Call & How?
C/O Name Address Phone

Other Info You Care to Add: