House Check Please fill out this form if you would like us to check on your home while it's unoccupied for any length of time. Note: Items with an asterisk are required entries Your Name: Email Address: Local Contact Information Address Phone Date of Departure Date of Return Please provide information for contacting you during your absence Address Phone Cell Phone Is there a key holder available for contact during your absence? NoYes If yes, please provide contact information below. Name Address Phone Cell Phone Additional Required Information Is your residence alarmed? NoYes Will you be leaving lights on? NoYes If yes, which lights? If any lights are on a timer, please list locations and times: Additional comments? Please review your information. If you are satisfied that you have provided all requested/required information, check the following box, enter the required security key and press the submit button. I have verified the infromation provided is correct.