City of Belleair Beach > 1TEST HOUSE CHECK REQUEST Submission Date: Owner's Name: House Address: Destination Address: Date Leaving: Date Returning: Phone: Email Address: Local Contact Phone: List names of any visitors: List any animals left in Home: Will lights be left on inside? —Please choose an option—YesNo Will lights be left on outside? —Please choose an option—YesNo Will TV or radio be left on? —Please choose an option—YesNo Is there an alarm system? —Please choose an option—YesNo Please Note: Any information given on this form is subject to the Public Records Law of Florida.