Financial Institution Registration

Financial Institutions & Security Officers
This partnership addresses public safety issues which impact Federal Way's Financial Institutions.

APPLICANT INFORMATION
First Name:*

Last Name:*

Position/Title (if applicable)

Company / Organization Name:

Address:*

Address 2:

City:*

State: (ie: WA)

Zip code:*

CONTACT INFORMATION
Phone: (include area code)*

Mobile Phone: (include area code, no dashes)

Mobile Provider:

Mobile Email Address

Fax: (include area code)

E-mail:*

Password:* (website access)

ADDITIONAL COMMENTS / REFERRED BY

In an effort to improve communication and assist Law Enforcement in identifying individuals involved
in criminal activity in our city, there is the availability of a secure website where commercial
and business property owners and managers will be able to post and review information of a
confidential nature to assist Law Enforcement in identifying said individuals.

The information contained on the web site is for Law Enforcement use only. Any unauthorized release,
copying, distribution or posting for any Non-Law Enforcement Use of any of the information contained
herein will result in the termination of access to this site and may expose an individual or corporation
to legal liability.

I understand the above stated guidelines and will abide by them. I understand that information on
the website can be removed at the webmasters discretion at any time. I also understand and agree
that failure on my behalf to abide by the information above will be grounds for dismissal from further
interaction with the Website.

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Questions? email financial@safecityfw.com