Family Violence Initiative

Sample Affidavit for Application - Firearms (s. 117.011)

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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 C.D., the person against whom the order is sought, cohabits with (or is an associate of ) E.F., who is prohibited by   (specify the prohibition order) made on the  day of  , 20 , (see Schedule A), from possessing any firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, or all such things.

AND THE INFORMANT SAYS THAT he/she has reasonable grounds to believe that E.F. would or might have access to a firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, or all such things that are in the possession of C.D., against whom this order is sought (specify grounds of the belief).

WHEREFORE the informant prays that an order placing terms and conditions on C.D.'s use and possession of a firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition, or explosive substance, or all such things, be granted.

Sworn before me at  
in the   this  
day of  , 20 .