Pompton Lakes, MT · Passaic County
Application for Police Services
Organizations and applicants use this form to request police officer services in Pompton Lakes and provide service and billing details.
What this form is
This application requests police officer services for specified duty dates, hours, and locations. Applicants provide the organization name, nature of the services, their printed name, signature, and date, along with the name, phone number, and address of the person to be billed. The form also states cancellation instructions and the minimum charge for late cancellations.
Who needs it
An organization or applicant requesting police officer services for scheduled work in Pompton Lakes should complete this application.
How to submit it
Complete sections I and II, then return the form to Lt. Derek Clark by fax at (973) 831-1412.
About notarization
This application is signed and dated without a notary; the form identifies no attachment or related sworn step.
How to submit this form
- 1
Download The Application
Download the Application for Police Services PDF.
- 2
Complete Sections I And II
Fill in the service request and billing contact details in sections I and II.
- 3
Check Your Entries
Review the information, then print your name, sign, and date the application.
- 4
Return The Form
Fax the completed form to Lt. Derek Clark at (973) 831-1412.
Frequently asked questions
- Do I need a notary for the Application for Police Services?
- No. This application is signed and dated without a notary, and it identifies no attachment or related sworn step.
- How do I submit the Application for Police Services?
- Complete sections I and II, then return the form to Lt. Derek Clark by fax at (973) 831-1412.
- What information does the application ask for?
- It asks for service dates, hours, organization and service details, location, applicant name and signature, and contact information for the person to be billed.
- What does the form say about canceling scheduled work?
- It says to call the Police Department at (973) 835-0400 at least two hours before the scheduled start time. Otherwise, the applicant is responsible for a minimum four-hour charge per officer.
Need something notarized?
This Application for Police Services doesn’t need a notary — but if you have another Pompton Lakes form that does, a commissioned online notary can help.