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Business Emergency Contact Form

  1. MPPD_Letterhead_Soens
  2. Business Information
  3. Does your business have a safe?*
  4. Does your business have an alarm system?*
  5. Is it an audible alarm?
  6. What type of alarm do you have? (Check all that apply.)
  7. Does your business have video surveillance?*
  8. Please provide a count of how many cameras are INSIDE the premises and their direction(s).

  9. Please provide a count of how many cameras are on the EXTERIOR of the premises and their direction(s).

  10. Please provide a list of contact telephone numbers for contact person(s) in the event of an alarm. List them in the order that you would like them contacted. For each person list Name/Address/Home Telephone #/Cell #/Date of Birth
  11. Contact 1 Same as Owner?*
    All information provided and statements made by me are complete, correct, and true to the best of my knowledge. (If submitting this form electronically, I understand that typing my name in the signature box replaces a hand written signature.)
  13. The information contained on this form will not be made public. It will remain on file at the Mount Pleasant Police Department.
  14. Leave This Blank:

  15. This field is not part of the form submission.