Smith County Sheriff S Office

SMITH COUNTY SHERIFF’S OFFICE 227 N. SPRING AVENUE, TYLER, TEXAS 75702 ALARM PERMIT APPLICATION

ALARM COMPANY:______SCSO PERMIT #______

TYPE OF ALARM: RESIDENTIAL______COMMERCIAL______

NAME OF APPLICANT:______

“9-1-1” PHYSICAL ADDRESS OF ALARM SITE: (If business, give business name) ______(Must include city and zip code)

MAILING ADDRESS, IF DIFFERENT:______TELEPHONE NUMBER AT THE ALARM SITE:______DIRECTIONS FROM LOOP 323 TO THE ALARM SITE: ______

DESCRIPTION OF ALARM SYSTEM: SILENT ALARM (Signal Outside Monitoring) _____YES _____NO AUDIBLE (1) (Sounds alarm manually) _____YES _____NO AUDIBLE (2) (Sounds alarm 15 min max auto reset) _____YES _____NO PANIC (Life Threatening Alarm) _____YES _____NO ROBBERY (Hold – Up Alarm) _____YES _____NO

PERSON RESPONSIBLE FOR NOTIFYING SHERIFF’S OFFICE UPON ALARM ACTIVATION: ALARM COMPANY: East Texas Alarm PHONE: 903-593-3225 ANSWERING SERVICE: ______PHONE:______NEIGHBOR/PASSERBY: ______PHONE:______

NAME OF REPRESENTATIVE TO BE CONTACTED UPON ALARM ACTIVATION: NAME RELATIONSHIP TO APPLICANT PHONE 1.______2.______3.______

SPECIAL INSTRUCTIONS TO RESPONDING OFFICERS: ______

APPLICANT SIGNATURE: ______DATE:______ALARM COORDINATOR: GAIL CLEAVER ______DATE:______(SEE REVERSE SIDE) SECTIONS 2.018 – WHEN PERMIT MAY BE REVOKED:

An alarm permit may be revoked upon the occurrence of one or more of the following:

(a) The permit holder has failed to make payment in full to Smith County for any fees assessed under Section 2.006 and 2.017 hereof within sixty (60) days of the date the Sheriff has mailed notice to the permit holder that such fees are due and owing. (b) The permit holder accrues more than nine (9) FALSE ALARMS during any twelve (12) month period, over and above the five (5) false alarms allowed during any twelve (12) month period. After the reinstatement in accordance with Section 2.017, above will be assess if the permit holder accrues more than three (3) false alarms during the remainder of any twelve (12) month period.

This application shall be signed by the person making the application for the permit, acknowledging that he/she has read the application, affirming the correctness and accuracy of the information given on the application, authorizing the release to the Sheriff of the information required hereunder, and, if such person making the application will not be the permit holder, certifying that he/she is authorized to act for the intended permit holder.

The alarm permit fee is $25.00 made payable to the Smith County Treasurer.

______Signature of Applicant Acknowledging Above Date

FOR OFFICIAL USE ONLY

PERMIT REC’D:______CHECK/M.O.#______

RECEIPT #:______EXPIRATION DATE:______

COMMENTS:______

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