House Check Request

The Dayton Police department offers a house check program to local residents while you are away from your home. This includes making sure the outer perimeter of your home is secure and there is nothing unusual on or about the premise. Fill out the below form or call the Dayton Police Department at (763)427-2017 to participate. **Please make sure to note if anyone is allowed at your home while you are away.  Also be sure to enter a local contact you trust if you are not able to be reached.

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First Name*

Middle Name (Full name, not just initial)*?

Last Name*

Date of Birth*

Address

Address Line 1*

Address Line 2

City*

State*

Zip Code*

Email

Home Phone

Cell Phone

Date Leaving*

Estimated Time Leaving* AM PM Unsure

Date Returning*

Estimated Time Returning* AM PM Unsure

Alarm System*

Yes

No

Lights on Timers*

Yes

No

Lights On - No Timers*

Yes

No

Name(s) and Phone Number(s) of Authorized Peoples to Access Home

Please List Here:

List Vehicles in Driveway - Not in Garage

Any Other Comments