2. Roseville residents who plan to be away from their homes for an extended period of time, (one week or more) are able to register their residence with the police department, providing an emergency contact in case a crime occurs at the property while they are away. Please note, officers are not able to check on properties.
4. Homeowner
6. Address*
8. City
9. State
10. Zip
12. Cell Phone or other contact information*
14. Email address
16. Date Leaving*
18. Date Returning*
20. Emergency Contact Name and Information*
21. Vehicle in Driveway
    -- Select One --YesNo
23. If yes, plate number(s)
25. If yes, model
27. Other information
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field