Online Forms

Trespass Letter of Consent

2. Name of Location

3. Type of Location*

   Business, Commercial Property, Apartment Complex, etc.

5. Location Address

7. If only submitting one address

8. Zip Code

10. If you want to submit multiple addresses on one form, please upload a list here.

12. Company Name (if applicable)

14. First Name*

15. Last Name*

17. Mailing Address

19. City

20. State

21. Zip

23. Business Phone

24. Fax

25. Home Phone

26. Cell Phone

28. Email #1*

29. Email #2

31. I certify that I have the authority to file such paperwork with the Eugene Police Department as the:*

    1. Owner

    1. Lessee

    1. Manager

    1. Other

33. Other

35. By submitting this document I do hereby designate each and every police officer now or hereafter employed by the City of Eugene as agent for the purpose of enforcing, Sections 4.805-4.809 of the Eugene Municipal Code. This authorization shall continue in full force and effect until such time as it is revoked in writing and said writing is duly delivered to the Eugene Police Department.*

    I have read and understand the above.

    1. Yes
37. If you have any questions about this program, contact Program Manager Harlow Meno 541-682-5642.

Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field