Enter Local Ordinance Information Local Ordinance Information If you are human, leave this field blank. Agency Name Type in the name of your agency Street Address e.g., "123 Main St" City e.g., "Anytown" State Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Phone General Public Contact Number Contact Name General Public Contact Name Email General Public Contact Email Website/URL Dispatch Number Number(s) that should be used to call PSAP What is Included in Your Program Burglar Alarms - Professionally Installed & Monitored Burglar Alarms - Do it Yourself & Professionally Monitored Burglar Alarms - Self Monitored Burglar Alarms Audible Only Holdup or Panic Alarms Fire Alarms Select All That Apply Alarm User Permit or Registration User Permit/Registration Required Optional Select an Option User Permit/Registration Term Annual Every Two Years Every Three years Good Until Cancelled Select an Option User Permit /Registration Required to Request Dispatch N/A Yes will not respond without Registration/Permit Yes fine Alarm Co if no Registration/Permit Yes fine User if no Registration/Permit Yes fine both if no Registration/Permit Select an Option Who is Responsible To get the User Permit/Registration? Alarm User Alarm Company Both Either Select an Option Initial User Permit/Registration Fee Enter your amount Renewal User Permit/Registration Fee Enter Your Amount Ways to Do User Permit/Registration Online Email Fax Mail In Person Select All That Apply Alarm Company Permit or Registration Installing Alarm Company Permit/Registration Required Not Required Choose an Option Installing Alarm Company Permit/Registration Term Annual Every Two Years Every Three years Good Until Cancelled Choose an Option Initial Installing Alarm Company Permit/Registration Fee Add your amount Renewal Installing Alarm Company Permit/Registration Fee Add your Amount Monitoring Alarm Company Permit/Registration Required Not Required Choose an Option Monitoring Alarm Company Permit/Registration Term Annual Every Two Years Every Three years Good Until Cancelled Choose and Option Initial Monitoring Alarm Company Permit/Registration Fee Add Your Amount Renewal Monitoring Alarm Company Permit/Registration Fee Ways to Do Alarm Company Registration Online Email Fax Mail In Person) Select All That Apply Penalties, Fines & Fees Description Of User Fines & Penalties A more detailed description Description of Alarm Co Fines & Penalties A more detailed description Other Info Cancellation Policy Describe your policy - are Cancellations Required/accepted? Options To Pay Fines Online Mail Phone In Person Select all that Apply Verification Policy Describe your policy - Do your require 1, or 2 calls, Video or Audio? Description and Comments A more detailed description of the program Submit
