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Affiant then conducted Standardized Field Sobriety Tests with the following results:
Based upon the totality of the circumstances, including the suspect’s actions,
statements, and performance as stated above, affiant was of the opinion that the suspect was
intoxicated or under the influence of an alcoholic beverage/controlled dangerous substance at
which time the suspect was arrested for the offense of DWI under the provisions of [State
statute here].
The suspect was transported to affiant’s office, advised of his/her rights pursuant to
[State statute here] and interviewed by affiant. During the interview, the suspect told the
affiant the following:
After the interview, the affiant directed the suspect to submit to a breath test to determine
suspect’s blood alcohol concentration, which the suspect refused.
Based upon the observations of the suspect operating his/her automobile, suspect’s
physical characteristics, his/her performance on the standardized field sobriety tests, suspect’s
statements to affiant and the education, training and experience of the affiant in investigating
and arresting intoxicated drivers, affiant has probable cause to believe that this suspect is
under the influence of an alcoholic beverage or controlled dangerous substance while he/she
was operating a motor vehicle, as stated above.
WHEREFORE, affiant respectfully requests that a search warrant be issued ordering the
suspect to submit to a [name of equipment] breath test at the direction of the arresting officer,
or in the alternative, authorizing the affiant or any other peace officer in [City, State], to search
for and seize whole blood in an amount sufficient for testing and analysis from the suspect in an
appropriate medical setting, as provided for by law.