Now you can leave town with greater peace of mind.

Alert the Madison Police Department of your departure and return plans to help us monitor your property while you are away. Please complete this short form to provide us with the information we need to be alert to unlawful activity on your property in your absence.

Contact Information

Name or Name of Business:*

Email Address:

Property Address:*

City, State, Zip:

Phone Number:*

or:

Destination Information

City and State:

Date Leaving:*

Date Returning:*

Emergency Contact Information

Name:*

Address:

Phone Number:*

or:

Does Emergency
Contact Have Key?

Yes

No

Safety Information

1) Who has authority to be in the house/business?

2) Was newspaper delivery suspended?

Yes

No

3) Will your mail be picked up? If yes, by whom?

4) Do you have a security alarm?*

Yes

No

Alarm Company - Name & Contact Number:

5) Are you leaving any lights on?*

Yes

No

Light Location or Time Frame:

6) Any Vehicles in Driveway?*

Yes

No

Vehicle Descriptions:

Miscellaneous Information

The City of Madison is pleased to offer this service as a convenience and benefit to its citizens. Please be advised that while the Madison Police Department strives to provide enhanced security through this information in the form of drive-by patrols and greater awareness, we cannot guarantee crime or theft prevention. The frequency and level of monitoring is subject to the operations and resources of the department during that period of time.