New Monitoring Client Information Form
*Indicates Required Field

*Company Name:

*Dealer ID:

*Account Number:

Panel:

Default:

Communicator Phone Number:

*Subscriber Name:

*Address:

*City:

*State:

*Zip:

*Main Premise Phone Number:

Second Premise Phone Number:

Call Waiting:
 Yes No

Local Authorities
(MUST be entered in order to entered to add a new account)

*Police:

Telephone:

*Fire:

Telephone:

Medical:

Telephone:

Emergency Notification List

Please indicate: H - Home number W - Work number C - Cell phone P - Pager number

1. Name

Telephone

Note

2. Name

Telephone

Note

3. Name

Telephone

Note

4. Name

Telephone

Note

5. Name

Telephone

Note

6. Name

Telephone

Note

7. Name

Telephone

Note

8. Name

Telephone

Note

9. Name

Telephone

Note

10.Name

Telephone

Note

Click here to enter more contacts for emergency notification.

Passcode

** Please note that passcodes can be up to 12 characters in length

1.

Name

Passcode

User

2.

Name

Passcode

User

3.

Name

Passcode

User

4.

Name

Passcode

User

5.

Name

Passcode

User

6.

Name

Passcode

User

7.

Name

Passcode

User

8.

Name

Passcode

User

9.

Name

Passcode

User

10.

Name

Passcode

User

Click here to enter more passcode notification.

Reporting Code and Zone Description

Please choose the reporting format:

Alarm Reporting Format

Code

Zone

Description

Special Instruction

Temporary Comments

Start Date Start Time

End Date

End Time


Please fill out the following for any account that will transmit supervised opening and closing signals. There will be a grace period of 30 minutes added to each side of the opening and closing signals, unless otherwise specified by the alarm company. Any other grace period indicated will be added to the original 30 minutes given on each side of the opening and closings.

Additional grace period of:

Openings

Closings

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Supervised

We will call on any openings outside of the time frame. When the store does not open , the notification list will be called. When the store does not close, we will call the premise and notification list.

Unsupervised

Unsupervised opening and closings do not require a schedule. The users can enter at anytime and no calls will be made. You may request opening and closing reports which will indicate when your party opened or closed.

*Name

*Email

Additional Emergency Contact Information (where applicable)

Please indicate: H - Home number W - Work number C - Cell phone P - Pager number

1. Name

Telephone

Note

2. Name

Telephone

Note

3. Name

Telephone

Note

4. Name

Telephone

Note

5. Name

Telephone

Note

6. Name

Telephone

Note

7. Name

Telephone

Note

8. Name

Telephone

Note

9. Name

Telephone

Note

10.Name

Telephone

Note

Additional Passcode Information (where applicable)

** Please note that passcodes can be up to 12 characters in length

1.

Name

Passcode

User

2.

Name

Passcode

User

3.

Name

Passcode

User

4.

Name

Passcode

User

5.

Name

Passcode

User

6.

Name

Passcode

User

7.

Name

Passcode

User

8.

Name

Passcode

User

9.

Name

Passcode

User

10.

Name

Passcode

User

AlarmWATCH™
Monitoring Response Worthy of Your Reputation

P.O. Box 81, Hunt Valley, MD 21030
410-785-3300 • Fax: 410-785-1742

866-500-8808