HUE & CRY,
Inc.
commercial -
Subscriber Information Form
Account Number: _______________________
Account Name:__________________________________ Contact Name:______________________________
Address:______________________________________________ Cross Street:__________________________
Premise Phone Number: (_______)__________________
Fax Number: (_______)___________________
Emergency Contacts - Please list at least three people who can be contacted in the event of an alarm.
1) Name: _____________________________
Title: ____________________
Pass code: _________________
Cell Phone Number: (________)_________________ Home Phone Number: (_______)_________________
2) Name: _____________________________
Title: ____________________
Pass code: _________________
Cell Phone Number: (________)_________________ Home Phone Number: (_______)_________________
3) Name: _____________________________
Title: ____________________
Pass code: _________________
Cell Phone Number: (________)_________________ Home Phone Number: (_______)_________________
Employee List / Authorized People On site - Aside from the emergency contacts, please list all people
authorized on site. Those who are not on the authorized list will have to be verified through emergency
contacts. In some cases, we will have to dispatch if we are unable to reach a responsible person.
Name: ______________________________ Title: ________________________ Pass code: _________________
Name: ______________________________ Title: ________________________ Pass code: _________________
Name: ______________________________ Title: ________________________ Pass code: _________________
Name: ______________________________ Title: ________________________ Pass code: _________________
Name: ______________________________ Title: ________________________ Pass code: _________________
Name: ______________________________ Title: ________________________ Pass code: _________________
Please advise authorized users to be extremely careful about revealing pass codes or 4-digit codes .
Please list any special request in which you would like your alarms handled: ________________________
_____________________________________________________________________________________________
*** Please note: Unless your account instructs otherwise, Central Station will follow the regular alarm procedures.
If you are unsure what these procedures are, please call 800.762.3196 and speak with a dispatcher.
Business Hours - Please list business hours and dates you will not be open.
Sun
Mon
Tues
Wed
Thurs
Fri
Sat
Open:
Close:
Dates Closed: (ex: holidays)
Authorized By: ___________________________ Date____________________
Insurance Company : _________________________ Agent: __________________ Policy #: _______________
Address: __________________________________________ Fax Number: (_________)___________________