Form Center

2. The acknowledger, being a duly authorized person to request a Police Security Check, understands that the purpose of the Police Security Check is to identify residences that are vacant and to increase police surveillance and security during the period of vacancy. Residences, which are vacant, will be checked by the police as time permits. It is understood that the Town of Huntersville does not assume responsibility for the home and that the Town will not provide twenty-four hour police protection. It is also understood that the Town of Huntersville and the Huntersville Police Department make no representations of warranties as to the results of the Police Security Check. Security Checks of a residence are not routinely approved for time periods in excess of 21 days. Please contact the Patrol Watch Commander at 704-464-5400 prior to submitting any request for a security check in excess of 21 days.
   
   House check forms will only be accepted by town residents and are not intended to be used by realtors or banks to secure vacant / foreclosed houses.
   
   The acknowledger authorizes the Police to enter the residence if any of the following conditions exist:
   A. There is an unlocked / broken door / window or other mode of entry is found or reported.
   B. A burglar alarm or fire alarm has been activated at the residence.
   C. The Police Officer(s) has/have reasonable cause to believe that there has been an unlawful entry.
   D. Utility damage that may require shutting off water, gas, or electricity in order to prevent further damage to property or to prevent continuation of an unsafe condition.
   E. Any other condition found by the Police Officer(s), which give reasonable cause to believe that there is an unsafe condition.
   
   I have read the information contained in the request for a Police Security Check and understand its terms. I also agree to hold the Town of Huntersville, Huntersville Police, and any other agents, employees, or designated persons, harmless for any damage resulting from an entry to the residence being made pursuant to this waiver and consent.
   
   By signing or submitting the Request for Security Check Form you are agreeing to the above conditions.
4. First Name*
5. Last Name*
7. Email*
9. Address*
11. City
12. State
13. Zip Code*
15. Phone*
16. Emergency Phone*
18. Starting & Ending Date & Time*
    Starting & Ending Date & Time Start Date

    Starting & Ending Date & Time Start Time

    —

    Starting & Ending Date & Time End Date

    Starting & Ending Date & Time End Time
20. Is there an alarm?*

    1. Yes
    2. No
21. If so, what is the name of the Alarm Company?
23. Are lights either:

    1. Left On
    2. On Timers
    3. Motion
    4. None
25. Vehicles Present
26. Vehicle Location

    1. Garage
    2. Driveway
    3. Street
28. Local Contact*
30. Persons Authorized on Premises
    (Name / Address / Phone)
32. Reason for Security Check
Leave This Blank:


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

    This field is not part of the form submission.

36. Submit

* indicates a required field