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2. Start Date *(first day the house will be unoccupied)*
   Start Date *(first day the house will be unoccupied)
3. End Date *(last day the house will be unoccupied)*
   End Date *(last day the house will be unoccupied)
5. Reason for Close Patrol Request:*
7. *See Disclaimer at the Bottom of the Form Regarding this Option

   1. Drive by Only
9. Owner
11. First Name*
12. Last Name*
14. Address*
16. *Must be a residence within the city limits of West Lake Hills
18. Driver's License/Identification Card Number:*
20. Cell Number: *
21. Cell Number #2:
23. Emergency Contact:
25. First Name:*
26. Last Name: *
28. Cell Number:*
29. Work Number:
31. Relationship: Family, Neighbor, Friend*
32. Do they have a key to the residence?*

    1. Yes
    2. No
34. Alarm:

    1. Yes

    1. No
36. Alarm: *If you select yes, please fill out the 2 fields below.
38. Alarm Company:
39. Does Emergency Contact have Alarm Code?

    1. Yes
    2. No
41. Other Contact
44. First Name
45. Last Name:
47. Cell Number:
48. Work Number:
50. Lights Left On:*

    1. None
    2. First Floor
    3. Second Floor
    4. Kitchen

    1. Back
    2. Front
    3. Living Room
    4. Bedroom
52. Will there be pets at home?

    1. Yes
    2. No
54. Pets: *If you select yes, please fill out the applicable fields below.
56. If so, how many?
58. Pet 1 - Type/Breed/Description
60. Pet 2 - Type/Breed/Description
62. Pet 3 - Type/Breed/Description
64. Pet 4 - Type/Breed/Description
66. Will there be any vehicles in the driveway?*

    1. Yes
    2. No
68. Vehicles: *If you select yes, please fill out the applicable fields below
70. Year:
71. Make:
72. Model:
74. License Plate:
75. Vehicle Color:
77. Year:
78. Make:
79. Model:
81. License Plate:
82. Vehicle Color:
84. Year:
85. Make:
86. Model:
88. License Plate:
89. Vehicle Color:
91. Other Vehicles:
93. Year:
94. Make:
95. Model:
97. Vehicle Color:
98. License Plate:
100. Year:
101. Make:
102. Model:
104. License Plate:
105. Vehicle Color:
107. People:

     1. Cleaning Company:

     1. Lawn Company:

     1. Pool Company:

     1. Other:
109. Cleaning Company:
110. Lawn Company:
111. Pool Company:
112. Other:
114. Name:
115. Name:
116. Name:
117. Name:
119. Do you have an external gate with a gate code? *

     1. Yes
     2. No
121. If so, what is the code so officers can open the gate and gain entrance to your property. If you have a second gate, please list this code as well.
123. Are there any areas of your residence exterior that may be dangerous for the officers – rotting wood on steps, decking or other areas, missing boards, steep drop offs? If so, please list them here so we can be aware of them beforehand.
125. Comments:
127. I understand that if I did not select "Drive by Only" at the top of this form, officers with the West Lake Hills Police Department may be walking around my house and checking doors and windows at any time of day between the “start” and “end” dates listed. If the officers find an unsecured door, I understand they will make entry and search the house to make sure nobody has broken in and may still be inside. I agree to call the West Lake Hills Police Department and let them know if I return prior to the “end” date listed.
129. Click Here to Agree to the Statement Above*

     1. I agree
130. Electronic Signature*
Leave This Blank:


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

     This field is not part of the form submission.

134. Submit

* indicates a required field