Milton New Hampshire Police Department
Complete this form if you are leaving town and would like Milton Police Department to keep an eye on your home or business while you are away
I request a House Check be made of my premises:
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Indicates required field
From (Date):
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To (Date):
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Name and Address
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Reason for House Check
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Premise Will Be Vacant
Other (Comment Below)
Protected by alarm?
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Yes
No
Type of Premise
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Residence
Business
Other
Lights left on?
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No
Yes, constant
Yes, on timer
Keys left with anyone?
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Yes
No
If Yes, Name and Phone Number
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Other persons who have access to the residence
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Vehicles left in yard
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Phone number you can be reached at:
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Other Info:
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Submit