Trespass Letter of Consent Application: For Residential Property

Before You Begin:
In order for your application to be processed, please select your whether this is an initial or renewal application

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Please Select One: *

Initial Application

Renewal Application

Owner Name: *

Date of Birth:

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Property Address: *

City, State, Zip Code: *

Cell Phone: *

After Hours Phone: *

Mailing Address, if different than above:

City, State, Zip Code:

Business Phone Number:

Home Phone:

E-mail address: *

Secondary Contact Name for Applicant: *

Secondary Contact Cell Phone for Applicant: *

Secondary Contact Home Phone for Applicant:

Secondary Contact Date of Birth for Applicant:

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By affixing my signature to this document I am identifying myself as the responsible party for the property listed above. I affirm and attest that the information provided in this document is true and accurate to the best of my knowledge, and do hereby designate each and every police officer employed by the City of Dallas as my agent and representative for the purpose of enforcing ORS 164.245 of the Oregon Revised Statutes.

I further understand and agree that as the responsible party for the property, I will: Appear in a court of law for any proceedings related to the enforcement of this TLC. Notify any other occupants or tenants of my participation in the TLC program. Immediately notify the police department of any changes to property status.

Unless revoked by the City of Dallas, this authorization shall continue in force for one year from the first day of the month in which the authorization was granted. (e.g., an application approved on October 15 will expire October 1 of the following year.) The TLC expires one year from the first day of the month in which the authorization was granted. It is the property owner’s responsibility to submit a renewal application.

In addition to your consent letter, your property must be posted with signs stating “No Trespass” and include a reference to Oregon Revised Statute “ORS 164.245.” Do not add any other verbiage to the sign.

If the status of your property changes in any way, you must notify the police department as soon as possible and arrange for your trespass letter of consent to be updated or removed from our files.

I have read and agree to the terms: *

Yes

Applicant's Electronic Signature (First and Last Name) *

Date:

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Trespass Letter of Consent Application: For Residential Property

Contact Information

Thomas Simpson

Chief of Police

Hours