Skip to Main Content

Vacation House Watch Request

Vacation Check Request

Steps

1. Please complete this form and contact information. This section is complete This section is incomplete
2. Vacation Information This section is complete This section is incomplete
3. Emergency Contact Information This section is complete This section is incomplete

Please complete this form and contact information.

Complete the following information and the police department will log your residence on an extra patrol while you are on vacation.
First Name
Last Name
Address1
Address2
City
State
Zip
Phone Number*
Email Address
Continue

Vacation Information

Date Leaving*
Date Returning*
Do you have any lights on?*
1. Yes
2. No
Location of Lights
Any vehicles in driveway?*
1. Yes
2. No
Vehicle Descriptions
Continue |Go Back

Emergency Contact Information

Name*
Address*
Phone Number*
Does emergency contact have a key?
1. Yes
2. No
Miscellaneous Information

Leave This Blank:

Submit Submit and Print | Go Back

Use of Copyrighted Materials or City Logo: This site contains copyrighted materials, including the official logo of the City of Bentonville, Arkansas. Except as otherwise expressly permitted under copyright law, no copying, redistribution or publication of copyrighted material will be permitted without the consent of City and the owner of the copyrighted materials. User acknowledges that it does not gain any ownership rights by downloading copyrighted materials.