Business Information Update Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required BUSINESS INFORMATION Business Name * Address * City * State * Texas Phone * After Hours Phone * Business Fax Is there an ALARM SYSTEM? (Check if YES) OWNER INFORMATION Owner(s): First Name * Owner(s): Last Name * Email Address * Your email address is required to submit this form. This information is only for the filing of this data. Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Phone * Alternative Phone * ADDITIONAL KEY-HOLDER INFORMATION (Not Owners) Alternate Person To Contact 1: Full Name Phone Alternate Phone Alternate Person To Contact 2: Full Name Phone Alternate Phone Alternate Person To Contact 3: Full Name Phone Alternate Phone Notice: Business Owner: This form is used by Police and Fire Personnel for emergencies and alarm response notification. All information provided is confidential and not disseminated to the public. For any questions or concerns, contact Kimberly Gordon, Communications Manager at 903-845-2166 or email kgordon@cityofgladewater.com
