Fillable NEW ALARM PERMIT APPLICATION UPDATE CALL-OUT LIST (City of Mount Vernon)

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NEW ALARM PERMIT APPLICATION UPDATE CALL-OUT LIST (City of Mount Vernon)

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NEW ALARM PERMIT APPLICATION
UPDATE CALL-OUT LIST
Mount Vernon Police Department strives to provide the best service possible. As first
responders, we must know who to contact in case of an after-hours occurrence at your home or
business. Please complete each line on both sides of the application.
PLEASE TYPE OR PRINT LEGIBLY
DATE
CALL OUT – ALARM PERMIT FOR: RESIDENCE BUSINESS
OWNER
(LAST) (FIRST) (MIDDLE INITIAL) (DATE OF BIRTH)
HOME
ADDRESS
HOME
PHONE CELL PHONE
EMAIL
ADDRESS____________________________________________
BUSINESS
NAME
BUSINESS
ADDRESS
BUSINESS
PHONE _____________________ BUSINESS HOURS
ALARM
COMPANY NAME
(IF APPLICABLE)
ALARM
COMPANY PHONE NUMBER
(IF APPLICABLE)
MOUNT VERNON CITY ALARM PERMIT NUMBER MA-
(IF APPLICABLE)
Page 1 of 2
X
CALL OUT INFORMATION
Please list names in preferred order of callout. Names listed may be called at any time, must have
access to the building and must be able to respond day or night. All information requested
is required and will be used by the Mount Vernon Police Department
1
st
Call Out
Last Name First Name Middle Initial
Home Phone Work Phone Cell Phone
Home Address Work Address
Date of Birth Driver’s License No. State
2
nd
Call Out
Last Name First Name Middle Initial
Home Phone Work Phone Cell Phone
Home Address Work Address
Date of Birth Driver’s License No. State
3
rd
Call Out
Last Name First Name Middle Initial
Home Phone Work Phone Cell Phone
Home Address Work Address
Date of Birth Driver’s License No. State
PLEASE COMPLETE AND SEND TO THE MOUNT VERNON POLICE DEPARTMENT
You may also email the completed documents to: Burglaralarms@mountvernonwa.gov
If you have any questions contact Sergeant Brent Thompson or the Receptionist at (360) 336-6271
Page 2 of 2
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NEW ALARM PERMIT APPLICATION UPDATE CALL-OUT LIST (City of Mount Vernon)

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Completed 14 July 2020

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