What does the Smoke & Carbon Monoxide Alarm Verification Form do?

It lets an owner and tenant verify that required smoke and carbon monoxide alarms are installed in the dwelling and function properly after testing.

Who completes the alarm verification form?

The form provides signature lines for both the property owner and tenant. If the tenant is the owner, the form says to write “Same” on the tenant line.

Do I need a notary for the Smoke & Carbon Monoxide Alarm Verification Form?

No. The form does not require notarization; the owner and tenant sign and date an affirmation under penalty of perjury.

How do I submit the alarm verification form?

The form lists City of Escalon Development Services at 2060 McHenry Avenue and gives Fax 209.691.7439, but it does not specify a submission method.

Escalon, CA · San Joaquin County

No notary required

Smoke & Carbon Monoxide Alarm Verification Form

Property owners and tenants use this form to verify that required smoke and carbon monoxide alarms are installed and tested in an existing dwelling.

What this form is

This voluntary verification form lets an owner and tenant affirm that required smoke and carbon monoxide alarms have been installed and tested in an existing dwelling. It relates to permitted alterations, repairs, or additions exceeding $1,000 in value; a building inspector can verify the alarms during the inspection process instead. The form asks for the dwelling address, owner and tenant names, and both signatures and dates.

Who needs it

An owner and tenant who choose the voluntary verification option complete the form for a dwelling where the stated alarm requirements apply.

How to submit it

The form names City of Escalon Development Services and lists 2060 McHenry Avenue, Escalon, California 95320, and Fax 209.691.7439; it does not state how to submit the verification.

About notarization

This form is signed and dated without a notary; the owner and tenant affirm under penalty of perjury that the required alarms are installed and tested.

How to submit this form

1
Download The Form
Download the Smoke & Carbon Monoxide Alarm Verification Form.
2
Complete The Form
Enter the owner and tenant names and the dwelling address; the tenant writes “Same” if also the owner.
3
Check Alarm Installation
Confirm the required alarms have been installed and tested as described on the form.
4
Sign And Date
Both signature lines must be completed and dated.
5
Contact Development Services
The form lists City of Escalon Development Services and its address and fax; it does not specify how to submit the verification.

Frequently asked questions

What does the Smoke & Carbon Monoxide Alarm Verification Form do?: It lets an owner and tenant verify that required smoke and carbon monoxide alarms are installed in the dwelling and function properly after testing.
Who completes the alarm verification form?: The form provides signature lines for both the property owner and tenant. If the tenant is the owner, the form says to write “Same” on the tenant line.
Do I need a notary for the Smoke & Carbon Monoxide Alarm Verification Form?: No. The form does not require notarization; the owner and tenant sign and date an affirmation under penalty of perjury.
How do I submit the alarm verification form?: The form lists City of Escalon Development Services at 2060 McHenry Avenue and gives Fax 209.691.7439, but it does not specify a submission method.

Need something notarized?

This Smoke & Carbon Monoxide Alarm Verification Form doesn’t need a notary — but if you have another Escalon form that does, a commissioned online notary can help.