Sample Affidavit For Search Warrant (Page 5 of 6) in pdf

STATE OF ______

[LIST LOCAL COUNTY/PARISH/CITY/ETC]

SAMPLE SEARCH WARRANT

TO:

Any Peace Officer in the City, State of

GREETINGS:

Pursuant to the Affidavit for a Search Warrant executed by

_______________________________, who has reason to believe that within the person of:

__________________________________________________________________

RACE/SEX _______________ DOB_____________ DL#______________

there exists evidence of ethanol, an alcoholic beverage or a Controlled Dangerous Substance in

the breath/blood of the above described person, which constitutes evidence tending to prove

the commission of the offense of Operating a Vehicle While Intoxicated in violation of [List

Statute here]. I am satisfied that there is probable cause to believe that the evidence so

described is located in the breath/blood of the above described person and that legal grounds

exist for the issuance of a search warrant; therefore,

IT IS ORDERED THAT:

the affiant shall immediately and personally serve a copy of this search warrant

on the suspect;

THE SUSPECT, PURSUANT TO THIS SEARCH WARRANT, IS ORDERED BY THE

COURT TO SUBMIT TO A BREATH TEST AT THE DIRECTION OF THE ARRESTING

OFFICER to test for evidence of ethanol or an alcoholic beverage;

if the suspect refuses to submit to the breath test as ordered by the Court, affiant (or

any other peace officer) is ordered to seize the above described person and obtain a

sample of whole blood in an appropriate medical setting in strict accord with medically

acceptable practices by a physician, physician assistant, registered nurse, emergency

medical technician, chemist, nurse practitioner or other qualified technician, as

provided by law;

the affiant shall preserve the original executed affidavit for the search warrant

and the faxed return of the affidavit and search warrant signed by the judge.

This warrant may be executed any time of the day or night, including Sunday, at any

place the person is found and is directed to any peace officer who may use such means and

force as necessary to obtain the bodily samples as directed in the warrant.

Sample Affidavit For Search Warrant Page 5