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(S4) Radio Request Form

  1. Campbell County Public Safety Document Header
  2. Radio Request Form
  3. Reason for Request

    Insurance Form must be completed for Stolen/Damaged radios; damaged/destroyed radios must be returned.

  4. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 

    • 1) your submission will not be signed in the sense of a traditional paper document, 
    • 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 
    • 3) you may still be required to provide a traditional signature at a later date.
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  6. This field is not part of the form submission.