The City of Burlington Police Department is creating a database of businesses and residences within the City of Burlington who may have video surveillance capabilities that could be utilized if needed for investigative purposes. We are asking for your partnership in helping us build this database by answering a few questions below. Our goal is to create a database that we can quickly reference to help obtain critical information and evidence for investigations and emergency situations.

Thanks for your assistance and partnership in creating an even safer Burlington.

Today's Date*

First Name*

Last Name*

Address*

Email Address

Phone Number

Business Name

Point of contact to Retrieve Footage

Please complete if different from above.

Name

Email/Phone

Surveillance Options

Camera View Locations

Interior Exterior Doorbell Front Yard

Side Yard Back Yard Roadway

Please select all that apply

Audio Capability

Yes

No

How long is footage saved?