Home Safety Improvement Program Request Form
Use this form to participate in the Home Safety Improvement Program. For more information, please see: http://bit.ly/OCIAuditInfo

Also be sure to download and print the following Forms

Audit Form (the form the Officer fills out): http://bit.ly/OCIAuditForm
Safety Improvement Cost Sheet (the form you fill out to get your money): http://bit.ly/OCIAuditCostSheet

After submitting this form, you will be contacted by OCI to confirm receipt of your request.

First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Additional Phone Number
Your answer
Home Address (where the safety audit will happen) *
Your answer
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