AFFIDAVIT

MUNICIPAL COURT OF ATLANTA

STATE OF GEORGIA

COUNTY OF FULTON - DEKALB

Personally appeared before me, the undersigned, an officer of the State or its political subdivision,

who after being duly sworn, deposes and on oath says that he/she has probable cause to believe that

(has committed a crime against the laws of Georgia)

and that said accused has in his/her possession instruments, articles, papers, items, substance, objects,

matter or things that constitute tangible evidence of the commission of the crime of

that said tangible evidence is comprised of

and that said evidence is presently concealed on the person of the named accused and on the premises

located at

The probable cause on which the belief of the affiant is based as follows:

AFFIANT

Sworn and subscribed to before me on
this the day of 20

JUDGE, MUNICIPAL COURT OF ATLANTA

ORDER FOR SEARCH AND SEIZURE

TO ALL PEACE OFFICERS OF THE STATE OF GEORGIA, GREETINGS:

Upon consideration of the allegations contained in the foregoing affidavit and upon facts submitted under oath to the undersigned, in addition to the facts set out in the affidavit, it is hereby adjudged that there is probable cause to believe that the said person(s) are violating the laws of Georgia in the manner stated to me under oath, and you are hereby commanded to enter the premises above described and to search the premises, the accused and any other person on said premises who reasonably might be involve in the commission of the aforesaid violation of the laws of Georgia, said search being for the discovery and seizure of instruments, articles, papers, items, substance, objects, matter or things described in the attached affidavit, and you shall use necessary and reasonable force as may be required to effect entry into the building or property described in the attached affidavit, and if you seize any instruments, articles, papers, items, substance, objects, matter or things as aforementioned you shall without unnecessary delay file a written return and inventory of such instruments, articles, papers, items, substance, objects, matter or things, under oath, with the undersigned judicial officer or with some other court of competent jurisdiction.

If said warrant has not been executed within 10 days of the date of this order the same shall be returned to the undersigned judicial officer immediately upon the expiration of said period of time.

This order issued at	A.M./P.M. on the	day of	20

JUDGE, MUNICIPAL COURT OF ATLANTA

RETURN

On
I executed the attached search warrant in the following manner:

1. Arrested
and

2. Search the person of the accused and the premises designated and other persons who were
Occupants of the premises as follows:
3. Left a copy of the search warrant with
together with an inventory of the property taken in the search.
4. The property listed below was seized:

I do solemnly swear that the property listed above is all the property seized by me on the search of the premises indicated in the attached warrant.

EXECUTING OFFICER

Sworn and subscribed to before me
this the	day of

JUDGE

Ten (10) days having expired from the date of issue of the attached warrant, the same is returned

to the Judicial Officer who signed the same un-executed.

This	day of

OFFICER

The attached warrant not having been executed within ten (10) days and having been returned to the

Court as un-executed, the same is hereby declared void.

This	day of

JUDICIAL OFFICER

WARRANT N0______________

MUNICIPAL COURT OF ATLANTA

SEARCH

WARRANT

________

________

THE STATE

VS.

_____________________________

Form 36-G-20, revised 6/11/01

AFFIDAVIT

vlivsey

2009-03-17

Atlanta Police Department