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Image of Atlantis

Dark House Request Form

Please provide the following information:
Name:
required
Email:
required
Address of your house:
 
Home Phone:
 
Cell Phone:
 
Home away from Home #:
 
Pager or Other Phone:
 
Please list people who will have a key and/or alarm codes that we can contact in your absence. Be sure to include Name, Home Phone and Cell Phone numbers.
Vehicles: Please list any vehicles or golf carts that will be left behind in carports or driveways. Be sure to include Make, Model, Color and Tag Number and State.
Important Facts about the home:
For example: people checking the home or repair person(s) that will be at the home. Please also list any special items such as grills, furniture, lights on timers or any thing you feel we should know that will help us to make your home safer while you’re away.
Dates that you will be leaving and returning. Please call us when you return so we can remove you from our list.


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City of Atlantis 260 Orange Tree Drive, Atlantis, FL 33462 PH: (561) 965-1744        Website Disclaimer   Privacy Statement