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2. Our Need for Business Information
   There are many times that we struggle to find an owner or manager of a business after he or she becomes the victim of a crime. Occasionally our officers observe or find suspicious activity around local businesses, but they do not have a contact with the business to call and ask questions about the activity. Below are some personal questions about your business. All of this information will be kept confidential. Please complete this form with your most current information and fill in the details you feel we should know. Any information such as leaving the register open, leaving lights on, etc. is important information to our officers. You only need to answer the questions you are comfortable with the Bridgeport Police Department knowing.
   
   In addition to the form listed below, the Bridgeport Police Department currently uses Blackboard Connect to notify the community with trusted neighborhood level public safety and community information.
4. Owner / Manager Information
6. Date Submitted
8. Business Name
10. Business Address
    Including City, State, Zip
12. Business Phone 1
13. Business Phone 2
15. Owner Name
17. Owner Address
    Including City, State, Zip
19. Home Phone
20. Cell Phone
22. Manager Name
24. Manager Address
    Including City, State, Zip
26. Home Phone
27. Cell Phone
29. Assistant Manager Name
31. Assistant Manager Address
    Including City, State, Zip
33. Home Phone
34. Cell Phone
36. Emergency Contacts
    Someone with a key in case of burglary, theft, vandalism, etc.
38. Name
40. Address
    Including City, State, Zip
42. Home Phone
43. Cell Phone
45. Name
47. Address
    Including City, State, Zip
49. Home Phone
50. Cell Phone
52. Business Information
54. Type of Business
56. Do you have an alarm?

    1. Yes
    2. No
57. If so, with what company?
58. Alarm Company Phone Number
60. Is the alarm silent or audible?

    1. Silent
    2. Audible
61. Which of the following do you have alarm sensors on?

    1. Doors
    2. Windows
    3. Roof
63. Do you have any hazardous or flammable materials inside the business? If yes, please list.
65. What are your normal business hours?
67. Please list any additional information you feel the Bridgeport Police Department should know.
69. Thank you for partnering with the Bridgeport Police Department to help fight crime!
Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field