Fill and Sign the To Any Officer with Authority and Jurisdiction to Conduct the Search Authorized by This Search Warrant Form

RETURN OF SERVICE STATE OF NORTH CAROLINA County In The General Court Of Justice District/Superior Court Division File No. SEARCH WARRANT IN THE MATTER OF To any officer with authority and jurisdiction to conduct the search authorized by this Search Warrant: I, the undersigned, find that there is probable cause to believe that the property and person described in the application on the reverse side and related to the commission of a crime is located as described in the application. You are commanded to search the premises, vehicle, person and other place or item described in the application for the property and person in question. If the property and/or person are found, make the seizure and keep the property subject to Court Order and process the person according to law . You are directed to execute this Search Warrant within forty-eight (48) hours from the time indicated on this Warrant and make due return to the Clerk of the Issuing Court. This Search Warrant is issued upon information furnished under oath or affirmation by the person(s) shown. This Search Warrant was delivered to me on the date and at the time shown below when the Office of the Clerk of Superior Court is closed for the transaction of business. By signing below , I certify that I will deliver this Search Warrant to the Office of the Clerk of Superior Court as soon as possible on the Clerk’s next business day. NOTE: When issuing a search warrant, the issuing official must retain a copy of the warrant and warrant application and must promptly file them with the clerk. G.S. 15A-245(b). This Search Warrant was returned to the undersigned clerk on the date and time shown below. I certify that this Search Warrant was received and executed as follows: I made a search of as commanded. I seized the items listed on the attached inventory. I did not seize any items. This Warrant WAS NOT executed within forty-eight (48) hours of the date and time of issuance and I hereby return it not executed. Date Date Issued Name Of Applicant Name Of Additional Affiant Name Of Additional Affiant Date Received Date Executed Time Issued Signature Name (type or print) Deputy CSC Assistant CSC CSC Magistrate District Ct. Judge Superior Ct. Judge Name Of Magistrate (type or print) Name Of Clerk (type or print) Signature Of Magistrate Signature Of Clerk Date Date Time Time AM PM AM PM Time Received Time Executed AM PM AM PM Department Or Agency Of Officer Incident Number Signature Of Officer Making Return Name Of Officer Making Return (type or print) Dep. CSC Asst. CSC CSC AM PM Original - File Copy - For Search of a Person, to Person from Whom Items Taken Copy - For Search of Vehicle/Premises, to Owner or Person in Apparent Control; if No Such Person Present, Leave Copy Affixed Thereon (Over) AOC-CR-119, Rev. 3/17