What is the Home Security Check Request Form for?

It lets Salem residents request a police check of their home while away and provide dates, contact information, and details about the premises.

What information does the form ask for?

It asks for your name, address, departure and return dates, phone numbers, information about lights, keys, and activity at the premises, and an emergency contact.

Do I need a notary for the Home Security Check Request Form?

No. The request is signed and dated without a notary, and the form lists no notarized or sworn attachment.

Salem, IL · Marion County

No notary required

Home Security Check Request Form

Salem residents use this form to request a police security check of their home while they are away.

What this form is

The form lets residents ask the Salem Police Department to check their home during a period of absence. It asks for departure and return dates, contact details, information about lights, keys, and activity at the premises, and an emergency contact. The signer agrees to the procedures described for responding to an open door, window, or signs of forced entry.

Who needs it

Salem residents who want police to check their home while they are away can complete and sign this request form.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This request is signed and dated without a notary; the form lists no notarized or sworn attachment, so the signer just signs and dates it.

How to submit this form

1
Download The Form
Download the Home Security Check Request Form.
2
Complete The Request
Fill in your contact details, absence dates, home information, and emergency contact.
3
Sign And Date
Read the procedures on the form, then sign and date the request.
4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What is the Home Security Check Request Form for?: It lets Salem residents request a police check of their home while away and provide dates, contact information, and details about the premises.
What information does the form ask for?: It asks for your name, address, departure and return dates, phone numbers, information about lights, keys, and activity at the premises, and an emergency contact.
Do I need a notary for the Home Security Check Request Form?: No. The request is signed and dated without a notary, and the form lists no notarized or sworn attachment.
How do I submit the Home Security Check Request Form?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Home Security Check Request Form doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.