District No.

THE INFORMATION of .......... of ........., who says on oath—

I am a member of the Garda Síochána and I am investigating an alleged offence under the National Monuments Acts, 1930 to 1987.

I believe that evidence relating to the commission of such offence is to be found in the

*

at ............ in court (area and) district aforesaid.

The basis for my so believing is as follows:—

And I hereby apply for the issue to me of a search warrant in relation to such place pursuant to section 22 of the said Act.

Dated this .... day of ......... 19 .... .

Signed .......................

Informant

SWORN before me this .... day of ......... 19 ....

at ....................

Dated this .... day of ......... 19 .... .

Signed .......................

Judge of the District Court

*State place as described in Sec. 22 (1) of the Act.