MAIL TO Moore_alarmapp Moore Alarmapp

User Manual: moore_alarmapp

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MAIL TO: The City of Moore, City Clerk’s Office

301 N. Broadway Moore, OK 73160

Phone (405) 793-5020 Fax: (405) 793-5025

Alarm Permit / Business Identification Program

Name of Resident/Business __________________________________________________________________

Street Address ____________________________________________________________________________

City/State/Zip_____________________________________________________________________________

Corporate Office (if different from above) ______________________________________________________

Home Phone ___________________ Business Phone __________________ Other Phone _______________

Emergency Contact Information

List at least 2 people other than yourself at two different addresses; be sure to put in complete address

1ST Contact Name _________________________________________________________________________

Address ______________________________________________________________________________

City _______________________ State ________________________ ZIP _________________________

Home Phone ________________ Office Phone __________________ Other Phone __________________

2ND Contact Name _________________________________________________________________________

Address ______________________________________________________________________________

City _______________________ State ________________________ ZIP _________________________

Home Phone ________________ Office Phone __________________ Other Phone __________________

3RD Contact Name _________________________________________________________________________

Address ______________________________________________________________________________

City _______________________ State ________________________ ZIP _________________________

Home Phone ________________ Office Phone __________________ Other Phone __________________

Guard Dog on Premises/ Other Comments ______________________________________________________

ALARM SYSTEM YES / NO ( IF YES, THE ALARM INFORMATION BELOW MUST BE COMPLETED)

Alarm Information

A one-time permit fee of $25.00 must be submitted with this application.

Please make checks payable to the CITY OF MOORE

Alarm Company Name ___________________________________________ State License # _____________

Alarm Company Telephone Number (______)_________________________ Date Of Installation __________

Type/Coverage of Alarm ____________________________________________________________________

(Example : Burglar, Motion Sensors, Fire, Smoke Detector)

Signature of Applicant ____________________________ Date ______________

Approval of City Clerk ___________________________ Date ______________

Approval of 9-1-1 Dir. ____________________________ Date ______________

BID # _____________

Map Page __________

Payment___________

CK# / Cash _________