Business / Residential Key Holder Information

Business / Residential Key Holder Registry

This information will be shared with the McKean County 911 center to be added to the dispatch CAD system for emergency personnel notification and response
Emergency Key Holder Information:
Business / Residence Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Owner Name
Email
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
________________________________________________________________________________ Key Holders (List in Contact Order):
Name
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Name
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Name
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Alarm Company Information:
Name
Phone Number
Format: (000) 000-0000.
Building Information:
Approx. Age of the Structure
Electrical Panel Location
Basement, garage, etc.
Natural Gas Meter Location
Outside left corner, basement, etc.
Other information:
Does Your Business Have a Knox Box:
_______________________________________________________________________________ To help us locate your address quickly, please provide names and addresses of your nearest neighbors (From your house / business looking toward the road)
Name & Address on Left
Name & Address on Right
Name & Address Across the Road
_________________________________________________________________________________ Structure Information:
Type of Structure:
Other: Explain
Number of Floors Above Ground
1,2,3.etc.
Do You Have a Reflective Address Sign:
Type of Outside Covering:
Other: Explain
Outside Color
Please list any information that would be helpful to emergency personnel
Should be Empty:

Business / Residential Key Holder Registry