IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT
IN AND FOR ALACHUA COUNTY, FLORIDA
STATE OF FLORIDA,CR# 00-00-0000000
Plaintiff,
vsAPPLICATION AND AFFIDAVIT
FOR SEARCH WARRANT
Defendant’s name here,
Defendant.
______/
Before me, the undersigned Circuit Judge, State of Florida, came this sworn application byOfficer 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 fromthe person ofDefendant’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:
- The Defendant was driving a motor vehicle.
- The Defendant’s operation of the motor vehicle caused or contributed to causing a traffic crash.
- The traffic crash occurredin ALACHUA County, Florida.
- The traffic crash caused serious bodily injury to another human being.
- 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).
- The Defendant is currently with a Law Enforcement Officer in ALACHUACounty.
[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 afelony law of the State of Florida.
AFFIANTSWORN 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
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
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 withinsaid 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 bloodto 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 FORALACHUACOUNTY
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 WARRANTINVENTORY 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