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Property Watch Request
As property owner, I hereby request the Holland Police Department check the following residence and property:

Address:        ____________________________________________________________

House Color:    ______________________ Type: ________________________________

Alarm Company:  _________________________________
(If Applicable)

Phone Number:   _________________________________
(If Applicable)

Start Date:     __________________ Time: _______________

End Date:        __________________ Time: _______________

The following have keys to my home:

Name:   ______________________________ Phone Number: _____________________

Name:   ______________________________ Phone Number: _____________________

Printed Name: __________________________________________________________

Signature:        ____________________________________ Date: _________________

I may be contacted at the following telephone number(s):

Contact Number(s):      ______________________________________________________

Town of Holland 27 Sturbridge Road, Holland, MA 01521
Phone: 413-245-7108 Fax: 413-245-7037
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