AMERITECH AM100 User Manual page 48

OWNER'S INSURANCE PREMIUM CREDIT REQUEST (cont.)
E. SMOKE DETECTOR LOCATIONS
Furnace Room
Basement
F. BURGLARY DETECTING DEVICE LOCATIONS:
Front Door
1st Floor Windows
All Accessible Openings, Including Skylights, Air Conditioners and Vents
G. ADDITIONAL PERTINENT INFORMATION:
Signature:
Kitchen Bedrooms
Living Room Dining Room
Basement Door Rear Door
All windows nterior locations
I
Date:
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Attic
Hall
All Exterior Doors