Annex G: Information to Obtain a Search Warrant (Sample)

Information of [service number, rank (if applicable), full name]
E23 456 789 Sgt Richard White

Military Police

[base, unit or element, or address if civilian]
CFB Greenview Military Police Section

The informant declares that the informant has reasonable grounds for believing that the following things or some part of them
[describe things to be searched for and offence in respect of which search is to be made – see Note (A) to article 106.06]
A quantity of Cannabis resin and a waterpipe are being sought as evidence in respect of the commission of an offence punishable under Section 130 of the National Defence Act and contrary to subsection 4(1) of the Controlled Drugs and Substances Act, namely that CPL Blue during the month of August, 2006, at his residence PMQ #7, Maple Dr., CFB Greenview, did unlawfully have in his possession a quantity of Cannabis sativa in the form of Cannabis resin.

are contained in the following place [description of place] (see paragraph (1) of article 106.05 – Issuance of a Search Warrant by a Commanding Officer, and Note (A) to this article)
The Private Married Quarter

of [owner or occupant of place]
Cpl Peter Blue

at [complete address or location]
#7 Maple Dr., CFB Greenview.

And the said informant further says that the grounds for so believing are that (state the grounds for the belief)
Jane Black, a civilian residing at #9 Maple Dr., CFB Greenview, has stated that she was present in #7 Maple Dr., CFB Greenview on or about 15 August, 2006 when Cpl Blue cut a cube of Hashish from a block and smoked the hashish in a waterpipe in the said place.

WHEREFORE the informant prays that a search warrant may be granted to search the said place for the said things.
Sworn (or affirmed) before me at CFB Greenview in the County of Mayfield, Nova Scotia this 17 day of August, 2006.

[signature of informant] (signed) Richard White, Sgt

[commanding officer] (signed) Louis Green, LCol

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