File No. STATE OF NORTH CAROLINA SEARCH WARRANT IN THE MATTER OF County In The General Court Of Justice District/Superior Court Division To any officer with authority and jurisdiction to conduct the search authorized by this Search Warrant: I, the undersigned, find that there is probable cause to believe that the property and person described in the application on the reverse side and related to the commission of a crime is located as described in the application. You are commanded to search the premises, vehicle, person and other place or item described in the application for the property and person in question. If the property and/or person are found, make the seizure and keep the property subject to Court Order and process the person according to law. You are directed to execute this Search Warrant within forty-eight (48) hours from the time indicated on this Warrant and make due return to the Clerk of the Issuing Court. This Search Warrant is issued upon information furnished under oath or affirmation by the person(s) shown. Date Issued Name Of Applicant Name Of Additional Affiant Name Of Additional Affiant Time Issued AM PM I certify that this Search Warrant was received and executed as follows: Date Received Date Executed Time Received RETURN OF SERVICE AM Time Executed PM PM AM I made a search of Date Name (Type Or Print) Signature Deputy CSC Assistant CSC CSC Magistrate District Ct. Judge Superior Ct. Judge as commanded. I seized the items listed on the attached inventory. I did not seize any items. This Warrant WAS NOT executed within This Search Warrant was delivered to me on the date and at the time shown below when the Office of the Clerk forty-eight (48) hours of the date of issuance and of Superior Court is closed for the transaction of business. By signing below, I certify that I will deliver this I hereby return it not executed. Search Warrant to the Office of the Clerk of Superior Court as soon as possible on the Clerk's next business day. Name Of Officer Making Return (Type Or Print) Signature Of Officer Making Return Department Or Agency Of Officer Incident Number Date Time AM PM Name Of Magistrate (Type Or Print) Signature Of Magistrate This Search Warrant was returned to the undersigned clerk on the date and time shown below. Date Time AM PM (Over) Name Of Clerk (Type Or Print) Signature Of Clerk Dep CSC Asst CSC CSC American LegalNet, Inc. www.FormsWorkFlow.com AOC-CR-119, Rev. 6/12 � 2012 Administrative Office of the Courts APPLICATION FOR SEARCH WARRANT I, (Insert name and address; or if law enforcement officer, name, rank and agency) , (and) (Name and/or describe other places or items to be searched, if applicable) being duly sworn, request that the Court issue a warrant to search the person, place, vehicle, and other items described in this application and to find and seize the property and person described in this application. There is probable cause to believe that (Describe property to be seized; or if search warrant is to be used for searching a place to serve an arrest warrant or other process, name person to be arrested) . The applicant swears or affirms to the following facts to establish probable cause for the issuance of a search warrant: constitutes evidence of a crime and the identity of a person participating in a crime, (Name crime) , and is located (Check appropriate box(es) and fill-in specified information) in the following premises (Give address and, if useful, describe premises) SWORN/AFFIRMED AND SUSCRIBED TO BEFORE ME Date Signature Date Name Of Applicant (Type Or Print) Signature Of Applicant Magistrate Dep. CSC Asst. CSC Clerk Of Superior Court Judge (and) on the following person(s) (Give name(s) and, if useful, describe person(s)) In addition to the affidavit included above, this application is supported by additional affidavits, attached, made by In addition to the affidavit included above, this application is supported by sworn testimony, given by (and) in the following vehicle(s) (Describe vehicle(s)) This testimony has been (check appropriate box) reduced to writing tape recorded and I have filed each with the clrek. NOTE: If more space is needed for any section, continue the statement on an attached sheet of paper with a notation saying "see attachment." Date the continuation and include on it the signatures of applicant and issuing official. AOC-CR-119, Rev. 6/12 � 2012 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com