Business Contact Form – Hancock County, Ky 911

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HOME
CONTACT US
MEET THE STAFF
F.A.Q’s
FORMS
- Business Contact Form
MAPPING AND ADDRESSING

Business Contact Information

The information that the community’s business owners can provide will be beneficial to them as well as police, fire and emergency services. With time being a critical component throughout the 911 process, the information collected from the emergency contact will expedite a possibly time-sensitive situation.

"*" indicates required fields

Business Name*

Business Phone Number*

Address*

Physical Address Mailing Address City State ZIP Code

Website

Alarm System/Hazards

Does the business have an alarm system?*

Yes

No

Monitored or Stand Alone System*

Stand Alone

Monitored by Alarm Company

Alarm Company Name*

Alarm Company Phone Number*

Alarm Systems Type*

Fire

Burgular

Fire Supression System*

Yes

No

Fire Supression Type*

Sprinklered

Other (Halon etc.)

Hazardous Materials On Property?*

Yes

No

Please List Hazardous Materials*

Contact Information

Main Contact Name*

Main Contact Home Phone Number*

Main Contact Cell Phone Number*

Second Contact Name

Second Contact Home Phone Number

Second Contact Cell Phone Number

Third Contact Name

Third Contact Home Phone Number

Third Contact Cell Phone Number

Contact Email

Additional Information

Please list anything else about the premise that may be benefical to emergency services, responding to your business.

File

Drop files here or

Max. file size: 2 MB.

Please upload any diagrams or pertinent files about your business you would like to include. Example: Floor Plans, Fire Loops, MSDS, etc.

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