First Time Home Alarm Registration

EASTON POLICE DEPARTMENT
ALARM ORDINANCE REGISTRATION

Please complete this form if you are registering your home alarm for the first time as a "New Registration"

Your Full Name (required):

Your Date of Birth (required):

Your Address (required):

Your Email (required):

Home Telephone (required):

Cell Phone (required):

Work Phone:

Emergency Telephone:

Keyholder(s): Keyholders must have keys AND the alarm code for your home

Name: Phone:
Address:

Name: Phone:
Address:

ALARM INFO: (required)
Safe word:
Monitored by Central Station? YESNO
Alarm Company Name: Phone No.:

FEATURES: please select YES or NO
Intrusion Detection: Fire Detection:
Medical Alert: CO Detection:
Panic Alarm: Low Battery:

INTRUSION DETECTORS: please select YES or NO
Is the alarm audible outside of your home> Does your alarm have an automatic reset?
Does your alarm only send a silent signal to the alarm co? If your alarm is audible, how long until it resets itself? mins. (20 minute maximum duration, please)

Do you have any dogs? If YES, how many?
Friendly? Use Caution?

REMARKS:

Please type the following into the box below for verification before hitting send:
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By submitting this form you hereby register as an alarm user in the Town of Easton, and agree to abide by the Town Ordinance regulations.

UPON SUBMISSION OF THIS FORM YOU MUST CONTINUE TO THE SECURE PAYMENT PAGE AND SUBMIT THE NECESSARY FEES TO COMPLETE YOUR REGISTRATION. FORMS SUBMITTED WITHOUT PAYMENT WILL NOT BE PROCESSED.