Notification Instructions:  Scott's Security Systems Inc.

 The purpose of the notification list is to assist the Central station in dispatching the authorities and notifying your backups of the situation at the premises.

  
       

Company Name

 Date of Application
Last Name First Name
Address  
City
State Zip Code
 Phone # Cell Phone #
Fax #  Email Address
Block # Lot #

Billing Information
   
  Check if the same as above
 
Company Name  
Last Name First Name
Address  
City
State Zip Code
 Phone # Cell Phone #
Fax #  Email Address

Notification Information
 
         
Verification #1   Police #   Call waiting
         
Verification #2   Fire #    
         
  Please indicate the method you us to communicate with the internet No internet ISDN 
DSL Cable
    Phone modem
   

The following is a list of persons to be notified
 
         
Name  

Phone # 

  Phone Pager  Cell phone
Name   Phone #   Phone Pager  Cell phone
Name   Phone #   Phone Pager  Cell phone
Name   Phone #   Phone Pager  Cell phone
Name   Phone #   Phone Pager  Cell phone

Comments
   
 
             
     
  If you wish to start over
     
  Use the print button if you wish to fax or use the U.S. postal Service.
     
  Email the fastest way to update your information.
     

  

Copyright © 2001 Scott's Security Inc. All rights reserved.
Revised: 03/18/03.