Vacation "House Check"
Fill out the form below and then drop it off or mail it to us at Troutdale Police Department, 141 SE Dora, Troutdale OR 97060. You can also fax the form to (503) 669-0875.
For Troutdale residents only.

General Information
Name
Address
Phone
Emergency Contacy Name
Emergency Contact Phone
Have Keys
 Yes No
 
House Details
Does House Have An Alarm System? Yes No
Does Alarm Have An Automatic Shut-Off? Yes No
Are There Dogs On Site? Yes No
Have You Arranged For Daily Deliveries To Be Stopped? Yes No
Is Anyone Authorized To Be On The Premises? Yes No
Authorized Visitor Name
Authorized Visitor's Phone
Authorized Visitor's Reason
Vehicles At Residence 1) License Number
  Description

2) License Number
  Description
  3) License Number
  Description
Condition Of House Upon Departure (Indicate anything that might cause someone to believe a crime has occurred, i.e. broken windows, torn or cut screens, etc...)
Will There Be Lights, Radio, TVs, Etc... Left On? Yes No
Are They On Timers? Yes No
Approximate On/Off Times
Departure Date
Return Date

This Data Will Be Destroyed Within Seven (7) Days After Your Stated Return Unless Otherwise Arranged

Submissions may not be received by our department until the next business day.