Account Number (CS#)__________________



Account Number (CS#)_______________________

NEW ACCOUNT SET-UP FORM Date:

Name:_______________________________________ Dealer:_____________________________

Address:_____________________________________ Signature:___________________________

_____________________________________ Premise#1: ( )____________________

City/State/Zip:_________________________________ Premise#2: ( )____________________

Residential Commercial

Supervised Timer Test (additional charges): Daily Weekly Monthly (no charge)

Password(s) ________________ & _________________

Panel Type/Format:__________________________ Template:___________________________

DSC Connect 24: GSM model_________________ Sim card #:______________________________

DSC Connect 24: Cell usage rate: 25msg (backup) , 100msg (primary) , 4mg (UL Fire)

Alarmnet: Must be setup as a dealer with us first and be issued a City/CS code and account block before directly contacting to setup GSM/IGSM/IP/TotalConnect

Emergency Numbers:

PD Dispatch Agency Name:________________________ Phone#: ( )____________________

FD Dispatch Agency Name:________________________ Phone#: ( )____________________

Responsible Party Contact Information:

Name: Phone#: PA/User#:

1. _________________________________ ( )______________________ __________

2. _________________________________ ( )______________________ __________

3. _________________________________ ( )______________________ __________

4. _________________________________ ( )______________________ __________

5. _________________________________ ( )______________________ __________

6. _________________________________ ( )______________________ __________

7. _________________________________ ( )______________________ __________

8. _________________________________ ( )______________________ __________

Comments:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Page 1 of 3

Account Number (CS#)_______________________

NEW ACCOUNT SET-UP FORM Date:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Code: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Zone: Signal State: A-alarm T-trouble R-restore Location of device:

Audible? Response or Event:

Account to be activated upon data entry completion. Keep account inactive

Place active account on test until: Date:_________________ Time:__________________

All Signals.

List: ____________________________________________

Page 2 of 3

Account Number (CS#)_______________________

NEW ACCOUNT SET-UP FORM Date:

Supervised Hours of Site (additional charge):

Open Early/Late Window Close Early/Late Window

Monday _______ _______ _______ _______

Tuesday _______ _______ _______ _______

Wednesday _______ _______ _______ _______

Thursday _______ _______ _______ _______

Friday _______ _______ _______ _______

Saturday _______ _______ _______ _______

Sunday _______ _______ _______ _______

Fail to Open: Yes or No Fail to Close: Yes or No

Passcard/User:

Name: Passcard# User#

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

______________________ ________ ______

Dealer Signature: __________________________________ Date:___________________________

Page 3 of 3

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