Alarm Licensing Permit
Permit Type:
*Please Note: Check with Yukon Police Records, (405) 350-7586, to verify the address of your alarm activation is in
Yukon Police and Fire jurisdiction before completing this alarm permit.
Yukon Police and Fire Departments DO NOT cover all Yukon MAILING addresses.
Name of Business or Resident: ________________________________________
Physical Address: _______________________________________________
Mailing Address (if different from physical): _______ _____________________________
E-Mail Address: ________________________ _______________________
Name of Business Owner:_________________________________________________
Phone Number: ( ) Alternate Phone number: Type( )
Please Specify Type: Home (H) Cell (C) Work (W)
Alarm Monitored by: _____ _ Phone_ _________ _________
Type (S) of Alarms in Use:
Emergency Contacts: Please specify type: Home (H) Cell (C) Work (W)
Name: Phone ( ) Relationship
Name: Phone ( ) Relationship
Name: Phone ( ) Relationship
~ New alarm permit fee is $50.00 and due upon activation.
~ Annual alarm renewal fee of $10.00 is due by December 31, for each year thereafter the alarm is active.
Please make checks payable to the “City of Yukon”
I, (the undersigned), understand that I am subject to a Fifty dollar ($50.00) fine per respo
nse for any false
alarm in excess of Two (2) false alarms within one (1) calendar year and a One Hundred dollar ($100.00) fine
for any false alarms in excess of Three (3) false alarms within one (1) calendar year.
Signature: Receipt #: _____________ (Office Use Only) Initials____
Date: Date Rec’d: Valid Thru:
1
00 S. Ranchwood Blvd., Yukon, Oklahoma 73099 ~ Records (405) 350-7586 ~ Fax (405) 350-5498
“Equal Opportunity Employer”
