District No.

THE INFORMATION OF ............................... of ............................. who says:

I am a member of the Garda Síochána not below the rank of Chief Superintendent. .............................., of ............................, was arrested on the ........... day of ............. 20 .... at ........ .a.m./p.m. on suspicion of having committed an offence to which section 50 of the Criminal Justice Act 2007 applies,

namely ..........................., and is at present detained at .......................... pursuant to

*a direction under section 50(3)(c) of the above Act, which said period of detention will expire on the ........ day of ........... 20.... at ....... a.m./p.m.

*a warrant under section 50(3)(g)(ii) of the above Act, authorising the extension of a period of detention, which authorised period of detention will expire on the ........ day of ........ 20.... at ...... a.m./p.m.

I have reasonable grounds for believing that the detention of the said person

*for a further period not exceeding 72 hours

*for a further period not exceeding 48 hours

is necessary for the proper investigation of the offence concerned and I say that the investigation is being conducted diligently and expeditiously.

The basis for my so believing is as follows:

And I hereby apply

*under section 50(3)(g)(i) of the said Act for a warrant authorising the detention of the said person for a further period not exceeding 72 hours,

*under section 50(3)(h)(i) of the said Act for a warrant authorising the detention of the said person for a further period not exceeding 48 hours,

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

Informant

SWORN before me this ...... day of .............. 20.......

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

Judge of the District Court

*Delete if inapplicable