Appointment of Police Officers as Agents
To the Officers of the Wilson Police Department:
I, (Name) ____________________________,
appoint each officer of the Wilson Police Department as agents for the purpose
of forbidding any persons from entering upon or remaining on my property
located at (Address) _______________________,
I understand that arrests may be made for trespassing under N.G.G.S. 14-59.13 based on this grant of agency, and I agree to testify in court in any case where my testimony may be necessary.
This, the ________ day of ____________________, ________.
Owner / Occupant of Property
___________________________, a notary public of
Witness my hand and official, this the ______ day of _____________, ______.
(Official Seal) _______________________________
My commission expires: __________________
This form needs to be updated in twelve months or sooner if there are any changes in this information.