UCONTROL CUSTOMER CARE
Alarm Activation Questionaire

Please take you time and fill out all of the required fields.  It is best to complete this information ahead of the the installation so that there is less of your valuable time taken by completing paperwork at the completion of the installation.  Please feel free to call us with any questions you may have.  All fields marked "*" are required.  Please keep in mind that you will be asked for a valid picture ID and your social security card for verification purposes.  Thank you and we hope that your experience with UControl will be pleasant and exceed your expectations.

First Name:*
Last Name:*
Address Street 1:*
Address Street 2:
City:*
Zip Code:* (5 digits)
State:*
Daytime Phone:*
Evening Phone:
Email:*
Drivers License Number:*
Central Station Password:*
4 Digit Arm/Disarm code:*
Comments:
Social Security #:*

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