Please fill in the House Check Form below requesting that Selective Enforcement (house check) be made periodically on my residence. All fields with an asterick* must be filled in.
I hereby certify that I am the owner and/or authorized representative of the property listed hereon, and request that Selective Enforcement (house check) be made periodically at this location for the time period indicated above. During my absence, I hereby invite and authorize any member of the Winter Springs Police Department to enter my premise for the purpose of conducting security inspections to insure the timely protection of my residence and property, and to effect the arrest of any unauthorized person(s) thereon in connection with the protection requested. In this connection, I hereby agree to sign and file any required affidavits and/or complaints with the Police Department and/or State Attorney's Office to effect the prosecution of any malefactors.
I understand this authorization becomes effective upon the date of my departure, and will automatically cancel on the listed return date unless I call to extend the time period. I also understand that I will need the correct PIN provided on this form when I call.
City of Winter Springs Police Department 407-327-1000
300 North Moss Road, Winter Springs, FL 32708