Vacation and Vacant Home List

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Leaving on vacation? Will your property be vacant for an extended period of time?

Submit this form to the Piatt County Sheriff's Office and in the event we become aware of a situation involving your property, we will attempt to contact you and/or your emergency contact.

Your name *

Property address *

Home phone

Cell phone

Date leaving *

Month

Day

Year

Expected return date *

Month

Day

Year

Will lights be left on?

Any vehicles left outside?

Will your mail be stopped? *

Local emergency contact name

Does this person have a key?

Vacation Location Name *

Vacation Location Address *

Vacation phone *

Your email address *

If more than one email, separate with commas

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Vacation and Vacant Home List