KEYHOLDER’S INFORMATION - RESIDENTIAL ACCOUNT Maximum Risk Protection Doc No: TD-002 Compiler: Member J.J Swarts Rev (Amdt) No: 6 Approving Officer: Member J.J Swarts Effective Date: 25/09/2014 CLIENT SURNAME : FULL FIRST NAMES : NICK NAME : STREET ADDRESS : POSTAL ADDRESS : CODE : PREMISES TEL. NR : E-MAIL : INSURANCE COMPANY : POLICY NUMBER : DOGS ON PREMISES: Yes No GATE KEYS/REMOTE: Yes No DOMESTIC WORKER/GARDNER: Yes No USER INFORMATION (PERSONS WITH ALARM CODES AND KEYS TO PREMISES) KEYHOLDER 1 : PHONE NR.: / KEYHOLDER 2 : PHONE NR.: / KEYHOLDER 3 : PHONE NR.: / KEYHOLDER 4 : PHONE NR.: / USER PASSWORDS (NOTE: PASSWORDS MUST NOT BE LONGER THAN 8 CARACTERS) USER 1 : PASSWORD : USER 2 : PASSWORD : USER 3 : PASSWORD : USER 4 : PASSWORD : MAID NAME : PASSWORD : GARDNER NAME : PASSWORD : PROTECTED AREA – ZONE DISCRIPTION 1. 9. 2. 10. 3. 11. 4. 12. 5. 13. 6. 14. 7. 15. 8. 16. TRANSMITTER CODE : INSTALLATION DATE : CONTROL PANEL : PROGRAM FORMAT : TRANSMITTER TYPE : GSM VHF PANEL LOCATION : SITE NUMBER :INSTALLERS NAME : RESPONSE TAG NO. : TAG LOCATION : TAG LOADED ON GUARDTRACK BY : SIGNATURE : LOADED ON WATCHMANAGER BY : SIGNATURE : By electronically submitting this document, I accept the terms and conditions as explained in this document. I agree to the contents of the document without applying my signature to it. I AGREE 3.15.221.67