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2. Notice
   This request is only for businesses (not residences) affected by closure due to COVID-19.
   
   This request will only be good for 30 days from date of submittal.
   
   This request is for Business that are located in the unincorporated areas of Merced County and not in the incorporated cities of Merced, Atwater, Livingston, Gustine, Los Banos and Dos Palos.
6. Is your business located in the unincorporated areas of Merced County?*

   1. Yes
   2. No
8. Name of Business*
10. Where is the business located?*
12. Has your business been closed due to COVID-19?*

    1. Yes
    2. No
14. Is there an alarm on this business?*

    1. Yes
    2. No
15. Are there cameras on this business?*

    1. Yes
    2. No
17. Are there any hazardous materials a responding Sheriff's Deputy would need to know about?*

    1. Yes
    2. No
18. Please explain:*
20. Are there any dogs left on-site?

    1. Yes
    2. No
22. Available Responder's Name*
23. Available Responder's Phone Number*
27. Requester's First Name*
28. Requester's Last Name*
29. Association to the Business*
31. Requester's Phone Number*
33. Requester's Email Address*
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field