2. City of Margate Alarm Application
4. Name (Resident/Business)*
5. If Corporation - President or business owner Name
7. Email Address
8. Main Point of Contact Phone Number*
10. Address*
12. City*
13. State*
14. Zip Code*
18. Alarm System Monitored by
20. Name of Alarm Company*
21. Phone Number*
23. Address
25. City
26. State
27. Zip Code
31. Emergency Contact Information #1
33. Name
34. Phone Number
36. Address
38. City
39. State
40. Zip Code
42. Emergency Contact Information #2
44. Name
45. Phone Number
47. Address
49. City
50. State
51. Zip Code
55. Is the registered location (please check one)*

    1. Commercial
    2. Duplex
    3. Single Family
    4. Multi-Family
56. Do you own or rent ?*

    1. Own
    2. Rent / Lease
57. Alarm Type:*

    1. Burglary
    2. Robbery
    3. Panic
    4. Fire
61. Please notify the Margate Police Department Alarm Coordinator of any changes in the above information at 954-935-5496. An alarm permit cannot be transferred to another person. City of Margate Ordinance 33-129 requires all businesses and residences with alarm systems to have valid alarm permits. Failure to complete and return this application with your fee for residential or for non-residential permits (check or money order payable to the City of Margate) will result in fines or court citations for non-permitted alarms. The permit holder must notify the Police Department in writing of any changes in the information on this permit.
63. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
65. Electronic Signature*
66. Date/Time*
    Date/Time

    Date/Time
Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

* indicates a required field