2. 
4. Complete form to voluntarily register camera information.
6. *This one-time registration applies to Southaven City limits only and registration does not give Southaven Police Department access to any of your hardware - it is location of the devices ONLY
8. Business Name
10. Primary Contact Name*
12. Address*
14. Neighborhood Name
16. 24-hour contact number*
18. Email address
20. EQUIPMENT TYPE*

    1. Doorbell Camera
    2. CCTV System
    3. Both
22. RECORDING PERIOD

    1. Only when motion is detected
    2. Only during business hours
    3. 24 hour recording
24. ESTIMATED RETENTION PERIOD:
    (how long before the video is overwritten?)
26. CAMERA COVERAGE:
    (What areas of the property do the cameras cover?)

    1. Front Yard
    2. Front Entry
    3. Back Yard
    4. Side Yard
    5. Parking Lot
    6. Street
    7. Cash Registers (Business)
    8. Interior (Business)
28. By checking this box, you agree to provide the location of your cameras to the Southaven Police Department and understand you may be contacted in the future by the Southaven Police Department.*

    1. I agree
Leave This Blank:


30. Submit

* indicates a required field