Province of ,
This is the information of A.B., of in the said (territorial division), (occupation), hereinafter called the informant, taken before me.
The informant says that (describe things to be searched for and offence in respect of which search is to be made), and that he believes on reasonable grounds that the said things, or some part of them, are in the (dwelling-house, etc.) of C.D., of , in the said (territorial division). (Here add the grounds of belief, whatever they may be.)
Wherefore the informant prays that a search warrant may be granted to search the said (dwelling-house, etc.) for the said things.
Sworn before me this day of , A.D. , at .
(Signature of Informant)
A Justice of the Peace in and for
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