Florence Police Department Trespass Authorization Form

Florence Police Department Trespass Arrest Authorization

With my name and information entered below, I certify that I am the owner/owner’s agent/person in lawful control of the below listed property. I request and authorize the Florence Police Department to enter my property and enforce Arizona Revised Statutes 13-1502, 13-1503, and 13-1504 and their entirety, with respect to all persons loitering on the property not conducting legal business.

Effective date:*

Property Address:*

Type of Property:*

Residential

Commercial

Number of Units:*

Commercial Type:*

Posted Property:*

Signage Posted on Property

Un-Posted Property

By checking this box below, I certify the above listed property has been posted with “No Trespassing” signs that indicate violators will be prosecuted.

I certify that this property has been posted with "No Trespassing" signs.

By checking this box below, I authorize the Florence Police Department, pursuant to ARS 13-1502 and its entirety, to advise anyone who is not a resident, guest, patron, or visitor to leave my property to not return for 30 days; and to arrest such person if they return within 30 days.

I authorize Florence Police Department to follow the above statement.

My authorized agent or I will cooperate fully in prosecution with anyone who is arrested for a violation of any local ordinance, or state law, including trespass.

I Agree

The manager or person primarily responsible for the aforementioned property is:

First Name:*

Last Name:*

Primary Phone Number:*

Secondary Phone Number:

Address of Manager/Responsible Person:*

Property owner/owner’s agent/person Information:

I am both the owner and primary responsible person of this property.

First Name:*

Last Name:*

Phone Number:*

Address of Property Owner:*

Email:

Date:

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