First Alert FA145C Manuel d'utilisateur télécharger pdf (Page 37)

– 37 –

OWNER'S INSURANCE PREMIUM

CREDIT REQUEST

This form should be completed and forwarded to your homeowner's insurance carrier for possible premium credit.

A. GENERAL INFORMATION:

Insured's Name and Address: ____________________________________________________________________________

____________________________________________________________________________

Insurance Company: __________________________________ Policy No.: _______________________________________

First Alert System: Model FA145C

Type of Alarm: Burglary Fire Both

Installed by: ______________________________________ Serviced by: ________________________________________

name name

______________________________________ ________________________________________

address address

B. NOTIFIES (Insert B for Burglary, F for Fire, where appropriate):

Local Sounding Device _________ Police Dept. ___________ Fire Dept. __________ Central Station __________

Name and Address: ____________________________________________________________________________________

C. POWERED BY: A.C. With Rechargeable Power Supply

D. TESTING: Quarterly, Monthly, Weekly, Other_____________________________________________

continued on other side

1 2 ... 32 33 34 35 36 37 38 39 40 41 42 43 44

Pas de commentaire

First Alert FA145C Manuel d'utilisateur Page 37