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2. 
4. Please answer the following questions to register your surveillance cameras with the Randolph County Sheriff’s Office.
6. Is your camera at a residence or a business?

   1. Residence
   2. Business
8. If a business, name of business:
10. Name of Owner
12. First Name
13. Last Name
15. Driver's License number including state.
17. Address
19. City
20. State
21. Zip Code
23. E-mail
24. Phone number:
26. What brand is your system?
28. How many outdoor cameras are at this address?
30. Where do your cameras face?
32. How long will your system store a recording?

    1. Less than 1 week
    2. 1 to 2 weeks
    3. 2 to 4 weeks
    4. Up to 60 days
    5. Up to 90 days
    6. Up to 6 months
    7. Up to 1 year
    8. More than 1 year
34. How may we obtain a copy of video if needed?

    1. USB (thumb drive, etc.)
    2. CD/DVD
    3. Wireless/Cloud
    4. Email
36. Is audio recorded?

    1. Yes
    2. No
38. When is the camera active?

    1. Motion
    2. Daylight only
    3. Darkness only
    4. 24/7
40. Is your system monitored by a company?

    1. Yes
    2. No
42. If yes, name of the company:
44. If this is a business, please provide emergency/after-hours contact information:
46. Name
47. Email Address
49. Phone Number
51. Once you submit your application, you will receive a copy of your submission via email. Thank you!
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field