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Security Camera Registry

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Please complete the form below if you would like to be part of this program:

1. Is your camera at a residence or a business?
 Residence Business

2. Owner/Business Name

3. Address where cameras are located:
Street Address: Apt/Suite#:

City: Postal Code:

4. Contact Information
Main Phone #:

Cell Phone #:

Email:

5. How long will your surveillance system store a recording?
 Less than 1 week 1 to 2 weeks 2 to 4 weeks Up to 60 days Up to 90 days Up to 6 months Up to 1 year More than 1 year

6. How may we obtain a copy of video if needed? (check all that apply)

 USB (thumb drive etc.) CD/DVD Wireless/Cloud<\p>

7. How many outdoor cameras are at this address?

 1 to 5 6 to 10 10 or more

8. Is audio recorded?

 Yes No

9. When is the camera active?

10. Where do your cameras face? (check all that apply)

 Front Side Rear Street/Vehicles

11. If this is a business, please provide emergency/afterhours contact information

Name: After Hours Phone Number: