ALARM PERMIT APPLICATION
Columbus Consolidated Government
Revenue Division
P O Box 1397
Columbus, Georgia 31902-1397
Ph: (706 )653-4100 Fax: (706) 225-3777
I. ALARM LOCATION INFORMATION
Individual’s Name or Company Name:
Alarm Address:
City / State: Zip:
Phone Number:
If Company, Contact Name & Ph. No.:
Billing address IF different from above
Address:
City / St. / Zip:
II ALARM LOCATION INFORMATION
. . Check here if this is a new installation
. . Check here if registering a change of ownership
. . Check here if you have an active alarm at a different address. Please provide address:
. . Check here if you have recently de-activated an existing alarm. Please provide address:
III. EMERGENCY NOTIFICATION
Please list (3) individuals who may know how to reach you in case of emergency. (Preferably people with keys
and alarm codes.)
Name: Phone:
Name: Phone:
Name: Phone:
Permit No:
Clerk:
Date:
You MUST notify your
monitoring company of your
valid permit number t
violation.
