VILLAGE OF MILLERSBURG

6 North Washington Street Millersburg, Ohio 44654
 FAX (330) 674-9044
 www.millersburgohio.com

 

 
Jeff Huebner, Mayor

Kevin Brooks, Village Administrator 
Karen Shaffer, CMC, Village Clerk-Treasurer, Tax Administrator
S. Thomas Vaughn, Police Chief 
Nate Troyer, Zoning Inspector

 Village Offices   (330) 674-1886
Income Tax   (330) 674-6891
Police Department   (330) 674-5931
"
 
Vacation House Check
Name 
Address
Date Leaving Date Returning 
Destination
Emergency Contacts
Name      Phone 
Address   Keys 
Yes  No
Name      Phone 
Address  Keys 
Yes  No
Additional Information
Light on 
Yes  No
 Timer on 
Yes  No
 If yes, time frame 
Where 
Anyone checking house  
Yes  No
         		 Name 
Vehicle in driveway 
Yes  No
 Vehicle in Garage 
Yes  No
Description of vehicle(s)