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Register a Surveillance Camera
* Required Field
CONTACT INFO
Contact Type
Residential
Business
Business Name
First Name*
Last Name*
Email*
Phone
Mobile
Fax
ADD SECONDARY CONTACT
First Name
Last Name
Email
Phone
Mobile
CONTACT ADDRESS
Street Address*
Apt # / PO Box
City*
State*
Zip Code
SURVEILLANCE SYSTEM ADDRESS
Same as Contact Address
Please enter a unique address for every location you have a surveillance system. If you have multiple cameras at one location you only need to enter the address once.
Street Address*
Apt # / PO Box
City*
State*
Zip Code
Add Another Address
*
I certify that I am the current owner of the residence/business located at at the address listed above and that I give consent for the New York State Division of Homeland Security and Emergency Services (DHSES) to register my information and closed circuit television or other surveillance system at the Registered Location in the DHSES Surveillance Access database. I further certify that I hereby give consent to DHSES to provide my contact information and Registered Location to law enforcement agencies upon written request to DHSES solely in the course of a criminal investigation and that if I wish to remove my name from the database, I must notify DHSES in writing or by completing
this form
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