Family Violence Initiative

Sample Affidavit for Application for Prohibition Order - Firearms (s. 111)

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NOT AN OFFICIAL FORM

Included only as guidelines for assistance with Criminal Harassment cases. For further information contact the National Weapons Enforcement Support Team (NWEST)
at1-800-731-4000 Ext 2053.

AFFIDAVIT

This is the information of A.B.,  (peace officer, firearms officer or chief firearms officer), of   in the said  (territorial division), hereinafter called the informant, taken before me.

THE INFORMANT SAYS THAT he/she has reasonable grounds to believe that it is not desirable in the interests of the safety of C.D., the person against whom the order is sought, or of any other person, that C.D. should possess any firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, or all such things.  (here set out the grounds of the belief).

WHEREFORE the informant prays that an order prohibiting C.D. from possessing any firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition, or explosive substance, or all such things, be granted.