GREEN BAY POLICE DEPARTMENT 2012 ALARM PERMIT REGISTRATION

Alarm Permit Registration Notice
City of Green Bay 27.501(4)  ALARM USER PERMIT.
Alarm users shall obtain a permit for the alarm system on the user’s premises.
U
S
E
R 		Business/Resident Name
Alarm Address  
 		 Zip Code
-
 Business       Residence        Government
                                                       		 Phone Number         Fax Number         
B
I
L
L
I
N
G		 Mailing Address (If Different)

 Zip Code
-
Email Address (Required for renewal notification and payment receipt)
Initial Permit Fee $25.00                Renewal Permit Fee $15.00
A
L
A
R
M		 Contact / Keyholder #1
 Phone #1
 Phone #2
Contact / Keyholder #2
 Phone #1
 Phone #2
Alarm Monitoring Company
 Phone #
Seller / Installer
 Phone #
Type of Alarm: (Check all that apply)     Hold-up        Burglary        Panic
Business Hours:
The Applicant or Authorized Agent affirms that all the information contained herein is true and correct to the best of his/her knowledge.  The application may be denied for false statements and/or non-payment of all fees due to the City of Green Bay.  Please NOTE: Multiple Property Owners: There must be seperate permits on file for each premise that uses an alarm system in the City of Green Bay.  All permits are good for the 2012 Calendar Year only.  All Burglary Alarm Permits are kept on file with the City of Green Bay Police Department.  Checks for alarm permits should be made out to The City of Green Bay.
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                                                                      Signature                                            Date
If you have questions or concerns about this permit application, please call (920) 448-3171 or (920) 448-3260. Alarm monitoring companies should be directed to notify the Green Bay Police of an alarm by calling (920) 448-3201.

Please Complete, Print, Sign, and Mail with required fee to:
Green Bay Police Department   Attn: Records Permits
307 S. Adams Street                                                         
Green Bay, WI 54301-4582