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2021 Alarm Business License Application

2. The City of Shaker Heights Alarm Ordinance, Chapter 503, provides standards and regulations applicable to alarm businesses. Any alarm business working in Shaker Heights must be licensed, regardless of the size of the company or the number of customers or subscribers. Failure to comply with Chapter 503 may result in termination of the Alarm Business License.
4. This application must be received no later than January 15, 2021. The license fee of $300 must be received no later than January 31, 2021. If application, payment and customer list is not received by said date, you will be subject to a $50 penalty. Alarm business license will be valid from February 1, 2021 to February 1, 2022.
6. The following items are required when applying for an alarm business license.
   1. Alarm business application (this form)
   2. $300.00 license fee (an invoice will be issued upon receipt/approval of this application)
   3. A complete customer list (to be attached to this application)*
8. *As a condition to the continuing validity of the license, an updated list of names and addresses or your subscribers must be submitted on a monthly basis.
10. Business Information
12. Name of Business*
13. Contact Person*
15. Phone*
16. Street Address*
18. City*
19. State*
20. Zip*
22. Contact Person's Email*
24. Other Preferred Email (if applicable)
26. Business Classification*

    1. Proprietorship

    1. Partnership

    1. Corporation

    1. LLC
28. Proprietorship - Owner Name
29. Phone Number
30. Phone Number (alternate)
32. Street Address
34. City
35. State
36. Zip
38. Partnership - Provide list of partners
    List must include name, address and phone number.
40. Corporation - state where incorporated
42. Customer List
    List must include all names, addresses and phone numbers of all persons in the City to whom and for whom alarm systems have been sold and/or installed and who are currently under contract for services.
44. Upload customer list*
46. Criminal Information
    Provide list of criminal convictions (except traffic) of applicant, each partner, officer, local office manager, and/or employee acting in the capacity of alarm agent. Must include name, date of conviction, state, charge, court, and case number
48. Upload criminal information list.
50. Certification
52. I do hereby certify that I will comply with the requirements of Chapter 503 including the following:
    1. I shall maintain a description of the alarm systems and devices offered for sale or lease to the public, and a description of any services related to alarm devices offered to the public, and a description of any services related to alarm devices offered to the public.
    2. Upon receipt of notice of approval of an Alarm Business License AND each month thereafter, I will deliver to the Chief of Police, c/o the Support Services Bureau for the City of Shaker Heights, a complete list of names and addresses of all persons in the City to whom or for whom alarm systems have been sold and/or installed and who are currently under contract to the alarm business for services; and,
    3. I will inform the Shaker Heights Police Department within ten (10) days after any substantial change in the information required in this application.
54. I declare that I have examined this application, including any attachments thereto, and I affirm to the best of my knowledge and belief that the information is true, correct and complete, and I understand that any false information shall be considered sufficient cause to void this application and may result in a denial or revocation of the License and/or further legal action.
56. Name*
57. Title*
59. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
61. Electronic Signature*
63. If you have any questions regarding this application, contact Patricia Matteucci at 216-491-1225, or patricia.matteucci@shakeronline.com.
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

* indicates a required field