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2. Program Policy
   Registration is voluntary and there is no cost associated with registration. Registering your information does not provide The Belleville Police Department with direct access to your camera. You may delete your registration at any time. An individual’s personal information will be kept confidential by the City unless subject to disclosure by court order. Your information will be accessed by Belleville Police Department personnel who are investigating a crime in the vicinity of where your camera is located. You will only be contacted by the Belleville Police Department in the future if there is a criminal incident in the vicinity of your security camera. Police personnel, if necessary, may request a copy of any video captured by your camera, which may assist in the investigation of a crime. The cost of any reproduction will be incurred by the Belleville Police Department.
4. Terms of Use
   The goal of the program is to deter crime and promote public safety by fostering collaboration between the Belleville Police Department and the community we serve. Accordingly, all registrants agree to the following terms and conditions: Any footage containing or related to criminal activity may be collected by the Belleville Police Department for use as evidence during any stage of a criminal proceeding. Under no circumstances shall registrants construe that they are acting as an agent and/or employee of the City of Belleville and/or the Belleville Police Department through the program. The Belleville Police Department will contact you directly, using the information provided on this site, to request the appropriate video surveillance footage. By submitting the information as set forth on the Private Video Surveillance Camera form, I understand and agree to the above policy and terms of use.
6. Residence or Business?*

   Please select one of the two options.

   1. Residential

   1. Business
8. Number of Cameras*
10. Address *
    Please provide full address of equipment location
12. City*
13. State*
14. Zip*
16. Primary Contact Name*
    Please enter the full name of the primary contact.
18. Primary Contact Phone Number *
    Please enter phone number with area code.
20. Primary Contact Email*
22. Additional Contact Name
    Please enter the full name of the additional contact.
24. Additional Contact Phone Number
    Please enter the phone number with area code.
26. Additional Contact Email
28. Video Storage Length
    How long is the video stored on your equipment?
30. Area of Coverage*

    1. Front yard/entry area
    2. Back yard/entry area
    3. Side yard area

    1. Alley
    2. Street
    3. Driveway, parking area

    1. Garage
    2. Storage Shed
    3. Other
32. Additional Details
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field