Fields marked with a * are required

I understand that the Pasco Sheriff’s Office accepts no responsibility for the security of my residence and the loss or damage to my property. I further understand that the duty of the Pasco Sheriff’s Office in the event of a problem at my residence shall be to attempt contact with the person(s) listed above at the telephone numbers provided. I authorize the Pasco Sheriff’s Office to allow the caretaker listed above full access to my residence. I understand that this request will automatically expire after thirty (30) days.