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Lynchburg Police Dept.

905 Court Street Lynchburg, VA 24504

LPD Off-Duty Police Officer Request Form

Contact Information

Name

Date of Birth

Billing Address

Event Information

Alcohol at Event?

Starting Date/Time of Event

Date Picker

Pay Rates: 3 hour minimum per officer per request

$40.00 per hour per officer / $42.00 per hour per Supervisor (Events requiring 4 or more officers)

$55.00 / $57.00 per hour per officer – Less than 7 days notice

$70.00/ $72.00 per hour per officer – Less than 48 hours notice and Holiday Rate

An invoice from the City of Lynchburg Billings and Collections will be sent to the above Billing Address. No Payment should be made directly to the officer.

LPD Officers are not permitted to work alcohol events unless the event is City sponsored or under City contract. All events require at least 14 days notice prior to the event.

Cancellation of request less than 48 hours from start time will result in a 3 hour minimum pay for all assigned officers.

I certify that I am at least 18 years of age and have the authority to request LPD officers for the event listed above.
I acknowledge that the Lynchburg Police Department is under no obligation to provide off duty officers for this event. It is understood that the off duty officer(s) may not be able to appear at the event or may have to leave the event before its conclusion if the officer(s), in the opinion of the Police Department, are needed to respond to an event requiring the presence of the police.

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