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2. This form is to request additional Police patrols and policing activities for vacationing residents, suspicious activities near homes and businesses, and other legitimate security concerns. Additional information from you in a follow-up contact from the Ingleside Police Department regarding your request is not uncommon.

4. Resident's First Name*
5. Resident's Last Name*
7. Resident's Home Address*

   Street Address

9. Address Line 2
11. City*
    -- Select One --Ingleside
12. State*
    -- Select One --Texas
13. Zip Code*
    -- Select One --78362
15. Resident's Phone Number*
17. Resident's Email Address
19. Address To Be Patrolled*
    -- Select One --The address to be patrolled is the same as my home address.The address to be patrolled is different from my home address.
21. Reason For Additional Patrol And Observation*

    1. I will be on vacation.
    2. I have noticed suspicious activity.
    3. Other
22. If other, specify
24. Address To Be Patrolled, If Different From Home

    Street Address

26. Address Line 2
28. City
    -- Select One --Ingleside
29. State
    -- Select One --Texas
30. Zip Code
    -- Select One --78362
32. Date To Start and End Additional Patrol*
    Date To Start and End Additional Patrol Start Date

    —

    Date To Start and End Additional Patrol End Date
34. Will Any Lights Be Left On?*
    -- Select One --YesNo
36. If Lights Are Left On, Are They On A Timer?
    -- Select One --YesNo
38. If Lights Are Left On, What Are The Locations?
40. Does Any Person Or Workers Have Access To The Premises?*
    -- Select One --YesNo
42. If People Have Access To The Premises, List Them Here.
44. Is There An Alarm On The Premises?*
    -- Select One --Yes, An Audible Alarm.Yes, A Silent Alarm.No, There Is No Alarm.
46. Will Any Vehicles Be Left On The Premises?*
    -- Select One --YesNo
48. If Vehicles Are Left On The Premises, List Them Here.

    Include Year, Make, Model, Color, and License.

50. Consent*

    I understand that I am providing this information to the Ingleside Police Department in order to assist them in any necessary police activity related to my home, property, or business during my absence. While I understand the police department will make a reasonable effort to check on my home, property, or business during my absence, I understand and confirm that no expressed or implied promise or warranty is made that any police officer will have to check on my home, property, or business at any time during my absence.

    1. I agree to the consent statement
52. Date Of Consent*
    Date Of Consent
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field