BILL'S LOCK & KEY - Restricted Key Authorization

NAME.

BUSINESS NAME

STREET ADDRESS SUITE/APT/SPACE/OTHER

CITY STATE ZIP

PHONE EXT PHONE EXT

FAX EMAIL

Corporation Partnership Individual Owner
NAME/S OF OWNER/S OR OFFICERS
THE FOLLOWING WILL BE AUTHORIZED ON THIS ACCOUNT

PLEASE LIST ONLY THOSE THAT YOU WOULD LIKE AUTHORIZED
TO HAVE "DO NOT DUPLICATE" OR "RESTRICTED" KEYS MADE
IT IS YOUR RESPONABILTY TO UPDATE THIS INFORMATION

PLEASE READ CAREFULLY BEFORE SIGNING

* Only those people that you have listed above will be authorized to have "Do Not Duplicate" or "Restricted" keys made for the above address.
* It is your responsibility to notify Bill's Lock & Key (in writing) of any changes on this account.
This includes: Selling the home/business or change in management. Bill's Lock & Key will not be responsible for information that has not been updated.

BUSINESS NAME

AUTHORIZED SIGNATURE ________________________________________ DATE ____/____/____
PRINT NAME TITLE

PLEASE MAIL COMPLETED APPLICATION TO:
BILL'S LOCK & KEY - 70-875 DILLON ROAD S-23 - DESERT HOT SPRINGS, CA 92241
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