Application For Criminal Warrant Form Page 2
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1
2WITNESSES
NAME ________________________________________
NAME ________________________________________
ADDRESS ______________________________________
ADDRESS _____________________________________
Street
Street
______________________________________________
_____________________________________________
City
State
Zip Code
City
State
Zip Code
HOME PHONE _________________________________
HOME PHONE _________________________________
WORK PHONE __________________________________
WORK PHONE _________________________________
VICTIM(S)
NAME ________________________________________
NAME ________________________________________
ADDRESS ______________________________________
ADDRESS _____________________________________
Street
Street
______________________________________________
_____________________________________________
City
State
Zip Code
City
State
Zip Code
HOME PHONE _________________________________
HOME PHONE _________________________________
WORK PHONE __________________________________
WORK PHONE _________________________________
I DO SOLEMNLY SWEAR (OR AFFIRM) THAT ALL THE INFORMATION CONTAINED IN THIS APPLICATION FOR A
CRIMINAL WARRANT IS TRUE AND CORRECT.
Sworn to and subscribed to before me
_____________________________________________
Your Signature
This ________ day of ________________________, 20____.
_____________________________________________
Date
____________________________________________________________
DO NOT WRITE BELOW/FOR OFFICE USE ONLY
______ Warrant issued ______ Application hearing
P.D. Report # _______________ _________________________
______ Warrant denied ______ Referred to Civil Court _________ _______________ _________________________
Other Comments: __________________________________________________________________________________
Visible injuries: _____________________________________________________________________________________
Offense(s) ____________________________________________
O.C.G.A. _______________________________
____________________________________________
O.C.G.A. _______________________________
Warrant Language __________________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Sworn to and subscribed before me this ___________ day of ____________________________________, 20_________
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Parent category: Legal