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Vacation Check Request

  1. OPD CAR AND FLAG

  2. VACATION CHECK REQUEST FORM

    ORANGE POLICE DEPARTMENT 1107 N BATAVIA, ORANGE, CA 92867-4615 FORM MAY BE SUBMITTED ONLINE, MAILED, DROPPED OFF IN PERSON OR FAXED, ATTN: VOLUNTEER PROGRAM QUESTIONS: 714-744-7507 Email: Volunteers@orangepd.org FAX: 714-744-7320 Checks are based on personnel availability and are conducted week days, excluding weekends and holidays. -1-Week Notice Preferred. Signature Required Authorizing Vacation Check-

  3. ALTERNATE OR EMERGENCY CONTACTS:

    Please indicate contact information for relatives, friends or someone we may contact in case we have questions or concerns regarding your property while you are away:

  4. PROPERTY INFORMATION

  5. Will there be pets left at your property while you are away? *

    Please note for safety reasons, if there is a pet in the back or side yard, we will not enter that area to check.

  6. Do You Have a Security System (alarm, other)? *

  7. Is there an outdoor pool or hot tub on your property? *

  8. Is there Backyard Access? *

    Please check 'Yes' if there is access AND it is unlocked.

  9. Is there Side Yard Access? *

    Please check 'Yes' if there is access AND it is unlocked.

  10. AUTHORIZED PERSONS ON PREMISE

  11. Including: Relatives, Gardner, Pool Service, etc

  12. Example: Relative, Gardener, Neighbor, Friend

  13. Authorized Persons on Premise

  14. Authorized Persons on Premise

  15. VEHICLES LEFT ON PREMISE

  16. Make

    Example: Dodge

  17. Model

    Ram truck

  18. Color / License #

    Blue, 1ABC234

  19. Location

    Driveway, Garage

  20. Example: "I live in a gated community and the gate code is 1234."

  21. Electronic Signature Agreement*

    I agree that all above information is accurate. I also agree to allow Orange Police Department Personnel conduct Vacation Checks at my residence. I understand checks are conducted based on personnel availability. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  22. Leave This Blank:

  23. This field is not part of the form submission.