24 Hour Central Station Monitoring
Alarm Monitoring Information Form
Please provide the information below so that we can transfer to a
Your alarm panel must be connected to a POTS (Plain Old
Dealer Name (if applicable)
Receiver/Account Number
(if known)
Name (Last, First)
Street
City
State
Zip
Email Address
Location Telephone Number
This is the telephone number the
Central Station will call to
"verify" the alarm before dispatch
Panel Telephone Number
This is the telephone
contacted to the panel - may
be the same as Location
Telephone number.
Alarm Panel Model
Special Instructions
Passcode/Password
This is the passcode you
will give to the Central
Station to
prove you are
the subscriber.
Special Options
(commercial)
Open/Close Reporting
24-Hour Supervised Test
GSM
MAC - Located on GSMVLP box
Special Options
(cellular)

Zone Number
Zone Description
Police
Fire
Zone 1
Zone 2
Zone 3
Zone 4
Zone 5
Zone 6
Zone 7
Zone 8
Zone 9
Zone 10
Zone 11
Zone 12
Zone 13
Zone 14
Zone 15
Zone 16
Zone 17
Zone 18
Zone 19
Zone 20
Zone 21
Zone 22
Zone 23
Zone 24
Zone 25
Zone 26
Zone 27
Zone 28
Zone 29
Zone 30
Zone 31
Zone 32
Zone 33
Zone 34
Zone 35
Zone 36
Zone 37
Zone 38
Zone 39
Zone 40
Zone 41
Zone 42
Zone 43
Zone 44
Zone 45
Zone 46
Zone 47
Zone 48
Zone 49
Zone 50
Zone 51
Zone 52
Zone 53
Zone 54
Zone 55
Zone 56
Zone 57
Zone 58
Zone 59
Zone 60
Zone 61
Zone 62
Zone 63
Zone 64

Subscriber Contacts
These are the people (may be yourself) that the Central Station will attempt to reach should
your panel signal an alarm.
Contact Name 1
Telephone Number
Contact Name 2
Telephone Number
Contact Name 3
Telephone Number

Authorities
Please provide the telephone numbers for your local authorities.  Do NOT use 911.
Police Department
Telephone Number
Fire Department
Telephone Number
Medical
Telephone Number

We will snail-mail you a hardcopy of the
Central Station Monitoring Agreement for
signature based upon the information you
have provided.

Copyright 2011
Vanguard Security Corporation
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