Vacation Notification Form

If you are going to be away from home for any extended period of time and would like to notify Montgomery Twp. Police as to whom we may contact in the event of an emergency, please fill out our form in one of two ways:

Fill out the Vacation Notification Form PDF and mail to Montgomery Twp. Police Dept., Attn: Laura Pavan, 100 Community Drive, Skillman, NJ 08558, or
Submit this form directly and securely below.

General Information

First Name

Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Cell Phone

Other Phone

Departure Date

Return Date

In the case of an emergency, do you wish to be notified?

Yes

Your Location

Emergency Contact

First

Last

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Cell Phone

Other Phone

Vehicles Left in Driveway

Vehicle #1

Make/Model

Color

License Plate

Vehicle #2

Make/Model

Color

License Plate

Vehicle #3

Make/Model

Color

License Plate

Keyholder Information

Contact Name

Phone

Additional Helpful Information

Certification

By emailing this form, I hereby authorize the action requested and/or police use of the information supplied. I certify that the above information is true and correct. I am aware that by submitting this form, my internet IP address will be made know to the Montgomery Twp. Police Dept. and can be traced if false information is provided. Please sign below to acknowledge agreement:

Print Name

Today's Date

Vacation Notification Form

General Information

Emergency Contact

Vehicles Left in Driveway

Keyholder Information

Certification

Community Center

Main Offices

Police