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<br /> RESIDENTIAL SERVICES CONTRACT �
<br /> 5104UE12 �
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<br /> GONTRACT I CUSTOMER JOB � LEAD � �
<br /> DA7E L��'t I�� ACCOUNT NO • NO SOURCE �
<br /> � � � I
<br /> ADT Seturity Services, Inc (`ADT") �ytomer Name �
<br /> Offlce Address ('�ustomer" a"I" or "me' or "my') j
<br /> —�ls'�t� �,�=�.,9�' !
<br /> 5 �°�`��' � i
<br /> ,�i�!��� ��h•7��'Address �
<br /> �
<br /> �� ��r�.� !
<br /> aty �
<br /> �,�`�--��'-'�'��',�' i �!��� �
<br /> i Siate � ZIP 1�1�r�� Tax Exempt No. i
<br /> � � ��.� I
<br /> Protected Premises' ����///��,�"""
<br /> � Telephone �!�� Tax Explre Date i
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<br /> ci�Traditional Phone O Other (Qualified) O Other (NonQualifled) I
<br /> www.MyADT.com �
<br /> 1.800.ADT.ASAPm Rlternate �
<br /> (1.800.236,272� � Telephone 1 O Home C�►Cel1 O Work i
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<br /> IF FAMILIARIZATION PERIOD IS � Altemate �
<br /> /'1 REJECTED INITIAL HERE Telephone 2 C7 Home O Cel! Owork f
<br /> t J (see Paragraph 14 of the Term: and i �
<br /> � Conditions for explanation) EMAIL
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<br /> � Communications AuthorizatiOn: I authorize ADT to provide me with information and updates aboutthe security system and new ADF and third-party I
<br /> products and services to the contact information provided by me. I may unsu6scri6e or opt out by ema(Iing donotcontaR�ADT.com or by calling �
<br /> 888.DNC4ADT (8883624238). Initial here �
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<br /> ConNrmation of AppoiMmeMS; I authorize ADT to ca11 me using an automated calling device to de�nrer a pre-recorded message to seVconfirm �
<br /> �� appointmerrts and provide other irrFormation and notices about xhe alarm ryrtem at the telephone number(s) provided by me. Initial here I
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<br /> Alarm System Ownership: � CustomervOwned � ADT-Owned �
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<br /> I ACKNOWLEDGE AN6 AGREE TO EACH OF THE FOLLOWING: (A) THIS COIYTRACT CONSISTS OF SIX (b) PAGES. BEFORE SIGNING THIS CONTRAG7,1 I
<br /> n HAYE READ, UNDERSTAND AND AGREE TO EACH AND EVERY TERM OF 7HI5 CONTRACT, INCLUDING BUT NOT UMITED TO P1iRAGRAPHS 5 AND 18 OF I
<br /> \! � TNE TERMS AND CONDffIONS. (B) THE INITIAL TERM OF THIS CONTRACT 15 THREE (3) YEARS. (Q ADF IS NOT A SECURRY CONSULTANT AWD CANHOT I
<br /> V ADDRE55 ALL OF MY POTENTIAL SECl1RITY NEEDS. ADT HAS EXPLAINED TO ME THE FULL RANGE OF EQUiPi1AENT AND SERYICES 7HA7 AD7 CAN �
<br /> 1 PICOVIDE ME. qDpRIONAL EQUIPMENT AND SERVICES OVER THOSE IpENTSFIED !N THIS CONTRACI' ARE AVAILABLE AND MAY BE PURCHASED FROM i
<br /> �J ADT AT AN ADDITIONAL COST T6 ME. I HAVE SELECTED AND PURCHASEp ONLY THE EQUIPMENT AN� SERVICES iDE1dT1F1ED iN THIS CONTRACI; (D) NO I
<br /> _\ AtARM SYSTEM CAN PROVIDE [OMPLETE PRO7'ECTION OR GUARAMEE PREVENTION OF LOSS OR iNJURY. FlRES, FLOODS, BURylARiES, ROBBEpIEi, I
<br /> �� MEDICAL PROBLEMS /YNO OTHER INCILIENTS ARE UNPREpICfABLE ANp CANNOT ALWAYS BE pEfEC'[EQ OR PREVENTED BY AN ALARM SYSTEM. I
<br /> �'� HUMAN ERROR IS ALWAYS POSSIBLE, AND THE HESPONSE TIME OF AOLICE, FlRE /WD MEDICAL EMERGENCY PERSONNEL IS OUiSIOE THE GOWTRO� I
<br /> � OF ADT. ADT MAY NOT RECEIVE ALARM'SIGNALS IF COMMUNICAT10N5 OR POWER IS INTERRUPTED FOR ANY RFASON, (E) ADT RECOMMENDS 7HAT 1 l
<br /> MANUALLY TEST THE ALARM SYSTEM MONTHLY APID ANY TEME I CHAtdGE TELEPHONE SERVICE, BY CAWN6 1.SOO.ADT.ASAP OR BY LOGGING IN TO f
<br /> WVYW.MYADT.COM. (fJ THtS CONTRACT REQUIRES FfNAL APPROVAL BY AN ADT AU7HORIZED MANAGER SEFORE ADT MAY PROVIDE ANY EQUIPMENT i
<br /> OR SEitVICES, AN6 IF APPROVAL IS DENIED, THEN THIS COI�TRACT YUILL SE TERMINATBb, AtJD ADTS OIdLY OQLIGATIOl1 WILL BE 70 NOTIFY ME Of I
<br /> �� SUCH TERMINATION AND REFUND ANY AMOUNTS i PAID IN ADVANCE. �
<br /> � ADT Representative Name � i
<br /> � � Rep. License No. Re �. ?�/♦ I
<br /> � �� � (tf Repuired? tD Ido. ����Q� t '�•�
<br /> � Customer's Approva�: Origlrial Signature Required (Nlust mat� Cusmmer IVame in Sectlon 1 abm�+e) f � ' !
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<br /> � 'C.v CC. ' JZ�"✓Y� � �-C��% ��"''�j/�� �
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<br /> NOTICE OF CANCELLAT10111 �
<br /> 1, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TiME PRIOR TO MIDNtGHT OP THE TH1RD BUSINE55 DAY j
<br /> APTER THE DATE OF THIS TRANSACTION. 5EE THE,pTTACHED NOTICE OF CANCELLATION fORM POR AN EXPLANATION I
<br /> Of THIS RIGHT. I ACKNOWLEDGE. BEING VERBALLY INFQRMED OF MY RIGHT TO C,4AICEL AT THE TIME OP EXECUTION i
<br /> OF TH15 CONTRACT AND RECEIPT OF THiS NOTICE. �
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<br /> FiNANC1AL DISCLOSURE STATEMENT
<br /> �!__ THERE I$ NO PINANC C HARGE OR C OF C REDIT'(0 % APR) A SSOQATE D WITH T HIS CO NTRqCT, 1
<br /> A: N�MBER OF � /{� y /���"� ,y ��. - J
<br /> PAYMENTS FOR THE , g,��NT OF EACH PAYMENT IS ��� f � TOTAL Of PAYMENTS FOKTHf INITtAL TERM IS ��L� v� I
<br /> INITIqL TEAM IS 36. �(rOTAL MONTHLY SERVICE CHARGE FROM BELOUVh � T��ES 8.) (EXCLUSlVE OF ANY APPLICABLE TAXES, FEES, F1NE5 I
<br /> �______ { AND RATE INOtEASES} �
<br /> LA1'E CHARGE-PAYRAFNT IS DUE PURSUANTTO MY SELECTED BIWNG -�� � � �
<br /> FREQUENGY, PRIOR TO THE STqitT OF SERVICE MY FlRST BIWCHARGE WILL i PREPAYMENT - IF I PREPAY THE � SEE SECTIONS 2, 7, 15 AND �
<br /> BE SENT/MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IIIAPOSE A 7aTAL aF PAYMENTS PRIOR FO � 19 OF TH{S CONTRACT FOR �
<br /> ONE-TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) ZHE END OF THE INFi1AL TERAA � AppITIONAL lNFOIiAAA'11pN
<br /> DAYS }'AST DUE, UP TO THE MAXIMUM AMOUNT PERMITfED BY U►W, $UT �N OF THIS CONTRACI;'THERE t5 NO ABOUT NONPAYMENT, DEFAULT �
<br /> NO EVENT WILL TH[S AMOUNT EXCEED�S5.00. 4 PENIALTY OR REFUND. . ANO A[6ELERATION. i
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