City of Suffolk Registration Form

City of Suffolk Registration Form
Alarm Registration/Permit Application
Initial Registration Fee: Residential $25.00/Commercial $25.00 Renewal Fees: Residential $10.00/Commercial $10.00
(Please print)
RESIDENTIAL
BUSINESS
Name of Registration Holder:
Business Name:
Name of responsible party:
Alarm Location:
(Include Building/Apt #)
(Include Suite or Unit #)
City:
State:
Zip:
State:
Zip:
Billing Address:
(if different)
City:
Email Address:
Cell Phone:
Home Phone:
Office Phone:
EMERGENCY CONTACTS
Name:
Phone #1:
Phone #2:
Name:
Phone #1:
Phone #2:
SPECIAL CONDITIONS
In order to ensure the safety of our officers, the public and to enable the Suffolk Police Department to better protect your property, please provide
information regarding potentially hazardous circumstances (i.e. guard animals, hazardous substances, etc.)
Comment:
ALARM INSTALLATION DETAILS
Alarm Installation Date:
/
/
Phone #:
Alarm Installation Company:
Address:
Monitoring Company:
(if different)
Address:
Phone #:
PLEASE READ THE FOLLOWING AND SIGN:
This is to certify that as the applying principal, my immediate family, tenants, or employees who have access to the protected premises have been given training which includes procedures
and practices to follow in the event that the alarm system is accidentally activated, I also acknowledge that the installation company left me a set of written instructions for the alarm system,
including written guidelines on how to avoid false alarms. The Police response may be influenced by factors including, but not limited to, the availability of officers, priority calls, traffic
conditions, emergency conditions and staffing levels.
Signature: (Owner)
Date:
/
/
In accordance with the Suffolk Alarm Ordinance ARTICLE II, ALARMS, DIVISION 3, POLICE RESPONSE ALARMS, if you have an alarm system in the city limits, it must be registered with
the city within 30 days of this notice. The fee for an Alarm Registration or an Alarm Registration Renewal is set forth below and shall be paid by the Alarm user. No refund of a registration fee or
renewal fee will be made. First false burglar alarm is free. The second false alarm is $50.00 (waived for completing alarm school online); third false alarm is $100.00; fourth false alarm or more is
$150.00. The first false robbery or panic alarm is free. The second false robbery or panic alarm is $100.00; third false robbery or panic alarm is $150.00; fourth or more false robbery or panic
alarm is $250.00 each.
For Customer Service Call: 1-866-950-8185
Initial Registration Fee: Residential $25.00/Commercial $25.00
Renewal Fees: Residential $10.00/Commercial $10.00
Mail this form and payment to:
City of Suffolk Alarm Program
P.O Box 142557, Irving, TX 75014
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