IN THE CIRCUIT COURT OF THE CIRCUIT IN AND FOR …



IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR ALACHUA COUNTY, FLORIDA

STATE OF FLORIDA, CR# 00-00-0000000

Plaintiff,

vs APPLICATION AND AFFIDAVIT

FOR SEARCH WARRANT

Defendant’s name here,

Defendant.

_______________/

Before me, the undersigned Circuit Judge, State of Florida, came this sworn application by Officer here, of the AGENCY, Florida, who was first duly sworn deposes and says that he/she believes and has good reason to believe that Florida Statute § 316.193(3)(c)2, DUI with serious bodily injury to another, a felony law of the State of Florida has being violated, and that evidence relevant to proving the felony is located within the following described person in Alachua County, Florida, to-wit:

Blood from the person of Defendant’s name here, White, Male, DOB: mm/dd/year.

The basis of your affiant’s belief is as follows:

[COPY OF OFFICER’S TRAINING AND EXPERIENCE IF AVAILABLE] Your Affiant, Officer here, of the AGENCY, Florida, is a sworn law enforcement office in the State of Florida, and has received training and experience in the investigation of criminal acts, including the detection and investigation of a felony violation of F.S. § 316.193(3)(c)2, to-wit: DUI with serious bodily injury to another person. YA believes that there is sufficient evidence for a blood draw pursuant to F.S. § 316.1933 (authorizing reasonable force to draw blood in crashes involving DUI with serious bodily injury).

NOTE: YA would consider all deaths directly caused by a traffic crash to also be a serious bodily injury.

Your Affiant learned from personal investigation, and/or fellow officers, that the following occurred within the past three hours:

1. The Defendant was driving a motor vehicle.

2. The Defendant’s operation of the motor vehicle caused or contributed to causing a traffic crash.

3. The traffic crash occurred in ALACHUA County, Florida.

4. The traffic crash caused serious bodily injury to another human being.

5. When the Defendant was contacted after the crash, the Defendant appeared to have their normal faculties impaired by alcohol or some other substance. See F.S. § 316.193(1).

6. The Defendant is currently with a Law Enforcement Officer in ALACHUA County.

[place additional facts here, if available: location / time of crash, how crash occurred, victim’s name & injuries, what are the indicators of impairment; similar to mittimus]

WHEREFORE, it is prayed that a search warrant issue, commanding YA, the Sheriff of ALACHUA County, Florida and their duly constituted deputy sheriffs, and/or an Officer of the Florida Highway Patrol, and/or an Officer with the Gainesville Police Department, and/or an Officer with AGENCY, with necessary and proper assistance, to search the above described person and withdraw a sample of blood in the daytime or the nighttime or Sunday, as the exigencies of the occasion may demand in order that such evidence may be procured to be used in the prosecution of said person or persons violating a felony law of the State of Florida.

| |

|AFFIANT |

SWORN to and subscribed before me this ______ day of ______, in the year _________.

| |

|JUDGE, Notary, A.S.A. |

(for electronic signature)_/s/__ A.S.A. name_______/s/__

A.S.A. name

Assistant State Attorney

Florida Bar No.: 0123456

120 W. University Ave

Gainesville, FL 32601

(352) 374-3670

email name@

The above sworn application for search warrant coming on to be heard and having examined the application and the above sworn affidavit set forth and other facts and thereupon being satisfied that there is probable cause to believe that the grounds set forth in said application and facts so exist and that the law is being violated as alleged, I so find, and that a search warrant is hereby allowed and issued.

| |

| |

|JUDGE |

_/s/__ A.S.A. name___/s/__(for electronic signature)

A.S.A. name

Assistant State Attorney

Florida Bar No.: 0123456

120 W. University Ave

Gainesville, FL 32601

(352) 374-3670

email name@

IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR ALACHUA COUNTY, FLORIDA

STATE OF FLORIDA, CR# 00-00-0000000

Plaintiff,

vs

SEARCH WARRANT

Defendant’s name here,

Defendant.

_______________/

IN THE NAME AND BY THE AUTHORITY OF THE STATE OF FLORIDA.

TO:   ALL AND SINGULAR THE SHERIFF AND/OR DEPUTY SHERIFFS OF ALACHUA COUNTY, FLORIDA, AND/OR OfficerS of the Florida Highway Patrol, and/or OfficerS with THE GAINESVILLE POLICE DEPARTMENT, and/or OfficerS with AGENCY, AND/OR ANY OF THEIR DULY CONSTITUTED AGENTS:

WHEREAS, complaint on oath and in writing, supported by affidavit has been made to the undersigned Circuit/County Judge of ALACHUA County, Florida, by Officer here, of the AGENCY, Florida.

AND WHEREAS, said facts made known to me have caused me to find that there is probable cause to believe that there is evidence of a felony violation of the laws of the State of Florida on and in a certain person in ALACHUA County, Florida, being known and described as follows:

The person to be searched is Defendant’s name here, White, Male, DOB: 08/28/1993, and reasonable force is authorized to obtain a blood sample from the Defendant for later analysis.

ALL OF WHICH contain evidence of the violation of the laws of the State of Florida, to-wit: Florida Statute § 316.193(3)(c)2, DUI with serious bodily injury to another, has been committed and evidence relevant to providing said felony is contained within said person;

NOW THEREFORE, you are commanded with a trained person, and such proper and necessary assistance as may be necessary, in the daytime or in the nighttime or on Sunday, to seize the aforesaid person, if located in ALACHUA County, Florida, and then and there to search said person, you are hereby authorized to seize and secure a sample of the Defendant’s blood for later analysis and/or testing, giving proper receipt therefore and delivering a duplicate copy of this warrant to the said person searched, and making a return of your doings under this warrant within ten (10) days of the date hereof, and you are further directed to have the seized blood analyzed and/or tested, said blood to be otherwise maintained pending further order of a Court having jurisdiction of this offense according to law.

WITNESS, my hand and official seal in ALACHUA County, Florida this ______ day of _____________, in the year _______.

____________________________________________

CIRCUIT/COUNTY JUDGE

IN AND FOR ALACHUA COUNTY

IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR ALACHUA COUNTY, FLORIDA

STATE OF FLORIDA, CR# 00-00-0000000

Plaintiff,

vs

Defendant’s name here,

Defendant.

_______________/

SEARCH WARRANT INVENTORY AND RETURN

Received this search warrant on __________________, and executed same on __________________, at _________ hours, by delivering a true copy thereof to ____________ and at the same time showing _____________ this original search warrant and reading to ___________ and explaining to ____________ the contents thereof, a blood sample was obtained from the person of the Defendant.

I, __________________, the law enforcement officer by who this warrant was executed, do swear that the above inventory contains a true and detailed account of all items taken by me pursuant to this warrant.

______________________________

Officer/Deputy/Trooper

STATE OF FLORIDA

COUNTY OF ALACHUA

Sworn to (or affirmed) and subscribed before me this _____ day of ___________, in the year _______, by ________________________________, who is personally known to me _____ or produced __________________________________ as identification

___________________________________

Signature of Notary Public

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