Residential Emergency Contact List -
ADVERTISEMENT
1RESIDENTIAL EMERGENCY CONTACT LIST
Account Number: ________________
Special Word/Pass code: _______________
Account Name:
___________________________________________________________
Street Address: _____________________________________________________________
City, State, Zip: ________________________
______
____________
Telephone Number: (
)
-
Telephone Number: (
)
-
(Primary)
(Secondary)
In case of an emergency or if an alarm is activated while you are not on the premises we need to have a list of people we may
notify. This should include work numbers, pager numbers, mobile numbers etc. Our standard procedure is to start at the top of
the list and stop once someone is contacted. If we are unable to contact someone on the list we will periodically start this
procedure again until someone has been contacted.
Please be aware, the persons on the list can not disregard the police from a dispatch unless you have given them the
authority to do so. Please place an X in the box for each person you wish to have this authority.
Disregard
___________________________
_________________________________________________________________
Yes
No
(Name #1)
(Primary Phone)
(Mobile)
(Pager)
___________________________
_________________________________________________________________
Yes
No
(Name #2)
(Primary Phone)
(Mobile)
(Pager)
___________________________
_________________________________________________________________
Yes
No
(Name #3)
(Primary Phone)
(Mobile)
(Pager)
___________________________
_________________________________________________________________
Yes
No
(Name #4)
(Primary Phone)
(Mobile)
(Pager)
___________________________
_________________________________________________________________
Yes
No
(Name #5)
(Primary Phone)
(Mobile)
(Pager)
___________________________
_________________________________________________________________
Yes
No
(Name #6)
(Primary Phone)
(Mobile)
(Pager)
Special Instructions –(Please note people who have access other than the above.)
If your alarm is activated, after dispatching police, if we are unable to contact anyone on the list, please note
• • • •
any actions you wish us to take.
In case of any changes please notify Dallas Security immediately @ 214-553-6103 Dial 0
• • • •
Signature ___________________________________
Date _____________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business