Complete the Vacant Residence Form below which will give the Rye Police Department valuable information in the event of an emergency at your residence while you are away.

Name*

Address*

Email*

Departure Date*

Return Date*

Phone where you can be reached while away

Is residence alarmed?
YesNo

Local contact person

Local contact phone

Will anyone else have permission to be at residence?
YesNo

If so, please list names

Other Information you think we should be aware of

Quiz (to prevent spam)