First Alert FA142C Instrukcja Użytkownika Pobierz pdf (Strona 37)

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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 Professional

FA142C System

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 ___________________________________________

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First Alert FA142C Instrukcja Użytkownika Strona 37