Contact Leesburg Police

Business Emergency Contact Form

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All commercial businesses must provide contact information in case of an after hours emergency at your business location.

Please correct the fields below:

Business Information

Business Name
Business Phone Number

Business Address

Street Address
Apt, suite, etc (Optional)
City
State
Zip Code

Primary Contact or Keyholder

First Name
Last Name
Job Position
Primary Number
Secondary Number

Secondary Contact or Keyholder

First Name
Last Name
Job Position
Primary Number
Secondary Number

Third Contact or Keyholder

First Name
Last Name
Job Position
Primary Number
Secondary Number
  1. To receive a copy of your submission, please fill out your email address below and submit.

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