trespass_noticeWhite – Police Report Yellow - Served Copy Pink - Manager/Tenant Copy Rev. 02/12
TRESPASS NOTICE
AUTHORIZED BY FRIDLEY CITY CODE CHAPTER 129
TO:
Name:
Date of Birth:
Address:
(Printed name of parent/guardian if person is under 18)
Specific conduct that forms basis for notice (include time, place, and circumstances):
Date of conduct: ________________________
You are prohibited from entering the following premises, including all grounds, outbuildings, parking areas, drives, and
sidewalks thereto (premises address):
(√ if applies) This notice includes areas under control of tenants. THE TENANTS OF THE PREMISES ARE
PRECLUDED FROM INVITING ONTO THE PREMISES ANY PERSON TO WHOM A TRESPASS NOTICE HAS
BEEN ISSUED.
This notice is in effect __________________________ and expires at 12:01 a.m. on _______________________.
Date: Date:
(must be within 30 days of the date of conduct) (up to one year from effective date)
Person to contact with respect to modifying, amending, or rescinding this notice:
Name: Title:
Address:
Phone Number:
(if not served by police officer) I verify that I personally handed a copy of this notice to the above person on the above
date (specify if different______________________). (Print and sign name)_____________________________________
(At least one of the following must be completed:)
Subscribed to and sworn before this ______ day of __________, 20___, (Notary Seal)
______________________________________ (Notary Public)
I acknowledge receipt of this notice _________________________________________________________________
(Signature is voluntary; parent/guardian should also sign if person is under 18)
or
Served by Police Officer _______________________Badge No. _______________ ICR _______________________
(May be served by police only authority of property manager or tenant.)
FRIDLEY CITY CODE PROVIDES:
Section 129.05. Prohibited Conduct.
1. No person shall trespass in or upon any covered premises of another and, without claim of right, refuse to depart
therefrom on demand of the property manager, or a tenant authorized to exercise control over the covered premises or
portion involved.
2. No person served with a trespass notice in conformity with this Chapter shall enter in or upon the premises
described therein during its effective period without the written permission of the notice issuer, agent or assign.
3. No person shall enter any public facility, utility, or grounds thereto, or any covered premises or portion thereof in
violation of conspicuously posted signs prohibiting or restricting access thereto, including, but not limited to, the
following: "No Trespassing", "Authorized Personnel Only", "Private", "Employees Only", "Emergency Exit Only".
Section 129.06. Violations. Any person violating any of the provisions of this Chapter is guilty of a misdemeanor.