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2. Please make sure that the location you are trying to register is located within the city boundaries. Go to the Street Listings page of the Public Works Department and check to make sure your street name and street numbers are listed.

   
   

   This form should be updated annually or when a change occurs.

4. Street Number*
5. Street Name*
   The address in Annapolis that you are providing night reference or alarm information for.
6. Suite Number
   If applicable
8. Zip Code*
9. Phone Number to Home or Business*
11. Type of Property*
    -- Select One --ResidentialBusinessGovernmentalNon-Profit / ChurchPublic SchoolPrivate SchoolOther
13. Business Name
    If applicable
14. Trade Name
    If different from business name
16. Mailing Address
    If different from the address above. Please include street number, street name, suite number, city, state, and zip code.
18. Your Name*
    Name of person completing form
20. Alternate Phone Number
    You can submit more than one phone number; e.g. your work phone number, cell phone number, etc.
21. Email
    You can submit more than one email address.
25. Emergency Contact 1
27. Name*
28. Phone*
30. Emergency Contact 2
32. Name
33. Phone
37. Special Conditions
    List hazardous conditions / materials, guard dogs, security personnel, weapons, directions to alarm site, etc.
41. Registration Type*
    -- Select One --New RegistrationInformation Update
45. Do you have security cameras at this location? *

    1. Yes
    2. No

    Cameras can be inside or outside the building.
47. Camera Information
    If you have cameras, please include the following information about them: camera locations, type, brand, age, operating system, and retention period for the recordings.
48. Alarm Type

    Check all that apply.

    1. Burglar
    2. Panic
    3. Medical
    4. Robbery / Hold up
    5. Fire
50. Type of Alarm User
    -- Select One --ResidentialBusinessGovernmentalNon-Profit / ChurchPublic SchoolPrivate SchoolOther
51. Alarm User Name
    For residents: enter the name of the person the alarm is registered with.
    For businesses: the name of the owner or lessee of the alarm system.
53. Name of Alarm Company
54. Phone of the Alarm Company
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit

* indicates a required field