ALARM MONITORING SERVICE AGREEMENT
-UPDATESUBSCRIBER INFORMATION:
DATE :
NAME:_____________________________________________ BILLING NAME:___________________________________
PHYSICAL ADDRESS:_______________________________ ATTN:_____________________________________________
____________________________________________________ ADDRESS:_________________________________________
CITY:_____________________ZIP:______________________ CITY:__________________________ZIP:________________
ACCOUNT # __________ RECEIVER # ________
*NOTE: (If your alarm account number isn’t completed this update can not be used)
DEALER:
LEFLER’S ELECTRONICS, INC
2610 OAKVIEW DRIVE SW
CONCORD, NC 28027
PHONE: 704-784-1022 FAX: 704-784-2406
AUTHORIZED INDIVIDUALS TO BE NOTIFIED
(PLEASE LIST BELOW IN ORDER OF PRIORITY OF NOTIFICATION IN THE EVENT OF AN ALARM
CONDITION. CALLS ARE MADE IN SEQUENCE OF PRIORITY UNTIL CONTACT IS MADE.) IF YOU DO
NOT WISH TO MAKE ANY CHANGES, PLEASE DISREGARD THIS UPDATE. AGAIN TO MAKE YOUR
UPDATES VALID YOUR ALARM ACCOUNT NUMBER MUST BE COMPLETED ABOVE.
NAME:
AREA CODE / PHONE NUMBER
1. _____________________________________________________ ___________________________________________________
2. _____________________________________________________ _____________________________________________________
3. _____________________________________________________ _____________________________________________________
4. _____________________________________________________ _____________________________________________________
5. _____________________________________________________ _____________________________________________________
6. _____________________________________________________ _____________________________________________________
7. _____________________________________________________ _____________________________________________________
CONTACT PERSONS: Someone who has the authority to make changes on your account.
1. ________________________________________ 2._________________________________
By: _______________________________________Date: ______________________________
SUBSCRIBER SIGNATURE
NOTE: If you do not have a yard sign stating that your location is protected by a Lefler
Electronics Alarm System, and you would like one, Please Call 704-784-1022 or make a note on
this update form and we will be more than happy to bring one out to your Home / Business.