ILSSA Boston is pleased to provide this fillable version of the Massachusetts Uniform Record of Trespass Warning / Notice.  This form is compliant with the requirements of the courts and with law enforcement.  

INSTRUCTIONS: 

Open this form using Adobe Acrobat. You can fill out this form online, then print and apply signatures. 

OR

Simply print out the blank form and fill out and sign manually.  

THEN

One Copy to remain on file with the Hotel or Agency

One Copy to be forwarded to the Police District or Agency that has jurisdiction over your property.

One Copy should (if possible) be given to the party being trespassed.