Katy Police Department

5456 Franz Rd.

Katy, TX 77493

Tel. 281-391-4848     Fax. 281-391-4873

 

~ Resident/Business Security Check Request ~

CITY OF KATY RESIDENTS/BUSINESSES ONLY

 

PLEASE WRITE OR PRINT CLEARLY AND CHECK YOUR INFORMATION CAREFULLY

 

Address: ____________________________ Name: ____________________________________

 

Request Made By: __________________________________ Phone: ______________________

 

Reason for Extra Patrol: ____ Premise will be vacant                 Other: _________________________

                                                                                                                                    i.e. Medical, Vandalism etc

 

Type of Premise:    Business  ___      Residence  ___             Other: ___________________________

 

Protected by Alarm System?   Yes ___  No ___

If Yes Comp. Name ______________________________ / Comp. Phone No: _________________

 

Lights on?   Yes ___ No ___        Constant? Yes ___ No ___           Automatic? Yes ___ No ___

 

Keys left with anyone?   Yes ___ No ___

 

If yes, Name:___________________ Address:_______________________ Phone:____________

 

Vehicles on premises? __________________ Description: _______________________________

 

Other persons that will have access to premises (Relatives, Workers, Neighbors, Employee)

 

 

 

 

C/O Name: _____________________ Address: _______________________ Ph: ______________

 

I request that a security check be made of my premises from ___________ to______________

and will notify you upon my return.                                                      MM/DD/YY                           MM/DD/YY

 

REQUEST EXPIRES IN 90 DAYS UNLESS THE POLICE DEPARTMENT IS  CONTACTED!

 

 

Signed: ____________________________________ Date of Request: ______________________

 

PLEASE … CONTACT KATY POLICE DEPARTMENT UPON YOUR RETURN!