Camera Registry Form (SCRAM)

2. Location Information

4. Is your camera at a business or residence? *
   -- Select One --BusinessResidence

5. Business Owner Name/Residence Owner Name*

7. Street Address*

   Location of the camera(s)

8. City*
   -- Select One --Lansing

9. State*
   -- Select One --Michigan

11. Contact Information

13. Name*

    Who to contact if police need to view your camera footage

14. Primary Contact Phone*

    Phone number for police to contact to view your camera footage

15. Secondary Phone*

16. Email Address

18. Camera Information

20. How many functioning cameras do you have?*
    -- Select One --1 camera2 - 4 cameras5 or more cameras

21. How long is your video footage stored?*
    -- Select One --Less than 1 week1 - 2 weeks2 - 4 weeksMore than 1 month

22. How can we retrieve your footage?*

    1. USB (thumb drive)
    2. CD / DVD
    3. Wireless or Cloud (download/email)

24. When is your camera system active?*
    -- Select One --Motion activatedDaylight onlyDarkness only24/7 (always recording)

25. What does your camera(s) capture?*

    1. Front of residence/business
    2. Rear of residence/business
    3. Side of residence/business
    4. Street
    5. Driveway
    6. Other

    Select all that apply

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field