Alarm Permit Application
Please fill out this form in its entirety and submit to the City of Gillette Police Department


** CHANGES MAY TAKE UP TO 10 DAYS BEFORE THEY SHOW UP IN THE SYSTEM **

What year are you registering for? *
Accounts must be Registered every year, you can Register for the following year starting November 15th of the current year.
Required
Alarm Owner Name: *
Residential Owner or Business Name
Your answer
Physical Address: *
What address is the Alarm at
Your answer
Billing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Primary Name (First and Last) *
Contact Information
Your answer
Primary Name Phone Number *
### - ### - ####
Your answer
Secondary Name (First and Last) *
Contact Information
Your answer
Secondary Name Phone Number *
### - ### - ####
Your answer
Third Name (First and Last)
Contact Information
Your answer
Third Name Phone Number
### - ### - ####
Your answer
Alarm Company Name *
Your answer
Alarm Company Billing Address *
Your answer
Alarm Company Phone Number *
### - ### - ####
Your answer
Gillette City Ordinance 14-13 *
Required
Signature *
Required
Date *
MM
/
DD
/
YYYY
Submit
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