IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR COUNTY, FLORIDA

STATE OF FLORIDA,

Plaintiff	AGENCY CR #:

-vs-	APPLICATION AND AFFIDAVIT

FOR SEARCH WARRANT

,

Defendant(s).

_____________________________/

BEFORE ME, the undersigned Judge, State of Florida, came this sworn application and affidavit by , a law enforcement officer employed by the , who was first duly Sworn, deposes and says that has 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 been violated, and that evidence relevant to proving the felony is located within the following described person located in County, Florida to-wit:

Blood from the person of ,, , DOB:

THE BASIS for Your Affiant's belief is:

Your Affiant,

Your Affiant, , of the , 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 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 occurred in 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 County.

WHEREFORE, it is prayed that a search warrant issue, commanding YA, the Sheriff of 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, 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 , .

_______________________________

Notary or Assistant State Attorney

The above Application for Search Warrant coming on to be heard and having examined the application made under oath 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 the facts do exist and that the law is being violated, I so find, and a search warrant is hereby allowed and issued.

______________________________

CIRCUIT JUDGE

S.A.review:	______________________

ATTORNEY NAME, Assistant State Attorney

IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR COUNTY, FLORIDA

STATE OF FLORIDA,

Plaintiff

-vs-	AGENCY CR #:

,	SEARCH WARRANT

Defendant.

____________________________________________

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

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

WHEREAS, complaint on oath and in writing, supported by affidavit has been made to me, the undersigned Judge of County, Florida, by , a law enforcement officer employed by the .

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 County, Florida, being known and described as follows:

The person to be searched is , , , DOB: , 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 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 on this __ day of , .

_______________________________

CIRCUIT JUDGE

IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT

IN AND FOR COUNTY, FLORIDA

STATE OF FLORIDA,	CR#

Plaintiff,

vs

,

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