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2. “Eyes on the Block” Community Safety Ring Doorbell Camera Program

   Eyes on the Block is a voluntary community safety camera pilot launched by the City of Jackson. To apply for the program, you must fill out the following information. For questions about the program, contact eyesontheblock@cityofjackson.org. 

6. Residential Information
8. Registrant First Name*
9. Registrant Last Name*
11. Phone Number*
13. Property Owner(s) name if you are renting:
15. Address with Camera*
17. City
18. State
19. Zip
21. Email*
25. Business Information
27. Emergency Contact Information
    List in order of contact preference
29. Business Name:
30. Business Phone
32. Business Address
34. Business State
35. Business Zip
36. Business Email
40. Data & Privacy Affirmation

    The city, tenant, and property owner acknowledge that access to footage by law enforcement is subject to the tenant's voluntary consent or a valid warrant/court order. The Jackson Police Department (JPD) will not independently monitor, nor have access to, any installed cameras.  Any video footage shared with JPD is strictly voluntary.   Any video footage provided will not be stored individually on any mobile devices, thumb drives, or emails, and will be cloud-based with limited access strictly for law enforcement purposes.

42. Name of Individual Completing Form*
43. Date*
    Date
45. E-signature Consent Disclaimer

    By clicking the “Submit” button, you are signing this form electronically and agreeing that your electronic signature is the legal equivalent of your manual signature.

Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field