EAST POINT POLICE DEPARTMENT

NOTICE OF EXCLUSION - DRUG FREE ZONE

INCIDENT NUMBER _________________

Name:                                                                                        Moniker/AKA: ______________________

Arrest Location: (Street Address or Intersection)  _______________________________________________________________

Sex _____ Race _____ DOB _________ Ht ________ Wt _______ Hair ________ Eyes ________
 

EXCLUSION

On the _____ day of ________________ 19 _____ at approximately ________ am/pm you were arrested in the City of East Point in an officially Designated Drug Free Zone for one or more of the following crimes: An attempt to possess a controlled substance (Georgia Code 16-13-33) or, Criminal conspiracy to possess a controlled substance (16-13-33), or, Possession of a controlled substance (16-13-30 or 16-13-31), or, Conspiracy to commit delivery of a controlled substance (16-13-33), or, Delivery of a controlled substance (16-13-33), or, Attempt delivery of an imitation controlled substance (16-13-30 or 16-13-31), or, Conspiracy to commit delivery of an imitation controlled substance (16-13-30.1), or Delivery of an imitation controlled substance (16-13-30.1 or 16-13-30-1 or 16-13-30-2), or An attempt to possess an imitation controlled substance (16-13-33), or Criminal conspiracy to possess an imitation controlled substance (16-13-33), or Possession of an imitation controlled substance (16-13-30 or 16-13-30.1 or 16-13-30.2).
 

Pursuant to the authority granted under East Point City Code 13-1028, you are excluded for a period of six (6) months from entering or remaining in any Designated Drug Free Zone. Refer to the attached map and description of the Drug-Free Zones.
 

Your exclusion will take effect on (Six(6) days from receipt of this notice) and will end on                 , which will be six (6) months from the start of this exclusion.
 

IF YOU ENTER OR REMAIN IN ANY DESIGNATED DRUG FREE ZONE DURING THE EXCLUSION PERIOD, YOU MAY BE ARRESTED FOR CRIMINAL TRESPASS (East Point City Ordinance 13-1029) or (Georgia Code 16-7-21).

Appeal: You may appeal your exclusion in writing. Include your name, address, and daytime telephone number. To be honored, your written appeal must be filed at the East Point Police Department within five (5) days of receipt of this exclusion notice, and must be accompanied by a copy of this notice. If you appeal, your exclusion will not go into effect until the Appeal Hearing Officer hears your appeal and makes a decision.
 

Variance: A variance from this exclusion may be granted at any time during the exclusion period. The Appeal Hearing Officer may issue a variance to a person who has been excluded and (1) is a bona fide resident of a Drug-Free Zone, or (2) requires access to a facility within a Drug-Free Zone to preserve his or her health or well-being as specified in City Code Section 13-1028 (employment, health care, education, access to a social service not available elsewhere, etc.). To apply for a Variance, bring proof of residency or reason for requiring access to a Drug-Free Zone to the ____________.
 

Officer's Signature                                                                     Assignment                         Date __________

The signature of the excluded person indicates that you received a copy of the Exclusion Notice and the map and description of the Drug-Free Zones.

Excluded person's signature                                                                                   Date _____________