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Bristol Police Department - Online Alarm Registration Form

2. Instructions:
   Pursuant to the City of Bristol Ordinance Section 2.5, all residential and business alarms systems must be registered with the Bristol Police Department. The primary reason for the ordinance is to reduce the number of false alarms. After the third false alarm in a calendar year, the alarm owner will be fined $90.00 for each false alarm throughout the remainder of the year. All questions should be directed to the BPD Records Division (860) 584-3066.
4. REGISTRANT INFORMATION:
6. Full Name:*
8. Business Name:
10. Address / Alarm Location:*
11. City*
12. State:*
14. Mailing Address:
16. City
17. State:
18. Zip Code:
19. Phone:
21. Property owner (if different than registrant)
23. EMERGENCY CONTACT INFORMATION:
    If your alarm sounds, who can the PD contact?
25. 1. Full Name*
26. Relationship:*
    -- Select One --FamilyFriendNeighborOther
27. Phone:*
29. 2. Full Name:
30. Relationship:
    -- Select One --FamilyFriendNeighborOther
31. Phone:
33. 3. Full Name:
34. Relationship:
    -- Select One --FamilyFriendNeighborOther
35. Phone:
37. ALARM INFORMATION:
39. Alarm Type:*

    1. Burglar
    2. Panic
    3. Fire
    4. Other
40. Alarm Location:*

    1. Residential
    2. Commercial
41. Alarm is:*

    1. Silent
    2. Audible
42. Alarm Routing:*

    1. Central Station
    2. Audible Only
44. Other:*
46. Alarm Company Information:*
    If central station is checked, list name, address & phone number of the alarm company.
48. REGISTRANT TO READ & UNDERSTAND:
    By submitting this form, the registrant agrees to comply with the provisions of the City of Bristol Alarm Ordinance Section 2.5. The registrant also understands that he/she shall be accountable for false alarms, excluding those caused by severe weather. Warnings and fines shall be issued pursuant to the Bristol alarm ordinance.
50. Date Signed:*
    Date Signed:
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field