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MPD Records Permit (Only Needed If Serving Subject) CASE NOTE: This document is only valid for a period up to one year from date of issue, if approved. It is the responsibility of the manager/owner/agent of the property to notify MPD of ownership change and/or request an updated letter be on file. Modesto Police Department Phone Number: (209) White Copy – Records Yellow Copy – Advised/Served Subject Pink Copy - Business MODESTO POLICE DEPARTMENT AUTHORITY TO ARREST I, hereby authorize officers of the MODESTO POLICE DEPARTMENT to enter my property located at Modesto, California and arrest any/all persons (including: on said property who do not have written permission to be on said property, or who are committing any offense in violation of any laws of the State of California and/or the City of Modesto Municipal Code. I, furthermore will prosecute all persons arrested to the fullest extent of the law. 602 PC – Trespassing 4-12.703(a)MMC - Camping on Private Property 555 PC – Loitering (Posted Signs Required) 4-12.704(b) MMC - Storing Camping Paraphernalia 4-7.1502 MMC –Disturbing the Peace BUSINESS NAME: PROPERTY MANAGER: PHONE: ADDRESS: (IF DIFFERENT THAN PROPERTY AGENT NAME: ALTERNATE PHONE: EMAIL: EMERGENCY CONTACT: PHONE: REQUESTED BY: OF BIRTH: SIGNATURE: DATE: ADVISED/SERVED SUBJECT: PRINT NAME: DATE OF BIRTH: ADDRESS: DL/ID SIGNATURE: DATE SERVED: WITNESS OFFICER: PRINT NAME: DATE: SIGNATURE: IBM 30 Days 60 Days 90 Days 180 Days 365 Days Other_______ Updated By: Date Issued: Expiration: SIGN