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AO 108 (Rev. 06/09) Application for a Warrant to Seize Property Subject to Forfeiture
UNITED STATES DISTRICT COURT
for the
__________ District of __________
In the Matter of the Seizure of
)
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(Briefly describe the property to be seized)
Case No.
APPLICATION FOR A WARRANT
TO SEIZE PROPERTY SUBJECT TO FORFEITURE
I, a federal law enforcement officer or attorney for the government, request a seizure warrant and state under
penalty of perjury that I have reason to believe that the following property in the District of
is subject to forfeiture to the United States of America under U.S.C. §
(describe the property):
The application is based on these facts:
’ Continued on the attached sheet.
Applicant’s signature
Printed name and title
Sworn to before me and signed in my presence.
Date:
Judge’s signature
City and state:
Printed name and title