Alarm Permit Application/renewal - City Of Chandler Police Department
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1Alarm Permit Application/Renewal
City of Chandler
Police Department
For initial registration, complete this permit application and submit it with payment to the Chandler Police
#
Department Alarm Unit. For a renewal permit, please review information for accuracy and update any necessary
fields. Sign, date and return application and payment to the Chandler Police Department Alarm Unit.
alarms@chandleraz.gov
$10.00 registration/renewal fee enclosed (Make checks payable to Chandler Police Department.)
Registration Fee Waiver (Residential Alarm Users age 65 and older are exempt from the permit fee.)
DOB (if exempt):
Location (physical address)
Responsible Party (mailing address)
Name (Last , First) or Business Name
Name (Last , First)
Street Address and Apt./Ste.
Street Address and Apt./Ste.
AZ
City
State
Zip
City
State
Zip
Phone 1
Phone 2
Phone 1
Phone 2
Email Address
Email Address
Contact Person 1
Contact Person 2
Name (Last , First)
Name (Last , First)
Street Address and Apt./Ste.
Street Address and Apt./Ste.
City
State
Zip
City
State
Zip
Phone 1
Phone 2
Phone 1
Phone 2
Email Address
Email Address
Special Conditions:
Monitored By
Sold By
Name (Last , First) or Business Name
Name (Last , First) or Business Name
Street Address and Apt./Ste.
Street Address and Apt./Ste.
City
State
Zip
City
State
Zip
Phone
Fax
Phone
Fax
Email Address
Email Address
It is the alarm owner's responsibility to prevent false alarms and to ensure that all system users are properly trained. I hereby certify that the above
information is accurate. I accept complete responsibility for any and all charges and/or fees incurred by installing and using this alarm system in
accordance with the City of Chandler Municipal Code Chapter 24.
Signature:
Date:
250 E Chicago St - Chandler, Arizona 85225
Form: CPD32-110
PO Box 4008, Mail Stop 303, Chandler, Arizona 85244-4008
Page 1 of 1
Revision: 07/11
Phone: 480-782-4201 | Fax: 480-782-4222
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