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Alarm - Key-holder Notification Form

The Lufkin Police Department is requesting that you comply with City Ordinance #3128, which requires any business or residence to register their alarm with the Lufkin Police Department. There is not fee to register your alarm. However, there will be a $30.00 fee for all false alarms after the fifth alarm in a calendar year. If you do not register your alarm it is a violation of the city ordinance and you will be issued a citation for violation of such. Please update your alarm registration annually or anytime you have a change. If you don not have an alarm please fill in the contact information for emergency situations that may happen at your location. If you have any questions or would like a copy of the city ordinance please contact: Stephanie Cagnon (936) 633-0316 stcagnon@cityoflufkin.com 

LOCATION

Name of Business/Residence

 

Telephone #                    Fax #

       

 

Gate Code

Address of Business/Residence

 

Mailing Address if different

EMERGENCY CONTACT PERSON (S)

Contact #1

 

Home Phone:  

Work Phone:  

   Cell/Pager:   

 

Contact #2

 

Home Phone:  

Work Phone:  

   Cell/Pager:   

 

Contact #3

 

Home Phone:  

Work Phone:  

   Cell/Pager:   

 

ALARM TYPE / COMPANY INFORMATION

Alarm Type:     Burglary - Silent    Burglary - Audible    Robbery - Silent    Robbery - Audible 

                          Hold up/Panic - Silent     Hold up/panic - Audible      Medical

 

Alarm Company Name:    Telephone Number: