Vacation Home Check

Sheriff Patch

You may electronically submit the following form as a request for the Polk County Sheriff's Office to check the perimeter of your home while you are on vacation.

If you live within the city limits of Dallas, Independence, Monmouth or Salem, please contact your respective Police Department. 

The Polk County Sheriff's Office is not obligated to inspect your home and expressly disclaims responsibility for any loss associated therewith. Courtesy Vacation House Inspections are undertaken as time and other assignments permit and at the sole discretion of the Polk County Sheriff's Office

If you prefer to print and send the form to our office you can download the pdf here.
The PDF form can be printed and mailed, faxed, or dropped off at the Sheriff's Office, 8 AM - 5 PM Monday through Friday, excluding holidays.

Owner Information
Date/Time Leaving
Time Leaving *
:
Date/Time Returning
Time Returning *
:
Requested by: