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Fillable Printable Sample Affidavit For Search Warrant

Fillable Printable Sample Affidavit For Search Warrant

Sample Affidavit For Search Warrant

Sample Affidavit For Search Warrant

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SAMPLE
STATEOF__________
[LISTLOCALCOUNTY/PARISH/CITY/ETC]
SAMPLE AFFIDAVIT FOR SEARCH WARRANT
BEFOREME,theundersignedauthority,personallycameandappeared
____________________________________,alawenforcementofficerinthe[LOCATION],
Stateof________,whorequeststhatasearchwarrantissueforthefollowing:
Wholebloodoralveolarlungairfromthepersonof:
RACE/SEX_______________DOB_____________DL#______________
whoiscurrentlyunderarrestfortheoffenseofOperatingaVehicleWhile
Intoxicated______Offenseandinaffiant’scustodywithintheterritorial
jurisdictionofthisCourt.
ThefactsandcircumstancesestablishingthebasisfortheissuanceofthisSearch
Warrantareasfollows:
Affiantisafulltimelawenforcementofficerwith__________________
_______________andhasbeenemployedinlawenforcementfor______years.Affianthas
successfullycompletedPoliceOfficerStandardizedTraining(POST)andistrainedtoperform
theStandardizedFieldSobrietyTest(SFST)andis/isnot(circleappropriateresponse)certified
tooperatethe[nameofbreathtestequipmentused].Thisexperienceandeducationhas
trainedaffianttodetectimpairedorintoxicateddriversby:
1)Observingtheirdrivingbehaviorwhichincludesbutisnotlimitedto
weavinginand/oroutoftheirlaneoftravel,trafficsignalviolations,and
speeding;
2)Observingtheirphysicalcharacteristicswhichincludearebutnotlimited
to:bloodshoteyes,unsteadybalance,slurredspeech,and/orodorof
alcoholicbeverage;and
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3)TheuseofStandardizedFieldSobrietyTestsincludingbutnotlimitedtothe
horizontalgazenystagmus,theonelegstandandthewalkandturntests.These
testsareusedbythelawenforcementprofessionandaffiantfindstheyare
accurateandreliableindicationsofintoxication(orlackthereof).Affianthas
arrestednumerouspeopleforDWIbasedupontheirpoorperformanceonthese
tests(aswellasreleasingmanypeoplebasedupontheirsatisfactory
performanceonthesetests).
Overtheaffiant’slawenforcementcareer,affianthasmadeapproximately______
arrestsforOperatingaVehicleWhileIntoxicatedandobservedthesameorsimilardriving
behaviorandphysicalcharacteristicsofalcohol/drugimpaireddriverthatarelistedabove.
Affianthasalsoformedopinionsonalcohol/drugimpaireddriversonmanyoccasionsandhis
suspicionshavebeenconfirmedbybreath,blood,orurinesamplesthatwereadministered
afterheperformedhisinvestigation.
Inthiscase,affiantorafellowknownlawenforcementofficerwasonpatrolonthe
____dayof__________________,20___,at_______o’clocka.m./p.m.,whenaffiantorsaid
fellowknownlawenforcementofficernoticedthesuspectoperatingamotorvehiclein[City,
State].Affiantpersonallyobservedorwasadvisedbyafellowknownlawenforcementofficer
ofthefollowingregardingsuspect’soperationofthevehicle(besuretoincludelocationof
operation):
Uponcontactingthesuspect,affiantpersonallyobservedand/orwasadvisedbya
knownfellowlawenforcementofficerofthefollowingthattendedtoestablishthatthesuspect
wasundertheinfluenceofanalcoholicbeverageordrugs:
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AffiantthenconductedStandardizedFieldSobrietyTestswiththefollowingresults:
Baseduponthetotalityofthecircumstances,includingthesuspect’sactions,
statements,andperformanceasstatedabove,affiantwasoftheopinionthatthesuspectwas
intoxicatedorundertheinfluenceofanalcoholicbeverage/controlleddangeroussubstanceat
whichtimethesuspectwasarrestedfortheoffenseofDWIundertheprovisionsof[State
statutehere].
Thesuspectwastransportedtoaffiant’soffice,advisedofhis/herrightspursuantto
[Statestatutehere]andinterviewedbyaffiant.Duringtheinterview,thesuspecttoldthe
affiantthefollowing:
Aftertheinterview,theaffiantdirectedthesuspecttosubmittoabreathtesttodetermine
suspect’sbloodalcoholconcentration,whichthesuspectrefused.
Basedupontheobservationsofthesuspectoperatinghis/herautomobile,suspect’s
physicalcharacteristics,his/herperformanceonthestandardizedfieldsobrietytests,suspect’s
statementstoaffiantandtheeducation,trainingandexperienceoftheaffiantininvestigating
andarrestingintoxicateddrivers,affianthasprobablecausetobelievethatthissuspectis
undertheinfluenceofanalcoholicbeverageorcontrolleddangeroussubstancewhilehe/she
wasoperatingamotorvehicle,asstatedabove.
WHEREFORE,affiantrespectfullyrequeststhatasearchwarrantbeissuedorderingthe
suspecttosubmittoa[nameofequipment]breathtestatthedirectionofthearrestingofficer,
orinthealternative,authorizingtheaffiantoranyotherpeaceofficerin[City,State],tosearch
forandseizewholebloodinanamountsufficientfortestingandanalysisfromthesuspectinan
appropriatemedicalsetting,asprovidedforbylaw.
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AFFIANTTel:(xxx)_______________
Fax:(xxx)_______________
SWORNTOANDSUBSCRIBEDbeforemeonthis_____dayof____________________,
20___,at_______o’clocka.m./p.m.
JUDGE
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STATEOF______
[LISTLOCALCOUNTY/PARISH/CITY/ETC]
SAMPLE SEARCH WARRANT
TO:AnyPeaceOfficerintheCity,Stateof
GREETINGS:
PursuanttotheAffidavitforaSearchWarrantexecutedby
_______________________________,whohasreasontobelievethatwithinthepersonof:
RACE/SEX_______________DOB_____________DL#______________
thereexistsevidenceofethanol,analcoholicbeverageoraControlledDangerousSubstancein
thebreath/bloodoftheabovedescribedperson,whichconstitutesevidencetendingtoprove
thecommissionoftheoffenseofOperatingaVehicleWhileIntoxicatedinviolationof[List
Statutehere].Iamsatisfiedthatthereisprobablecausetobelievethattheevidenceso
describedislocatedinthebreath/bloodoftheabovedescribedpersonandthatlegalgrounds
existfortheissuanceofasearchwarrant;therefore,
ITISORDEREDTHAT:
1)theaffiantshallimmediatelyandpersonallyserveacopyofthissearchwarrant
onthesuspect;
2)THESUSPECT,PURSUANTTOTHISSEARCHWARRANT,ISORDE REDBYTHE
COURTTOSUBMITTOABREATHTESTATTHEDIRECTIONOFTHEARRESTING
OFFICERtotestforevidenceofethanoloranalcoholicbeverage;
3)
ifthesuspectrefusestosubmittothebreathtestasorderedbytheCourt,affiant(or
anyotherpeaceofficer)isorderedtoseizetheabovedescribedpersonandobtaina
sampleofwholebloodinanappropriatemedicalsettinginstrictaccordwithmedically
acceptablepracticesbyaphysician,physicianassistant,registerednurse,emergency
medicaltechnician,chemist,nursepractitionerorotherqualifiedtechnician,as
providedbylaw;
4)theaffiantshallpreservetheoriginalexecutedaffidavitforthesearchwarrant
andthefaxedreturnoftheaffidavitandsearchwarrantsignedbythejudge.
Thiswarrantmaybeexecutedanytimeofthedayornight,includingSunday,atany
placethepersonisfoundandisdirectedtoanypeaceofficerwhomayusesuchmeansand
forceasnecessarytoobtainthebodilysamplesasdirectedinthewarrant.
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Issuedthis_______dayof_________________________,20___,at____o’clock
a.m./p.m.
JUDGE
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Thesuspectwasgivenacopyofthissearchwarrant/orderon_____________________,20__,
at_____o’clocka.m./p.m.
By:_______________________________
PeaceOfficer
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