Alarm registration certificate



Download 10.37 Kb.
Date conversion29.04.2016
Size10.37 Kb.
CITY OF BUNKER HILL VILLAGE

ALARM REGISTRATION CERTIFICATE

PLEASE ISSUE A SEPARATE CHECK IN THE AMOUNT OF $10.00 FOR THE ALARM RENEWAL. IF REGISTERING AFTER DECEMBER 31, THE AMOUNT IS $20.00

Date 12/20/07 Burglar Alarm  Fire Alarm  Both 
Last Name       First Name      
Home Address       Home #      
Business Address       Business #      
Cellular #       Other #      
Name & Address of OWNER if different from above:      
Address:      Phone #      
List two people who are to be notified, in your absence, in the event of an activated alarm. These contact persons should respond to alarm site within one (1) hour and grant access to location. If necessary they should be able to deactivate alarm.
1. Name       Phone #      
Cellular #       Other #      
2. Name       Phone #      
Cellular #       Other #      
Name & address of person/business entity providing burglar/fire alarm protection service:
      Phone #      

Name & address of person/business entity providing repairs to alarm system as needed:


      Phone #      
Other Occupants:      

     
Pets Yes  No  How Many:       Type:       Indoor  Outdoor 


How Many:       Type:       Indoor  Outdoor 
Check one: New  Renewal  Check #       Cash  Amount      
_______________________________________

Applicants Signature


The database is protected by copyright ©essaydocs.org 2016
send message

    Main page