Yuba City Police Department
Serving Yuba City
since 1908
Yuba City Police Department
9-1-1 Cell Phone Registration Form
9-1-1 Cell Phone Registration Form

Date:

Name:

Cell Number:

Address:

City: Zip Code:

Gate/Door codes:

Residence is single occupant:

Residence is multi- occupant:

If Multi-Occupant please list names and phone numbers for each:

Vehicles associated with all occupants.  Please include make, model, color, and license plates of all vehicles:

Emergency contact name #1

Emergency contact phone #1

Emergency contact name #2

Emergency contact phone #2


 



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