Alarm System Permit

Type of Permit:*

Residential Business

Government Facility School

System Information

Name of Business / Entity:*

Alarm Company:*

Emergency Contact: (name & phone#)*

Alarm Company Phone #:*

Personal Information

First Name:*

Last Name:*

Phone #:*

Alarm Address:*

City:*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip Code:*

Fee Information

Please note all fees are non-refundable. There is a $30 service charge for all returned checks.

Please indicate license request:

New - 15 days <b>prior</b> to installation New - 15 days <b>after</b> installation

Renewal - 2 years

I accept responsibility for payment of all fees and fines that may result from the operation of the alarm system servicing the above premises until such time I notify the Police Department of removal of the system and/or relocation. I am also responsible for notification to the Police Department of any alarm company changes within 10 days of change.

Please mark the provided box indicating you accept the above stated conditions: *

I Agree