(To be reported by January 31 for denied applications and for approved applications for orders that expired during the preceding year, pursuant to 18 U.S.C. § 2519(1)) Select: (i.e., DA, etc.) Select or enter a title: Select: Select: (FBI, DEA, etc.) Select or enter an Agency Name: (Most Serious) Select: (Select One) (including most cell phone wiretaps) Check One 0 0 Page 1 (Check all that apply to this order/authorization) (including email) (land line) (specify) (specify) (specify) (Check all that apply to this order/authorization) (e.g., cell phone, pager) (e.g., single family house, apartment, mobile home, rooming house, dormitory) (e.g., store, office, restaurant, gym, hospital, school) (e.g., pay telephone, park, station, airport, library, street, cemetery) (e.g., motel, prison, jail, vehicle, another specified location not listed) (either "roving" as shown in item 5, or other circumstances) (Use /s/ or Check Endorsement Box) Page 2 (To be reported by March 31 for terminated investigations, pursuant to 18 U.S.C. § 2519(2)) NOTE + = (Future results should be reported on the WT-3 Supplementary Report) Page 3 Page 4 (Additional Extensions) Check One Page 5