DIVISION OF POLICE

 

CONSENT TO COLLECT BIOLOGICAL SAMPLES

FOR DNA ANALYSIS

I, _________________________________________________HAVE BEEN INFORMED BY _____________________________________AND _____________________________________,

WHO HAVE PROPERLY IDENTIFIED THEMSELVES AS AUTHORIZED OFFICER(S) OF THE ____________________________ DIVISION OF POLICE OF MY CONSTITUTIONAL RIGHT NOT TO HAVE BIOLOGICAL SAMPLES TAKEN FROM ME WITHOUT A SEARCH WARRANT.

KNOWING OF MY CONSTITUTIONAL RIGHT TO REFUSE TO SUCH A SEARCH, I WILLINGLY GIVE PERMISSION AND CONSENT TO THE ABOVE NAMED OFFICER(S) TO OBTAIN THOSE BIOLOGICAL SAMPLE(S) THEY DEEM NECESSARY FRO DNA TESTING PURPOSES, TO WIT:

_________________________________________________________________________________________

THE ABOVE NAMED OFFICER(S) FURTHER HAVE MY PERMISSION AND CONSENT TO TAKE FROM MY PERSON THE BIOLOGICAL SAMPLES LISTED ABOVE WHICH THEY DESIRE FOR DNA TESTING PURPOSES IN THE CASE OR CASES UNDER INVESTIGATION.

 

THIS WRITTEN PERMISSION TO OBTAIN BIOLOGICAL SAMPLES WITHOUT A SEARCH WARRANT IS GIVEN BY ME TO THE ABOVE NAMED OFFICER(S) VOLUNTARILY AND WITHOUT ANY THREATS OR PROMISES OR COERCION OF ANY KIND.

SIGNED BY ME ON THIS ________ DAY OF _______________, 20____, AT _______A.M/P.M.

LOCATION OF CONSENT: _________________________________________________________

SIGNED: __________________________________ WITNESS: ___________________________________

ADDRESS: _________________________________ WITNESS: ____________________________________

CITY: ______________________ STATE ________

DOB: ______________________________________

SSN: _______________________________________ CASE NO: ____________________________________