Alarm Permit Request

Instructions: Complete this alarm permit application, and mail or hand deliver a check or money order payable to The City of Robstown for $25.00 to:

Robstown Police Department Records Clerk: Alarms
Robstown Police Department
430 E. Main Ave.
Robstown, TX 78380

Cash will not be accepted.

Failure to obtain an alarm permit will be a violation of Robstown City Ordinance 4.07.003, Permit Required(a). Violation of this city ordinance will result in a fine of $50.00.

"*" indicates required fields

Date Submitted*

Property Type

Residential

Commercial

Industrial

Business Name*

Your Title*

Permit Holder Name*

First Last

Your Name*

First Last

How would you like us to contact you?*

Call

Mail

Your Phone Number*

Your Email*

Your Email

Alarm Information

Property Address*

Street Address Address Line 2 City State ZIP Code

Use your name and the property address for billing as well?*

Yes

Billing Name*

First Last

Billing Address*

Street Address Address Line 2 City State ZIP Code

Alarm Monitoring Company*

Alarm Phone Number*

Emergency Contacts

Names of friends/family/neighbors we may contact in case of an emergency.

Emergency Contact #1 Name

First Last

Emergency Contact #1 Phone

Emergency Contact #1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Emergency Contact #2 Name

First Last

Emergency Contact #2 Phone

Emergency Contact #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Please mail or hand deliver a check or money order in the amount of $25 made payable to the City of Robstown as instructed above. Cash will not be accepted.

Applicant's / Authorized Signature*

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