The Georgetown Police Department needs an updated contact list from your business.
Please fill out the form below. Please enter one name and phone number per line.
Either mail or drop off this form to:
Georgetown Police Department
Sgt. Kevin DeFeo
47 Central St
Georgetown, MA 01833
Date: _____/______/______
Is this form being completed for a business or residence? _________________________
Name of business: ______________________________________________________
Business/Residence address:______________________________________________
Main business telephone number: __________________________________________
Primary contact's name: __________________________________________________
Primary contact's phone number: (______)____________________________________
Secondary contact's name: ________________________________________________
Secondary contact's phonenumber: (______)__________________________________
Third contact's name: ____________________________________________________
Third contact's phone number (______)______________________________________
Do you have an private alarm system? yes / no
If yes what alarm company provides service:___________________________________
Alarm company phone number:_____________________________________________
Additional Comments ____________________________________________________
_____________________________________________________________________
______________________________________________________________________
Please complete as many sections as possible.
All information submitted will be treated as confidential.
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