Notice of Withdrawal of Consent to Remain on Campus

Date ____________________

 

To ______________________________

 

You are hereby notified by the undersigned, a person designated by the Chancellor of the Irvine Campus of the University of California to maintain order on such Campus, that your consent to remain on the Irvine Campus has been withdrawn.

 

You are further notified that, if you should remain on Campus or should return to the Campus within 14 days of this warning without specific consent to do so, you may be found guilty of a violation of Section 626.4 of the Penal Code of the State of California.

 

Signature______________________________

Time and date of withdrawal of consent______________________________