MAGISTRATE COURT OF GWINNETT COUNTY STATE OF GEORGIA CASE NO.:__________________ CIVILIAN WARRANT APPLICATION HEARING VERIFICATION OF ADDRESS & CONTACT INFORMATION Applicant MUST have a valid address for the Accused. The Accused is legally entitled to reasonable notice of any warrant application proceeding. The Court cannot accept any citizen warrant application absent verified proof of same by Applicant. If mail notice is returned as undeliverable, the Court will not conduct the warrant hearing. Notice mailed to the Accused's relatives or friends will not be deemed "reasonable" notice. Under penalty of perjury, I swear (or affirm) that the following information is true and correct: (Please write legibly.) [ ] Yes [ ] No I have personal knowledge of the Accused's PRESENT HOME Address. Please list same:_________________________________________________________________________________ __________________________________________________________________________________ [ ] Yes [ ] No I have personal knowledge of the Accused's PRESENT WORK Address. Please list same:_________________________________________________________________________________ __________________________________________________________________________________ Describe how you have personal knowledge of Accused's Address(es): _____________________________________ __________________________________________________________________________________ List any and all phone numbers you have for the Accused: HOME: _____________________________ CELL: _____________________________ WORK: _____________________________ EMAIL: _____________________________ OTHER (Describe): ___________________ I DO SOLEMNLY SWEAR (OR AFFIRM), UNDER PENALTY OF PERJURY, THAT ALL THE INFORMATION CONTAINED IN THIS ADDRESS VERIFICATION FORM IS TRUE AND CORRECT. I FURTHER UNDERSTAND THAT GIVING FALSE INFORMATION TO THE COURT UNDER OATH COULD RESULT IN PROSECUTION FOR FALSE SWEARING AND/OR PERJURY, WHICH ARE BOTH FELONY OFFENSES UNDER GEORGIA LAW, CARRYING A MAXIMUM PENALTY OF ONE (1) TO TEN (10) YEARS IN PRISON. Signed, this ____ day of __________________, 20____. ___________________________________________ Warrant Applicant American LegalNet, Inc. www.FormsWorkFlow.com