Form Wt-2 - Report Of Application And/or Order Authorizing Interception Of Communications
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2WT-2 (Rev. 08/10)
A
O
U
S
C
DMINISTRATIVE
FFICE OF THE
NITED
TATES
OURTS
PART 1 (JUDGE’S REPORT)
REPORT OF APPLICATION AND/OR ORDER
AUTHORIZING INTERCEPTION OF COMMUNICATIONS
(To be completed upon approval or denial of application pursuant to 18 U.S.C. 2519(1))
1. JUDGE AUTHORIZING OR DENYING THE APPLICATION
Judge’s Name:
County/Court/District/Jurisdiction:
State:
Court Reference No.:
2. SOURCE – OFFICIAL MAKING APPLICATION
Official’s Name:
Title:
Jurisdiction/Agency:
Telephone No.:
(i.e., AUSA, DA, etc..)
3. PROSECUTION OFFICIAL AUTHORIZING APPLICATION
Prosecutor:
District/Jurisdiction:
Prosecutor Reference No.:
Telephone No.:
DAAG Name:
(Fed Cases Only)
3A. LAW ENFORCEMENT AGENCY CONDUCTING THE WIRETAP
Agency’s Name:
Contact Person:
Telephone No.:
Agency Reference No.:
(FBI, DEA, Sheriff, etc..)
4. OFFENSE
5. TYPE OF ORDER
(MOST SERIOUS)
(Check Ordinary or Roving Order)
’
Ordinary
Specification Order
Description
(Routine)
(e. g., Narcotics, Gambling)
’
Roving – Relaxed Specification Order under 18 U.S.C. 2518 (11)
(ALSO CHECK “NO LOCATION SPECIFIED” IN ITEM 8, BELOW)
6. DURATION OF INTERCEPT
Order or
No. of
Date of
Check One
Date Order
Was this Order/Extension Granted with
Extension
Days
Application
Denied
Granted
Denied or Granted
Modification or Amendment?
(Check only if “Yes”)
”
ORIGINAL REQUEST
Modified/amended – DATE:
R
”
st
1
Extension
Modified/amended – DATE:
R
”
nd
2
Extension
Modified/amended – DATE:
R
”
rd
3
Extension
Modified/amended – DATE:
R
TOTAL NUMBER OF EXTENSIONS:
TOTAL DAYS AUTHORIZED:
List additional extensions on
separate sheet
7. TYPE OF INTERCEPT
(Check all that apply to this order/authorization)
”
”
”
WIRE INTERCEPT OF PHONE
ORAL – check device(s)
ELECTRONIC – check device(s)
”
”
”
COMMUNICATIONS – check device(s)
Microphone / Eavesdrop
Other electronic
Computer
(including
”
”
Cellular or mobile telephone
E-mail)
device
Other type
(specify)
(specify)
”
”
Digital pager
Standard Telephone
(land line)
”
”
Other type of telephone communication
Fax machine
”
device
Text messaging
(specify)
8. LOCATION SHOWN IN INTERCEPT ORDER
(Check all that apply to this order/authorization)
”
”
PORTABLE DEVICE - CARRIED BY/ON INDIVIDUAL
PERSONAL RESIDENCE
(specify)
(specify)
(e.g., single family house, apartment, mobile home, rooming house, dormitory)
(e.g., cell phone, pager)
”
”
BUSINESS
OTHER LOCATION
(specify)
(specify)
(e.g., store, office, restaurant, gym, hospital, school)
(e.g., motel, prison, jail, vehicle, another specified location not listed)
”
”
PUBLIC AREA
(specify)
NO LOCATION SPECIFIED IN ORDER
(specify)
(e.g., pay telephone, park, station, airport, library, street, cemetery)
(either “roving” as shown in item 5, or other circumstances. Describe.)
Judge’s signature:
Telephone No.:
Date:
INSTRUCTIONS
When Part 1 (Judge’s Report) is completed, do the following:
(1)
Send a copy to one of the following:
Mail -
Administrative Office of the U.S. Courts, Attn: Statistics Division (WT),
One Columbus Circle, NE, Washington, DC 20544
Fax -
202-502-1422
E-mail - SD-Wiretap@AO.USCOURTS.GOV
(2)
Provide the Form WT-2 to the official making the application
(3)
Retain a copy for the judge’s files
Report Prepared By:
Telephone No.
(Area Code)
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