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2. Privacy Notice
   PLEASE NOTE: ANOKA COUNTY TAKES YOUR PRIVACY VERY SERIOUSLY. WE WILL TAKE EVERY AVAILABLE PRECAUTION TO MAINTAIN THE SECURITY AND INTEGRITY OF YOUR PRIVATE INFORMATION. PRECAUTIONS HAVE BEEN TAKEN TO MAKE ANOKA COUNTY’S WEBSITE AND E-MAIL SECURE, BUT ABSOLUTE SECURITY IS NOT GUARANTEED. IF YOU CHOOSE TO SUBMIT YOUR INFORMATION ELECTRONICALLY, YOU ASSUME ANY RISKS ASSOCIATED THEREWITH.
4. Date Start*
   Date Start
   This is the first day you want to have a vacation check.
5. Date End*
   Date End
   This is the last day you want to have a vacation check.
7. Homeowner's Name*
   Who owns the home that will be checked?
8. Homeowner's Email*
   Occasionally we need to confirm the information on checks. Your email will only be used for this purpose.
10. Address*
    What is the complete street address of the home?
12. City*
    -- Select One --AndoverColumbusEast BethelHam LakeLinwoodNowthenOak Grove

    The Anoka County Sheriff's Office can provide Vacation Checks only in the cities listed here where the Office provides patrol services. If you do not live in one of these cities, you cannot request a Vacation Check from the Sheriff's Office. Contact your local police department.
14. Cell phone*

    Will you have a cell phone with you?

    1. Yes
    2. No
15. Cell Phone Number
17. Cars*

    Will there be any cars in the driveway?

    1. Yes
    2. No
18. Makes and Models
    What are the makes and models?
20. Other Persons Checking

    Is there anyone checking on your home or who has a key?

    1. Yes
    2. No
21. Identify Them
    Who is checking? What is their cell phone number? What kind of car do they drive?
23. Anyone Else?*

    Does anyone have permission to be at the home?

    1. Yes
    2. No
24. Who are they?
    Identify the persons with permission to be at your home.
26. Lights on Timers?*

    1. Yes
    2. No

    Are there lights on timers inside the home?
28. Additional Information
    Is there any additional information you would like to include?
Leave This Blank:


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

    This field is not part of the form submission.

32. Submit

* indicates a required field