CONSENT TO SEARCH COMPUTER/ELECTRONIC EQUIPMENT
I, _____________________________, have been asked to give my consent to the search of my computer/electronic equipment. I have also been informed of my right to refuse to consent to such a search.
I hereby authorize ________________________ and any other person(s) designated by [insert Agency/Department] to conduct at any time a complete search of:
¤ All computer/electronic equipment located at ___________________
_________________________. These persons are authorized by me to take from the above location: any computer hardware and storage media, including internal hard disk drive(s), floppy diskettes, compact disks, scanners, printers, other computer/electronic hardware or software and related manuals; any other electronic storage devices, including but not limited to, personal digital assistants, cellular telephones, and electronic pagers; and any other media or materials necessary to assist in accessing the stored electronic data.
¤ The following electronic devices:
[Description of computers, data storage devices, cellular telephone, or
other devices (makes, models, and serial numbers, if available)]
I certify that I own, possess, control, and/or have a right of access to these
devices and all information found in them. I understand that any contraband or evidence on these devices may be used against me in a court of law.
I relinquish any constitutional right to privacy in these electronic devices and any information stored on them. I authorize [insert Agency/Department] to make and keep a copy of any information stored on these devices. I understand that any copy made by [insert Agency/Department] will become the property
of [insert Agency/Department] and that I will have no privacy or possessory interest in the copy.
This written permission is given by me voluntarily. I have not been threatened, placed under duress, or promised anything in exchange for my consent. I have read this form; it has been read to me; and I understand it. I understand the _____________ language and have been able to communicate with the agents/officers.
I understand that I may withdraw my consent at any time. I may also ask for a receipt for all things turned over.
Signed: ________________ Signature of Witnesses: _______________
Date and Time:__________ Date and Time:_______________
Consent Form: Search and Seizure of Computers
As published in:
Searching and Seizing Computers and Obtaining Electronic Evidence in Criminal Investigations
Computer Crime and Intellectual Property Section, Criminal Division
U.S. Dept . of Justice
