Alarm Registration Form

Alarm Registration Form

Sec. 13-43 of the City of Alpharetta ordinance requires the registration of any fire, robbery, burglary, holdup, medical or panic alarm both audible and inaudible (silent). Registration is required to assist law enforcement personnel with determining the location of an alarm, emergency contact information, and notifying them of any other unique conditions or hazards that may exist.

Burglar/Fire Alarm Registration

Alarm Location:*

Address Line 1

Address Line 2

City

State

ZIP Code

Alarm Type:*

Business Alarm Resident Alarm

Is the Business Operated Out of a Residence

Yes No

Business Name (as it appears on the store front)

Daytime Phone Number of Business

Building Type

Business Type

Business Alias (another name your business is known as)

Business Email Address

Homeowner's Name (as it appears on alarm company's bill)

First Name

Last Name

Primary Phone

Secondary Phone

Residence Email Address

Alarm Monitoring Company Name*

Alarm Monitoring Company Phone*

In addition to registering your alarm, the City of Alpharetta encourages you to create an Emergency Profile for free at emergencyprofile.org

Emergency Contact Information (list in call order)

Contact # 1 Name*

First Name

Last Name

Primary Phone for Contact # 1*

Secondary Phone for Contact # 1

Email for Contact # 1*

Contact # 2 Name

First Name

Last Name

Primary Phone for Contact # 2

Secondary Phone for Contact # 2

Email for Contact # 2

Contact # 3 Name

First Name

Last Name

Primary Phone for Contact # 3

Secondary Phone for Contact # 3

Email for Contact # 3

Contact # 4 Name

First Name

Last Name

Primary Phone for Contact # 4

Secondary Phone for Contact # 4

Email for Contact # 4

Additional Information/Hazard Notification

Provide any other information or hazards we need to be aware of:

Information provided on this form will only be used in case of an emergency (fire, burglary, water leak, etc) and will be held confidential by the NG911 center. Contacts may be updated at any time.

I have read and understand the ordinance that pertains to alarms in the City of Alpharetta, the penalties for violations of the ordinance, and the falsification of the application. Click here for the ordinance: COA Alarm Ordinance

Name*

First Name

Last Name

Date*

Finance Approval

Approve Reject

Rejection Reason

Customer Id #

Finance Representative Name

First Name

Last Name

Date