AO 442 (Rev. 11/11) Arrest Warrant UNITED STATES DISTRICT COURT for the __________ District of __________ United States of America v. ) ) ) ) ) ) Case No. Defendant ARREST WARRANT To: Any authorized law enforcement officer YOU ARE COMMANDED to arrest and bring before a United States magistrate judge without unnecessary delay (name of person to be arrested) , who is accused of an offense or violation based on the following document filed with the court: ' Indictment ' Superseding Indictment ' Information ' Superseding Information ' Violation Notice ' Complaint ' Order of the Court ' Probation Violation Petition ' Supervised Release Violation Petition This offense is briefly described as follows: Date: Issuing officer's signature City and state: Printed name and title Return This warrant was received on (date) at (city and state) Date: Arresting officer's signature , and the person was arrested on (date) . Printed name and title American LegalNet, Inc. www.FormsWorkFlow.com AO 442 (Rev. 11/11) Arrest Warrant (Page 2) This second page contains personal identifiers provided for law-enforcement use only and therefore should not be filed in court with the executed warrant unless under seal. (Not for Public Disclosure) Name of defendant/offender: Known aliases: Last known residence: Prior addresses to which defendant/offender may still have ties: Last known employment: Last known telephone numbers: Place of birth: Date of birth: Social Security number: Height: Sex: Hair: Scars, tattoos, other distinguishing marks: Weight: Race: Eyes: History of violence, weapons, drug use: Known family, friends, and other associates (name, relation, address, phone number): FBI number: Complete description of auto: Investigative agency and address: Name and telephone numbers (office and cell) of pretrial services or probation officer (if applicable): Date of last contact with pretrial services or probation officer (if applicable): American LegalNet, Inc. www.FormsWorkFlow.com