Dear property owner,

Please take this time to fill out the following emergency contact/alarm information data form in order for us to update our files.

By updating this information we can ensure that we are able to contact you in case of an emergency involving your family or property!

Note: Your submission will be sent securely and you will be briefly redirected to a HTTPS secured site. The IP address of your computer will be logged. Your information is sent directly to the Billerica Police Dept. If you would prefer to call the police station to pass on this information you may call (978) 671-0900 x172.

Emergency Notification Information
Proprietor:
Address:
Telephone:
Email:
Emergency Contact(s) Or Keyholder(s)
Contact One
Name:
Address:
Telephone:
Contact Two
Name:
Address:
Telephone:
Contact Three
Name:
Address:
Telephone:
*If Property Is Alarmed
Alarm Company:
Telephone:
Type of Alarm: