Electronic Government Solutions - Alarm Registrations

APPLICANT INFORMATION
GEORGETOWN COUNTY BUSINESS ALARM REGISTRATION FORM
Business Name:
Business Owner Name:	Fed Tax I.D / SSN:
Physical Location of Alarm Address:
City:	State: ZIP Code: -
Phone:	Cell:
Email:
BUSINESS BILLING ADDRESS (IF DIFFERENT FROM ABOVE)
Street or PO Box Address:
City:	State: ZIP Code: -
Phone:	Cell: Email:
Type of Alarm (Check each that apply): FIRE stand alone system Security/Burglar stand alone system
Combined Fire & Security System
Alarm Company Name:
Alarm Company Location: Office Phone:
Alarm Company Name:
Alarm Company Location: Office Phone:
ADDITIONAL CONTACTS (LIST AT LEAST TWO PEOPLE)
Key Holder Name:
Phone: Cell Phone:
Key Holder Name:
Phone: Cell Phone:
Key Holder Name:
Phone: Cell Phone:
LIST HAZARDOUS MATERIALS STORED ON SITE:(MSDS SHEETS MUST BE MADE AVAILABLE IF REQUESTED) Hazardous Materials information requested is “voluntary” for the purposes of False Alarm Registration.

If Partnership or Corporation, list all partners/principal officers, addresses, phone numbers below

MAIL COMPLETED FORMS TO GEORGETOWN COUNTY BUILDING AND ZONING DEPT, PO DRAWER 421270, GEORGETOWN, SC 29442. OR VISIT WWW.GEORGETOWNCOUNTYSC.ORG AND FILL OUT APPLICATION FORM ON-LINE AND SUBMIT TO THE COUNTY.
Per Georgetown County Ordinance 2005-28 the first three false alarm service fee will be waived. All subsequent false alarms shall be assessed a $100.00 fee for each occurence.