Webster Police Department House Check Form

NOTE: The purpose of reporting a house check with the Webster Police Department is two-fold.
1. By completing this report, the police department will have a telephone number to contact you in case of emergency.
2. If there is a problem in your neighborhood, the police department can check your house to make sure it is secure.

The Webster Police Department does not physically check each residence while the homeowner is away, but uses the house check as a tool if the need arises. In addtion, only residents residing within the Town or Village of Webster may use this form.

If you do not wish to use this online form to complete your housecheck, feel free to CLICK HERE to download and print the form in PDF format. (Adobe Acrobat Reader® required). You may fax the completed form to (585) 872-7010 or deliver it to the police department. Our address is 1000 Ridge Road, Webster, NY 14580

Full Name:
Street Address:
Date Leaving: (mm/dd/yyyy)
Date Returning:(mm/dd/yyyy)
Primary Phone:	A valid phone number is required for verification purposes.
House Key Left with anyone:
If Yes, Name of Contact:
Contact's Primary Phone:
Neighbors Made Aware:
Where you are staying:
Any Lights Left On:
Location of Lights:

If any vehicles are being left, please describe: (Use the comments section at the end for additional)
Vehicle 1 Year:	Vehicle 2 Year:	Vehicle 3 Year
Veh 1 Make/Model:	Veh 2 Make/Model	Veh 3 Make/Model
Vehicle 1 Plate:	Vehicle 2 Plate:	Vehicle 3 Plate:
Vehicle 1 Color:	Vehicle 2 Color:	Vehicle 3 Color

Any weapons left:
If Yes, Make, Model Location
Mail Delivery Stopped:
Paper Delivery Stopped:
Is Residence Alarmed:
Alarm Company Phone #:
Comments:

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