2. Security Alarm Permit
4. Business Name*
   Enter N/A if not applicable
5. First Name*
   Enter N/A if not applicable
6. Last Name*
   Enter N/A if not applicable
7. Date of Birth
   Used to identify applications with similar names.
9. Address of Residence or Business*
11. City
12. State
13. Zip
15. Phone Number*
16. Nature of Business
    Are there presence of dangerous materials, chemicals, or hazardous materials.
17. Business Owner/ Resident *
19. Mailing Address if different than above.
20. Email Address
22. Type of Alarm

    1. Perimeter
    2. Motion
    3. Audio

    1. Video Recording
    2. Live Audio Monitering
    3. Dial Up Monitering
24. Responsible Party
    The following, in order of responsibility, are the individuals authorized to respond to determine if the alarm is false or not, determine if there is any damage or loss, and to secure the business. The licensee is responsible to keep this list current. If during the length of this license the names listed below change, the licensee is required to notify the American Fork Police Department of the necessary changes.
26. First Contact
27. First Name*
28. Last Name*
30. Address*
32. Phone Number 1*
33. Phone Number 2
35. City
36. State
37. Zip
39. Second Contact
40. First Name*
41. Last Name*
43. Address*
45. Phone Number 1*
46. Phone Number 2
48. City*
49. State*
50. Zip*
52. Third Contact
54. First Name
55. Last Name
57. Address
59. City
60. State
61. Zip
63. Phone Number 1
64. Phone Number 2
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit Submit and Print

* indicates a required field