Emergency Contact Registration

The New Berlin Municipal Authority (NBMA) is changing their emergency response company. If you haven’t already done so, please provide them with the most up to date information via the form below.

Please DO NOT send the form to the New Berlin Borough Office. You may send it to the NBMA via email at nbmunauth@dejazzd.com or by one of the other methods listed on the form.

**Note to mobile device users** If you are experiencing difficulties using the fillable form, a free app called “Adobe Fill & Sign DC” is available for both iPhone and android users. If you have this app, you can complete a fillable form on your mobile device.