Skip to Main Content
Departments & Offices
Select a Category
Building & Development
Career Support Services
Elections & Voter Registration
Electoral Board Forms
Fire and Rescue
Fire, Rescue & Emergency Management
Mapping & Geographic Information
Planning and Zoning
VA Cooperative Extension
Workforce Resource Center
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Insert person's name and full address here
You are hereby notified that your presence on or in the property located at:
Full address of property
is no longer desired and will not be tolerated and that you are to refrain from entering therein or thereon for any reason whatsoever.
You are further notified that upon violation of this notice, you may be subject to immediate arrest or a trespass warrant will be sworn for your arrest and prosecution.
Signature of Owner of or Legal Custodian of the Property:
Printed Name of Owner or Legal Custodian of the Property:
After selecting Print, select File, and Print to print screen. This form is not submitted online.
Leave This Blank:
* indicates a required field
Slideshow Left Arrow
Slideshow Right Arrow