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House Check Program
The Casselberry Police Department provides a service to the community by checking on homes of residents who are away due to scheduled vacations or unexpected travel. The program is provided as a service to those who will be gone up to 90 days, is free and only requires the resident complete the below House Check form.
The program is provided free of charge and is limited to 90 days of service. Please note that scheduled house checks will include periodic checks of the residence. The frequency will be determined by the activity in the area and the workload of the officer assigned to the area.
Please notify Casselberry Police Department Communications at 407-262-7606 if you return BEFORE the date listed on your request and cancel the service.
Be advised this service provides no guarantee of loss or damage to your property. The Casselberry Police Department shall not be held responsible or liable for any damages or loss which occur during absence. By submitting this request and signing the form, you are waiving all liability, rights, claims and causes of action against the City of Casselberry, the Casselberry Police Department and its employees and representatives.
THE FORM MUST BE SIGNED OR THE SERVICE WILL NOT BE PROVIDED
Submit
Please complete the form below and submit the request online. Alternatively, the below form can be printed, SIGNED, and brought or mailed to the Casselberry Police Department located at 4195 South U.S. Highway 17/92, Casselberry, Florida 32707. If submitted by postal mail, please write "Attention: House Check" at the bottom of the envelope.
Departure Date*
Departure Date
Return Date*
Return Date
Note
If return date is not known, indicate an approximate date and ensure you contact Communications at (407) 262-7606 to cancel this service upon return.
Name of Resident*
Location Address*
City*
State*
Zip*
Cellular Phone Number
Please provide at least one phone number
Additional Phone Number
Please provide at least one phone number
Travel Destination
Local Emergency Contact
Name
Name of local emergency contact
Phone Number
Phone number(s) of local emergency contact
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Security Information

Other Information

Other Information
Will any vehicles be left at the house?*
1. Yes
1. No
If yes, please list the make, model, color, and tag number of the vehicles
Will anyone be working at or be allowed in the house while the homeowner is gone?*
1. Yes
1. No
If yes, please enter the name of those permitted
Additional Information
Please use this area for additional information you wish to provide.
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Signature

Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Electronic Signature*
1. I agree
Signature of Homeowner*
Date*
Date
If submitted by postal mail, hand sign the form here

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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House Check Program

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