City of Temple Terrace Customer Service

2. Please review the following requirement for Alarm Registrations in the City of Temple Terrace:
   All alarms owned or operated within the City of Temple Terrace are required to be registered under City Ordinance (6.605).
   Please complete and submit this form or print out the following form below.
   

   Please use the following format for entering telephone numbers: (813) 506-6500.

   
   
4. Registration Action
6. 
   
8. Select Action:*
   -- Select One --select from dropdown list...--------------------------------------------------------------------------New RegistrationUpdate Existing RegistrationCancel Registration (alarm no longer in service)
10. 
    
12. Alarm System:
14. 
    
16. Please enter all required information below.
18. 
    
20. Select Alarm Type:*
    -- Select One --select from dropdown list...--------------------------------------------------------------------------Residential Alarm SystemBusiness Alarm SystemOther Type Alarm System
22. Alarm Make: *
24. Alarm Model:*
26. Alarm Company:*
28. Alarm Company Telephone:*
30. 
    
32. Registrant:
34. 
    
36. First Name: *
38. Last Name:*
40. Your Role:*

    1. Owner / Tenant
    2. Manager / Agent
42. 
    
44. Alarm Address:
46. 
    
48. The address where the home or business is located. Include suite or apartment numbers on address line 2 where appropriate.
50. 
    
52. Alarm - Address Line 1:*
54. Alarm - Address Line 2:
56. Alarm - City:*
58. Alarm - State:*
60. Alarm - Zip:*
62. 
    
64. Mailing Address:
66. 
    
68. Please enter your mailing / billing address. Include suite or apartment numbers on address line 2 where appropriate.
70. 
    
72. Mailing - Address Line 1:*
74. Mailing - Address Line 2:
76. Mailing - City:*
78. Mailing - State:*
80. Mailing - Zip:*
82. 
    
84. Telephone Numbers:
86. 
    
88. Important! This is the primary method of contact in the event of an emergency. You may include additional numbers or contact information in the notes sections at the end of this form.
90. 
    
92. Telephone - Day:*
94. Telephone - Night:*
96. Telephone - Cell:
98. 
    
100. Emergency Contacts:
102. 
     
104. Please list two additional contacts in the event we cannot reach you in an emergency. Indicate who may have a key to enter your home or business.
106. 
     
108. Contact-1 First Name: *
110. Contact-1 Last Name:*
112. Contact-1 Telephone:*
114. Contact-1 Telephone - Cell:
116. Address
118. City
119. State
120. Zip
122. Contact-1: Is this person a hey-holder?*

     1. Yes
     2. No
124. 
     
126. Contact-2 First Name: *
128. Contact-2 Last Name:*
130. Contact-2 Telephone:*
132. Contact-2 Telephone - Cell:
134. Contact-2: Is this person a hey-holder?*

     1. Yes
     2. No
136. 
     
138. Comments/Notes:
140. 
     
142. Please use this space to provide additional details about your home or business that might be important in the event of an emergency. Include information about pets that may reside at the location; or other concerns that may aid responding emergency officials.
144. Enter comments/notes here:
Leave This Blank:


145. Submit Submit and Print

* indicates a required field