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Request a House Check

Request a House Check

Steps

1. Basic Information(current) This section is complete This section is incomplete
2. Alternate / Emergency Contact(s) This section is complete This section is incomplete
3. Property Information This section is complete This section is incomplete
4. Authorized Person(s) on Premises (ex. relative, friend, gardener) This section is complete This section is incomplete
5. Authorized Vehicles on Premises This section is complete This section is incomplete

Basic Information

This house check request is good for 30 days. If you would like to extend the house check, please contact the department at 508-883-1212.
Start Date
Start Date
End Date
End Date
Name
Address
Address Line 2
City
State
Zip Code
Phone Number
Alternate Phone Number
Continue

Alternate / Emergency Contact(s)

Please list alternate/emergency contacts available while you are away (in case we have questions about the property).
Name of Contact 1
Contact 1 Phone Number
Contact 1 Address - Line 1
Contact 2 Address Line 2
City
State
Zip Code
Name of Contact 2
Contact 2 Phone Number
Contact 2 Address - Line 1
Contact 2 Address Line 2
City
State
Zip Code
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Property Information

Animals on Premise?
1. Yes
2. No
Type of Animal
Location on Premise (ex. backyard, inside)
Alarm?
1. Yes
2. No
Alarm Company Name
Alarm Company Phone Number
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Authorized Person(s) on Premises (ex. relative, friend, gardener)

Authorized Person 1 Name
Authorized Person 1 Phone Number
Authorized Person 2 Name
Authorized Person 2 Phone Number
Authorized Person 3 Name
Authorized Person 3 Phone Number
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Authorized Vehicles on Premises

Authorized Vehicle 1 Make/Model
Authorized Vehicle 1 Color
Authorized Vehicle 1 License Number
Authorized Vehicle 2 Make/Model
Authorized Vehicle 2 Color
Authorized Vehicle 2 License Number
Authorized Vehicle 3 Make/Model
Authorized Vehicle 3 Color
Authorized Vehicle 3 License Number

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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