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Residential Emergency Contact Form

  1. Residence Information

  2. Does your home have a safe?*

  3. Does your home contain any firearms ( operable or otherwise )? *

  4. Does your home contain any pets?*

  5. Does your home have an alarm system?*

  6. Is it audible?

  7. Does your home have video surveillance (interior or exterior)?*

  8. Emergency Contacts

    Please provide a list of contact telephone numbers for contact person(s) in the event of an emergency or alarm. List them in the order that you would like them contacted.

  9. Alarm Information

  10. Type of Alarm

    Check all that apply

  11. Applicant acknowledges there is an Ordinance in Franklin Borough concerning registration requirements, false alarms, and penalties (Municipal Code; Chapter 77 - "Alarms").

  12. Leave This Blank:

  13. This field is not part of the form submission.