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YOUR NAME IN FULL Address Address Address Postal/Zip YOUR LOCAL KINGDOM HALL Address Line 1 Address Line

Line 2 Address Line 3 Postal/Zip Code Line 1 Line 2 Line 3 Code



Dear Sirs: Please notify all members of your congregation that consent, implied or otherwise, to visit my property at the address stated above for any purpose relating to the work of Jehovah's Witnesses or the Watchtower Bible and Tract Society has been revoked. I will consider any future visit to be an act of wilful trespass and may prosecute to the full extent of the law, civil or criminal. You must not visit on the pretence of updating records. Check the electoral roll for up to date ownership information. Notice has also been served to your headquarters organisation at 25 Columbia Heights Brooklyn, NY 11201-2483. I shall hold you both severally and jointly liable for any infraction of this notice to cease and desist. You have been warned!


Mr. (print name) Ms/Miss/Mrs. (print name)

(signature) (signature)

Please note: All adult members of the household should sign this notice.
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