Leland Police Department

"While You Are Away"

"While You Are Away" is a housing check provided to residents while they are on vacation.

Use the form below to send us a e-mail

Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
Date/Time of Departure:
Date/Time of Return:
Will a vehicle be left at the residence? Yes No
License & Description:
Will the lights be turned on? Yes No
If Yes, Which Rooms?
In case of emergency, Please Contact:

Primary Contact Name:
Primary Contact Address:
Primary City:
Primary State:
Primary Zip Code:
Primary Contact Phone:
Secondary Contact Name:
Secondary Contact Address:

Secondary City:
Secondary State:
Secondary Zip Code:
Secondary Contact Phone:
Additional Information: