CV-517, 02/11 Order for Collection of a Biological Specimen for DNA Analysis 247165.76(6), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY State of Wisconsin, Plaintiff, - vs - Name Date of Birth Order for Collection of a Biological Specimen For DNA Analysis Case No. Telephone Number Address Present Location THE COURT FINDS: of 247165.76(6), Wisconsin Statutes and the defendant is required to provide a biological specimen to the state crime laboratories for deoxyribonucleic acid (DNA) analysis. A copy of the district attpetition and the statutes are attached. THE COURT ORDERS: 1. You are ordered to present yourself to the [County Name] County Sheriff, located at [Address] no later than [Date] , between the hours of a.m. and p.m., for the collection of a biological specimen, obtained by buccal swab, for deoxyribonucleic acid (DNA) analysis and inclusion of the results of that analysis in the state crime 2. You must bring a copy of this order with you. 3. You must also bring two forms of identification, including one form of government-issued, photographic identification. If you wish to contest this Order, you must appear in person on Date Time Location Circuit Court Judge/Circuit Court Commissioner at which time you will have the opportunity to show cause to the court why you should not be required to provide a biological specimen for DNA analysis. American LegalNet, Inc. www.FormsWorkFlow.com CV-517, 02/11 Order for Collection of a Biological Specimen for DNA Analysis 247165.76(6), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 VIOLATIONS OF THIS ORDER: If you do not appear in person to contest this order at the time, date and place set forth above, and you do not present yourself for collection of a biological specimen as directed, all of the following apply: 1. You may be held in contempt of court and be subject to sanctions as provided in Ch. 785, Wisconsin Statutes. 2. may authorize arrest or detention or use of reasonable force against you to collect the biological specimen. THIS IS A FINAL ORDER FOR THE PURPOSE OF APPEAL IF SIGNED BY A CIRCUIT COURT JUDGE. DISTRIBUTION: 1. Court 2. District Attorney 3. Defendant/ Attorney 4. Sheriff American LegalNet, Inc. www.FormsWorkFlow.com