STANFIELD POLICE DEPARTMENT RESIDENTIAL SECURITY CHECK


Name Phone #

Address

Leaving on (day/month/time) Returning on (day/month/time)

Lights to be left on (please list):

Lights on timer (please list):


1.In Case of Emergency Contact (name, address, phone #);


Does this person have access to your residence? Yes No


2.In Case of Emergency Contact (name, address, phone #);


Does this person have access to your residence? Yes No

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Town of Stanfield Town Hall
103 W Stanly Street Stanfield, NC 28163 | ph. 704-888-2386

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