Owner's Insurance Premium Credit Request - First Alert ReadyGuard-R User Manual

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:
First Alert's ReadyGuard-R
Type of Alarm: Burglary
Installed by:
B. NOTIFIES (Insert B = Burglary, F = Fire)
Local Sounding Device
Central Station Name:_______________________________________________________________________
Address:
Phone:
C. POWERED BY: A.C. With Rechargeable Power Supply
D. TESTING: Quarterly
Other _______________________________
Name
Address
Police Dept.
Monthly
continued on other side
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Policy No.:
Fire
Serviced by:
Fire Dept.
Weekly Other
Both
Name
Address