Le Roy Police Department

Dear Business Owner/Operator,

The LeRoy Police Department is requesting your assistance in updating call card information for your business in LeRoy.
These call cards are used in the event of an after hours emergency or unusual occurrence at your business. If you have
multiple locations with the same responder information, please send written notice when returning this letter. The
information you return will only be used for Law Enforcement and Fire Department purposes. Please notify the LeRoy
Police Department in writing in the event that any of the given information changes.

Business Name: ___________________________________________
Business Address:__________________________________________
Business Telephone: _________________________________

Hours of Business: _________________________________________

Keyholder #1: (Name) _____________________________________
(Telephone Numbers) _____________________________________

Keyholder #2: (Name) _____________________________________
(Telephone Numbers) _____________________________________

Keyholder #3: (Name) _____________________________________
(Telephone Numbers) _____________________________________

Is your Business alarmed ? Y N Alarm Company ________________
Alarm Company Telephone _____________

I would like the LeRoy Police Department to conduct random, after hours security checks of my business during routine patrols, whenever possible, and to contact a key holder in the event the business if found un-secure or an emergency situation is discovered.

Y N Comments: ___________________________________

Please describe any after hours activity that may occur at your place of business: _______________________________________________________________

Please list people and vehicles that may be at your place of business after hours:

Person Providing Information/Capacity:

Date of Information:

Please return this completed form to the LeRoy Police Department, 111 E Center St., LeRoy, IL 61752, care of Officer Mike Bennett.

You may reach the LeRoy Police Department at the following numbers:

911 (Emergency Dispatch)
(866)-888-5030 (Toll Free METCOM Dispatch)