HENNING POLICE DEPARTMENT

(218) 583-2903

Temporary Property Vacancy Notification

Instructions

If you are a resident or business owner in the City of Henning and are going to be leaving town for long or short term purposes, you may use this form to notify the Henning Police Department so that patrolling officers may randomly inspect your residence or business to ensure the security of your home or business while you are away.

Application Process

Complete the form in its entirety.

E-mail the form back to the Henning Police Department or simply drop it off.

HENNING POLICE DEPARTMENT

607 Second Street – P.O. Box 55

Henning, Minnesota56551

Phone: (218) 583-2903

Fax: (218) 548-2404

E-Mail:

Temporary Residence and Business Vacancy Notification

Today’s Date / Last, First, Middle / Business Name
Driver(s) License # / Residence / Business Address, City, State, Zip
Home Telephone Number / Cell Phone Number / E-Mail Address / Departure Date and Time / Return Date and Time
Will Anyone be Checking on Your Home or Business While You are Away?
Yes No If “Yes” Who? / Caretaker Telephone #
Is there anyone else who is allowed to be in your home or business while you are away? If so, give names below.
Please provide license plate numbers and Vehicle Registration information of all vehicles that will either be parked or allowed to be on your premises while away. This information will assist Law-Enforcement
License Plate
1. / Registered Owner Name / Comments or Special Instructions
License Plate
2. / Registered Owner Name / Comments or Special Instructions
License Plate
3. / Registered Owner Name / Comments or Special Instructions
License Plate
4. / Registered Owner Name / Comments or Special Instructions
License Plate
5. / Registered Owner Name / Comments or Special Instructions
License Plate
6. / Registered Owner Name / Comments or Special Instructions
Will you be leaving any security lights on while away?
YesNo If “Yes” Indicate times and locations.
Do you have an alarm system installed?
Yes No If “Yes” Do you have a Key Holder who will respond to alarm calls and be able to deactivate the alarm?
Name of Key Holder / Address, City, State, Zip of Key holder / Key holder Telephone
Alarm Company Name / Alarm Company Telephone
Additional Information