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Oak Park Department of Public Safety Vacation Check
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W10=
*
First name
*
Last name
*
Phone
*
Address
*
Departure date
*
Return date
*
Email
*
Deliveries stopped?
Yes
No
*
Will mail and newspapers be picked up?
Yes
No
*
Are lights on a timer?
Yes
No
*
Will there be vehicles in driveway?
Yes
No
Vehicle 1 year
Vehicle 1 make
Vehicle 1 model
Vehicle 1 color
Vehicle 1 license plate number
Vehicle 2 year
Vehicle 2 make
Vehicle 2 model
Vehicle 2 color
Vehicle 2 license plate number
*
Emergency contact #1 name
*
Emergency contact #1 address
*
Emergency contact #1 phone
Emergency contact #2 name
Emergency contact #2 address
Emergency contact #2 phone
*
Today's date
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