NOTE: Fields marked with an "*" are required and must be filled in to submit the form.
Type of Alarm  
 
   
Part I. Owner Information  
First Name*  
Last Name*  
Business Name*  
Address*  
City*  
State*  
Zip Code*  
Email
Phone Number*  
   
Part II. Contact Information  
1. Name*   Phone Number*   Cell Number
2. Name*   Phone Number*   Cell Number
3. Name Phone Number Cell Number
   
Part III. Alarm Installer  
Company Name
License Number
Address
City
State
Zip Code
Phone Number
   
Part IV. Monitoring Company  
Company Name
Address
City
State
Zip Code
Phone Number
   
Part V. Business Information  
Business Hours  
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Manager Name
Phone Number
Business has a security guard
   
Part VI. System Information  
Alarm Type



Signal Type


   
Part VII. Confirmation  
By checking this box I agree to the following statement. REQUIRED WHEN FILING ONLINE! I agree to hold harmless the Township of Hamilton Police Department from any liability resulting from the use of automatic protection devices. Ifurther understand that I am soley liable for each and every alarm originating from the above premisis and have secured all required permits andcompleted all relevant applications that pertain to the above automatic protection device.I further agree to supply my alarm monitoring company with my alarm number (when received) and advise them to give the alarm number FIRSTthen the location when reporting an alarm to the police department.
   
Signature*  
Date*