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W WOODBURN POLICE DEPARTMENT 1060 Mt. Hood Avenue, Woodburn, Oregon 97071 Phone: (503) 982-2345 FAX: (503) 982-2370 Trespass Arrest Authorization I/We, Address Please print your full name Phone_ I/We, Address Please print your full name Phone_ are the occupants and/or are legally responsible person(s) for the below listed property, which is within the incorporated city limits of Woodburn. Property address or location: If named rental unit give name: No persons other than myself, and those listed below have permission to be on this property. If the Woodburn Police Department finds any unauthorized person(s) at this address/location, I request you arrest that person(s) for Criminal Trespass. I will sign a Criminal Complaint, appear in court and vigorously assist in the prosecution of all person(s) found at this address/property. ORS. 164.245 Criminal Trespass II A person commits the crime of criminal trespass in the second degree if the person enters or remains unlawfully in or upon premises. I have read the above definition of Criminal Trespass and understand it. Person(s) who have permission to be Person(s) who do not have permission to on/at the above listed property: be on/at the above listed property: 1. 2. 3. 4. 5. 1. 2. 3. 4. 5. Signed: Date: This form must be signed and returned to the Woodburn Police Department. For Agency Use Only Date Received: Initials: Forms may be sent by Mail, Fax, Drop-off or email to [EMAIL REDACTED].