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2. HOMEOWNER, please fill out the form below to submit your alarm permit. You will receive your permit number in 7-10 business days.
6. Applicant’s Name (or Business Name)*
8. Alarm Location Address (include Apt/Suite)*
10. City*
12. State*
14. Zip*
16. Home Phone Number*
18. Work Phone Number*
20. Mailing Address (if different)
22. City
24. State
26. Zip
28. Homeowner Email Address (not alarm company)*
30. Please select one of the following
32. This Alarm is a*

    1. Residential Alarm
    2. Business Alarm
34. Alarm Company Name*
36. Alarm Company Phone*
40. List two people with keys to your home or building and a working knowledge of your alarm system that could respond within 30 minutes to assist police in resetting your alarm.
42. #1 Name*
44. #1 Phone number*
46. #1 Alternate Phone*
48. #2 Name*
50. #2 Phone Number*
52. #2 Alternate Phone*
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field