NEW DURHAM POLICE DEPARTMENT
Street Address:____________________________________________
Mailing Address (if different) __________________________________
Please list all people living in the residence
Last Name |
First Name |
Age |
DOB |
Tel # |
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Do you own any dogs? ____ Have they been licensed? ____ Vaccinated?__
Is your home alarmed? _____
Who is your Alarm Company?______________
If your home is alarmed, please list two (2) keyholders to call in case your
alarm is activated. 1._________________________Phone#________
2._________________________Phone#________
Is there anything we should know about your home or family that would assist us in case of an emergency? (i.e. handicapped person, home business with flammable chemicals, guard dogs etc.)
Thank you in advance for you cooperation. This information will be kept confidential.
Shawn C. Bernier
Chief of Police
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