Sussex Fire Department N63W24335 Main Street Sussex, WI 53089 Tel: 262-246-5197 www.villagesussex.org

Occupancy Contact Update Form

Village of Sussex Fire Department

In order to better assist your company in the event that you have a fire or other emergency situation at this location, we ask that you fill out the following information. You can fax or e-mail this form back to the Sussex Fire Dept.

Company Name

Company Numbers

Phone Number (required)

Fax number

Hours of Operation

Knox Box

Yes

No

Knox Box Location

Electronic copy of building & evacuation plan

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Additional Information

Emergency Contact 1:

Position

Key Holder

Yes

No

Phone number

Afterhours Phone number *

Cell Number *

Email

Emergency Contact 2:

Position

Key Holder

Yes

No

Phone number

Afterhours Phone number

Cell Number

Email

Emergency Contact 3:

Position

Key Holder

Yes

No

Phone number

Afterhours Phone number

Cell Number

Email