Form Ao 109 - Warrant To Seize Property Subject To Forfeiture - United States District Court

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AO 109 (Rev. 12/09) Warrant to Seize Property Subject to Forfeiture
for the
__________ District of __________
In the Matter of the Seizure of
(Briefly describe the property to be seized)
Case No.
Any authorized law enforcement officer
An application by a federal law enforcement officer or an attorney for the government requests that certain
property located in the
District of
be seized as
being subject to forfeiture to the United States of America. The property is described as follows:
I find that the affidavit(s) and any recorded testimony establish probable cause to seize the property.
YOU ARE COMMANDED to execute this warrant and seize the property on or before
(not to exceed 14 days)
’ in the daytime – 6:00 a.m. to 10:00 p.m.
at any time in the day or night, as I find reasonable
cause has been established.
Unless delayed notice is authorized below, you must also give a copy of the warrant and a receipt for the
property taken to the person from whom, or from whose premises, the property was taken, or leave the copy and receipt
at the place where the property was taken.
An officer present during the execution of the warrant must prepare, as required by law, an inventory of any
property seized and the officer executing the warrant must promptly return this warrant and a copy of the inventory to
United States Magistrate Judge
’ I find that immediate notification may have an adverse result listed in 18 U.S.C. § 2705 (except for delay
of trial), and authorize the officer executing this warrant to delay notice to the person who, or whose property, will be
searched or seized
(check the appropriate box)
(not to exceed 30)
until, the facts justifying, the later specific date of
Date and time issued:
Judge’s signature
City and state:
Printed name and title


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