Application For A Search Warrant {AO 106}

AO 106 (Rev. 01/09) Application for a Search Warrant UNITED STATES DISTRICT COURT for the __________ District of __________ In the Matter of the Search of (Briefly describe the property to be searched or identify the person by name and address) ) ) ) ) ) ) Case No. APPLICATION FOR A SEARCH WARRANT I, a federal law enforcement officer or an attorney for the government, request a search warrant and state under penalty of perjury that I have reason to believe that there is now concealed on the following person or property (identify the person or describe property to located in the District of be searched and give its location): The person or property to be searched, described above, is believed to conceal (identify the person or describe the property to be seized): The basis for the search under Fed. R. Crim. P. 41(c) is (check one or more): ' evidence of a crime; ' contraband, fruits of crime, or other items illegally possessed; ' property designed for use, intended for use, or used in committing a crime; ' a person to be arrested or a person who is unlawfully restrained. The search is related to a violation of facts: U.S.C. § , and the application is based on these ' Continued on the attached sheet. days (give exact ending date if more than 30 days: ' Delayed notice of under 18 U.S.C. § 3103a, the basis of which is set forth on the attached sheet. ) is requested Applicant's signature Printed name and title Sworn to before me and signed in my presence. Date: Judge's signature City and state: Printed name and title American LegalNet, Inc. www.FormsWorkflow.com