Alarm Form

Night Call

Please provide 3 to 4 night call names and phone number to be contacted in case of emergency or security concern situations. Please list in order that you wish them to be contacted.
If you have a security alarm installed in your business please give us the name and phone number of the company.
***If there are any hazmat materials in your business, check here: *
Name and Signature of person filling out this form
Submitting this form will send a copy to the Madison County Sheriff and to the email address filled in above. You may print a copy for your own records after submittal.