-

CONSENT TO SEARCHCHICAGO POLICE DEPARTMENT

TIMEDATE

, have been advised of my constitutionalI,(Print Full Name)

right not to have a search made of the premises/vehicle described below without a search

warrant first being obtained. I have also been advised that I do not have to consent to this warrantlesssearch unless I wish to do so.

Having been advised that I do not have to consent to a warrantless search, I hereby authorizewho have iden- and give my consent to and

(Officer) (Officer)tified themselves as Chicago Police Officers assigned to the

(Unit)to conduct a complete search at this time of the premises/vehicle under my lawful control anddescribed as .

In addition, I hereby authorize and give my consent to the above named officers to obtainand remove from the searched premises/vehicle any materials, documents, or other items thatmay be used in connection with a legitimate law enforcement purpose.

By my signature on this document, I hereby state and certify that this consent to search is

being given by me to the above named officers knowingly, voluntarily, and without having

received any threats, promises, or duress of any kind.

(SIGNATURE)WITNESS

CPD-11.483 (REV. 5/07)

REPORTING MEMBER'S NAME STAR NO. EMPLOYEE NO. SIGNATURE

REPORTING MEMBER'S NAME STAR NO. EMPLOYEE NO. SIGNATURE

SUPERVISOR'S NAME STAR NO. SIGNATURE

INCIDENT INFORMATIONRD NO. EVENT NO. CONSENT TO SEARCH INVENTORY NO.I-UCR CODE

SUPERVISORY APPROVAL

REPORTING MEMBER(S)

(NON-DEPARTMENT MEMBER, IF AVAILABLE)

(PRINTED NAME)

(SIGNATURE)

UNIT

TO BE COMPLETED PRIOR TO SEARCH

CONSENTIMIENTO DE CATEO FECHA (DATE) HORA (TIME)

(CONSENT TO SEARCH)DEPARTAMENTO DE POLICIACHICAGO POLICE DEPARTMENT

Yo, , se me ha informado que tengo(Nombre Completo - Print Full Name)

el derecho constitucional denegarme a que se registre el local/vehiculo descrito abajo sin antesobtener una orden de cateo (registro). Tambien se me ha informado de mi derecho a nopermitir que se registre sin dicha orden de cateo,a menos que yo de mi consentimiento.

Despues de haber sido informado, y entendiendo que no tengo que consentir a un registro sin

orden de cateo de la presente doy mi consentimiento a : y

quienes se han identificado como oficiales del(Nombre del Oficial - Officer)

Departamento de Policia de Chicago, asignado a(Unidad/Grupo - Unit)

que conduzcan un registro (cateo) completo en este momento del local/vehiculo que seencuentra bajo mi control legal y descrito como:

-Ademas, doy mi autorizacion y mi consentimiento a los oficiales arriba mencionados para

que obtengan y se lleven del local/vehiculo registrado (cateado) cualquier material,documento, u objeto que se pueda usar en relacion y proposito legitimo de la ejecucion de la ley.

Poniendo mi firma a este documento, declaro y certifico que este consentimiento para

registrar ha sido dado a sabiendas y en forma voluntaria, por mi, a los oficiales arriba

mencionados sin haber recibido amenazas, promesas o coaccion de ninguna clase.

(FIRMA - SIGNATURE)

TESTIGOS (NO MIEMBRO DEL DEPARTAMENTO DE POLICIA SI ES POSIBLE)

CPD-11.483 (REV. 5/07)

UNIDAD/GRUPO (UNIT)

REPORTING MEMBER'S NAME

STAR NO.

EMPLOYEE NO.REPORTING MEMBER(S)

SUPERVISORY APPROVAL

INCIDENT INFORMATIONRD NO. I-UCR CODE EVENT NO. CONSENT TO SEARCH INVENTORY NO.

STAR NO. SIGNATURE

EMPLOYEE NO. SIGNATUREREPORTING MEMBER'S NAME

REPORTING MEMBER'S NAME STAR NO. SIGNATURE

(FIRMA - SIGNATURE)

TO BE COMPLETED PRIOR TO SEARCH

(Nombre del Oficial - Officer)

(NOMBRE IMPRIMIDO - PRINTED NAME)