DACT Questionnaire Question Title * 1. • Incident ID Number (Whatever means you wish for internal identification of this specific event) Question Title * 2. Date of incident Question Title * 3. City and state of incident for customer premise Question Title * 4. City and state of receiving central station Question Title * 5. Time of incident, including time zone (ET, CT, PT, other) Question Title * 6. 10-digit originating phone number (the phone number of the panel at premise in question (xxx) xxx-xxxx) Question Title * 7. Is the panel dialing a DID (local number) or toll free number? Local Toll free Question Title * 8. Is the number that the panel is dialing being RCF (Remote Call Forwarded) or pointed to another number (DID)? RCF DID Question Title * 9. Description of the incident (Include your incident ID number and use your own words to describe what you believe happened) Question Title * 10. Communication format being used SIA Contact-ID 4+1 4+2 3+1 DMP ITI Bosch Other (please specify) Question Title * 11. Type of Alarm Fire Burglary Panic Medical Other (please specify) Question Title * 12. Central Station Receiver being used for this account Sur-Gard Bosch DMP Ademco Osborne/Hoffman ITI Other Question Title * 13. If available, email Sur-Gard debug file or any .wav file recording of the event to DACTsurvey@csaaintl.org. Please include your incident ID number in the text of the email so that the file can associated with your questionnaire response. Are you emailing a sound file? Yes No Question Title * 14. Telephone provider of the central station service on which the incident occurred AT&T Verizon CenturyLink Level 3 Other (please specify) Question Title * 15. Telephone provider at the customer premise if known AT&T Verizon CenturyLink Windstream Other (please specify) Question Title * 16. Manufacturer of the panel installed Honeywell/Ademco GE Bosch DMP ITI DSC Napco Other (please specify) Question Title * 17. Model number of the panel installed, if known Question Title * 18. Your name, company, and email address (so we can contact you with follow up questions) Done