Office Use Only
Permit #
Clerk
Amount
Date Issued
ALARM REGISTRATION APPLICATION
One-time Fee: $25 Senior Waiver (age 65):
Date: ☐ New ☐ Update ☐ Replace Decal #
1. SUBSCRIBER INFORMATION
If a rental, is subscriber ☐Landlord ☐ Tenant?
☐ Residential Permit (list both spouse names)
Name:
Mailing Address:
City: State: ZIP:
Home Phone:
Work #: Name
Work #: Name
Cell #: Name
Alarm Street Address (if different than mailing address):
City: State: ZIP:
☐ Both – for business in home, complete both sections
☐ Commercial/Nonresidential Permit
Business Name:
Mailing Address:
City: State: ZIP:
Phone:
Contact Name
Contact Home Phone
Contact Other Phone
Alarm Street Address (if different than mailing address):
City: State: ZIP:
II. ALARM COMPANY INFORMATION
Alarm Company: Phone:
Type of Alarm
(check all that apply): ☐ Audible ☐ Silent ☐Intrusion/Burglar ☐ Duress/Hold-up
III. EMERGENCY NOTIFICATION
List two responsible representatives (other than the applicant) who can and will respond within 30
minutes to an alarm activation to assist the Police in determining the cause of the alarm activation and to
secure the premises.
Name: Home: Work: Other:
Name: Home: Work: Other:
City of Sumner Code, Section 9.10 requires all businesses or residences with burglary alarm systems to have valid alarm
registrations. Failure to complete this application or to pay your $25 fee could result in no police response to your alarm
system and/or a penalty of $50 or more.
Registration of an alarm system does not create a contract, duty or obligation, either expressed or implied, for police to
respond. Any and all liability and consequential damage resulting from the failure to respond to a notification is hereby
disclaimed, and governmental immunity as provided by law is retained. By registering an alarm system, the user acknowledges
that any police response may be based on factors such as availability of police units, priority of calls, weather conditions, traffic
conditions, emergency situations and staffing levels.
Signature:
Return completed form to Sumner Police Dept, 1104 Maple Street, Ste 140, Sumner, WA 98390
253-863-6384
Please help prevent false alarms.
ALARM REGISTRATION APPLICATION
Please note that all payments must be cash or check. We do not have the ability to accept credit cards.
