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2. 
4. Request for Residence Check
   Please fill out this form at least 48 hours before your departure date.
6. Note:
   Residence checks are intended for person(s) who must leave their residence for event such as vacations, business trips and similar events for a time span of one to thirty days. Persons who will be gone in excess of thirty days should consider consulting a property management company for assistance. Requests for residence checks greater than thirty days will not be accepted. Multiple residence checks for the same property that run consecutive and exceed thirty days will not be accepted. If your departure or return dates change at any time or you return home early, please contact the Hoke County Sheriff’s Office and notify the Patrol Commander or On Duty Patrol Supervisor at 910-875-5111.
8. Resident's First Name*
9. Resident's Middle Name
10. Resident's Last Name*
12. Home Phone Number*
13. Cell Phone Number
15. Address*
17. City*
18. State*
19. Zip*
21. Directions to Residence
22. Date of Departure
    Date of Departure

    Date of Departure
23. Date of Return
    Date of Return

    Date of Return
24. Lights

    1. Inside House
    2. Outside House
    3. Automatic
26. Vehicles Left at Residence
    Please list each vehicle that will be left at the residence.
28. Vehicle 1
30. Make of Vehicle
31. Color of Vehicle
32. Tag Number
34. Vehicle 2
36. Make of Vehicle
37. Color of Vehicle
38. Tag Number
40. Vehicle 3
42. Make of Vehicle
43. Color of Vehicle
44. Tag Number
46. Other Vehicles on Premises
    List the make, color and tag number for all other vehicles that will be on the property while you are away.
48. Other Vehicles
50. Other Persons Having Access to Property
    Please list the name, address and telephone number of each individual that will have access to the property while you are away.
52. First Name
53. Last Name
55. Address (House Number and Street Name)
56. Phone Number
58. City
59. State
60. Zip
62. First Name
63. Last Name
65. Address (House Number and Street Name)
66. Phone Number
68. City
69. State
70. Zip
74. Other Persons with Access to Property
    List all other persons not already listed, who have access to the property while you are away. Include name, address and telephone number.
75. In Case of Emergency May We Call You Collect?*

    1. Yes
    2. No
77. VERIFICATION
    I verify that my typed name below constitutes my true and legal signature and I give consent for the Hoke County Sheriff's Office to take any and all means at their disposal to ensure the protection of my residence. I understand that it is important, if I have a change in my departure or return schedule that I contact the Hoke County Sheriff's Office immediately at 910-875-5111. I realize that my failure to cancel this request, should I return early, may result in my being mistaken as an intruder.
79. Signature*
    Typing your name here constitutes your legal signature and agreement to the terms contained within this form.
Leave This Blank:


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

    This field is not part of the form submission.

82. Submit Submit and Print

* indicates a required field