AFFIDAVIT IN SUPPORT OF DOMESTIC VIOLENCE SEARCH WARRANT
I, ______________________ , having been duly sworn upon my oath according to the law, depose and say:
1.On ___________________, 200__, I was subjected to an act of Domestic Violence by the above defendant.
2. I allege that the defendant committed an act of Domestic Violence as described in the attached Complaint, such acts posing an imminent danger to my life, health or well-being.
3. I also believe that the defendant is in possession of a weapon(s) that I reasonably believe would expose me to a risk of serious bodily injury.
4. These weapon(s) consist of (be as specific as possible)______________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ __________________________________________________________________________________ .
5. I am aware that the defendant possesses or has access to these weapons based upon (how the victim is aware of weapons)
__________________________________________________________________________________ __________________________________________________________________________________.
6. The defendant’s weapons, noted in Item 4, are located at (be as specific as possible as to location of the weapons and owner of the premises, if not the defendant.) ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ __________________________________________________________________________________ .
7. I would request that the items in Item 4, as well as any other weapon that may be located by law enforcement at the location(s), be seized for safekeeping purposes. I would further request all of the defendant’s permits to carry a firearm, firearms purchaser identification card, and any outstanding applications to purchase firearms be seized.
Oath administered and witnessed by:
_______________________________ Hearing Officer
Date:________________
