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Alarm License Renewal Application Form

  1. Alarm Location Information *

    Provide local information.

  2. Premise being licensed to have an alarm.

  3. Mailing Address*

  4. Ownership – Principals, Sole Owners, Shareholders, Partners, etc.

  5. If you have more than two owners, please attach a listing.

  6. Emergency Contacts

    A minimum of (2) two contacts are required. Do NOT provide ownership information as listed above.

  7. Alarm Monitor Information

    Company information.

  8. Execute*

    By selecting I agree option below you are giving your electronic signature.

  9. No False statements

    Your submission of this form certifies that the information provided is true and correct.

  10. Information for individual completing this form.

  11. Leave This Blank:

  12. This field is not part of the form submission.