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IF YOU ARE LOOKING FOR RESOURCES/HELP WITH OPIOID ADDICTION, PLEASE CALL WORTH COUNTY PUBLIC HEALTH 641-324-1741.

Security Check Form

Request a security check of your property.

Security Check Form

Destination Address
City
State
Zip Code

Reason for Farm Check
Contact Phone

Full Name
911 Address
City
State
Zip Code

Contact Phone

Date Leaving
Date Returning

Name of Key Holder
Key Holder's Phone Number

Is There an Alarm?
If Yes, What Type and Where?
Name of Alarm Company
Contact Phone

Name of Person Checking/Watching Residence
Contact Phone

Are All Buildings Locked?
If Only Some of the Buildings are Locked, Which Ones Are They?
Will There Be Any Lights On?
If Lights Are On, Where?
Is Anyone Else Allowed on the Property?
If Yes, Who?
Who is your Gas and Electric Provider?
Any Other Special Information?

Sheriff

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