2. Please mail or drop off payment within 7 business days:

   Universal City Police Department, Attention: Alarm Section, 2150 Universal City Blvd, Universal City, TX  78148

4. Type Of Occupant*

   1. $10.00 - Residential
   2. $25.00 - Commercial
5. Name of Occupant(s)*
6. Drivers License # / State*
7. Same Occupant/Billing Address*

   1. Yes
   2. No
9. Street Address (Universal City, TX 78148)*
10. Billing Address, If different
12. Cell Phone
13. Home Phone
14. Work Phone
16. Monitoring Company Name
17. Monitoring Phone Number
19. Contacts:

    The below named individual(s) can be contacted and respond within 20 minutes of activation.

21. 1) Primary Person

    1. Same as Occupant
23. Name
24. Cell Phone
25. Home Phone
26. Work Phone
28. 2) Secondary Person
30. Name
31. Cell Phone
32. Home Phone
33. Work Phone
35. 3) Third Person
37. Name
38. Cell Phone
39. Home Phone
40. Work Phone
42. Remarks: (Indoor/Outdoor Pet(s), Swimming Pool, High Fence, etc.)
Leave This Blank:


44. Submit Submit and Print

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