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Fill and Sign the Application Affidavit for Search Warrant Ao 106eastern District of Form

Fill and Sign the Application Affidavit for Search Warrant Ao 106eastern District of Form

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AO 106 (Rev. 06/09) Application for a Search WarrantUNITED STATES DISTRICT COURT for the Northern District of Oklahoma 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 be lieve that on the following person or property (identify the person or describe the property to be searched and give its location): located in the District of , there is now concealed (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 pe rson who is unlawfully restrained. The search is related to a violation of: Code Section Offense Description The application is based on these facts: ’ Continued on the attached sheet. ’ Delayed notice of days (give exact ending date if more than 30 days: ) is requested under 18 U.S.C. § 3103a, the basis of which is set forth on the attached sheet. 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 Northern Oklahoma

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