Authority to Arrest Trespassers

*denotes required field

City of Phoenix

Phoenix Police Department

(Precinct Name)

Authority To Arrest Trespassers

The undersigned owner, occupant, or designated agent for the premises known as: (Business Name)

Being a: (Check the following which apply)
Vacant Lot Parking Lot Business Common Area Vacant Residence Vacant Building Other

Located at: (one address per form)

In the City of Phoenix, Arizona, hereby authorizes the Phoenix Police Department to patrol the premises indicated above and arrest person/s trespassing pursuant to Arizona Revised Statutes sections 13-1501 through 13-1504. Trespassers include those who are not on the premises to visit or conduct lawful business with the management or a resident of the premises. A person commits Criminal Trespass by knowingly: 1) entering or remaining unlawfully on any real property after a reasonable request to leave by the owner or any person having lawful control over such property, or 2) are on the premises after a reasonable notice prohibiting entry. This authority applies 24 hours a day.

The undersigned agrees to cooperate fully in the prosecution of person/s subsequently arrested for trespassing violations occurring on the premises. Trespassing signage must be posted on the property.

This form is valid from the date of signature for one year. Any changes in ownership or management must be noted to the police department as soon as possible.

Dated:

TERMS OF ACCEPTANCE AND SIGNATURE

Owner, Resident, or Designated Agent

I, the [Owner, Resident, or Designated Agent] for this premises, warrant the truthfulness of the information provided on this Authority to Arrest form. Electronic Signature (Please type your first and last name)

Title

Date of Birth

Mailing Address

City

State

Zip Code

E-Mail Address

Cell Phone

Work Phone

I understand that by checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

Phoenix City Hall
200 W. Washington Street
Phoenix, AZ 85003Map

Main 602-262-6011

TTY 602-534-5500

Phone Directory

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