The Plaintiff’s address for contact is: Place: Email: The Plaintiff’s address is (place of business). Service on the Defendant It is not intended to serve this application on the Defendant. Date: Signed by (full name) Investigator appointed/seconded (delete whichever is inapplicable) by the Independent Commissioner Against Corruption Commissioner of Police Eligible person within the meaning of the Australian Crime Commission Act 2002 (Cth) (delete whichever is inapplicable) Rule 14(2) Form SA1A Originating application for surveillance warrant ORIGINATING APPLICATION FOR SURVEILLANCE WARRANT Surveillance Devices Act 2016 s 17 Applicant’s name (in full): Name of investigating agency to which the applicant belongs: Applicant’s rank/position: Application 1. I apply for a warrant under section 17 of the Surveillance Devices Act 2016 for the purposes of the investigation of a matter by—
I request that I am / the responsible officer is / both I and the responsible officer are(delete whichever is inapplicable) identified in the warrant (if necessary) under the code name(s): (insert code name(s)). (delete if inapplicable) Date: Signed by (full name) Applicant Rule 14(2) Form SA1B Application for renewal of surveillance warrant APPLICATION FOR RENEWAL OF SURVEILLANCE WARRANT Surveillance Devices Act 2016 s 17 Note— If the warrant has previously been renewed/varied, this form should be modified so that the details of any previous renewals/variations are set out clearly. Applicant’s name (in full): Name of investigating agency to which the applicant belongs: Applicant’s rank/position: Application 1. I apply for renewal of the warrant issued under section 17 of the Surveillance Devices Act 2016 on (insert date of issue) by (insert name of Judge), a Judge of the Supreme Court of South Australia. 2. The warrant was issued for the purposes of the investigation of a matter by—
Date: Signed by (full name) Applicant Rule 14(2) Form SA1C Application for variation of surveillance warrant APPLICATION FOR VARIATION OF SURVEILLANCE WARRANT Surveillance Devices Act 2016 s 17 Note— If the warrant has previously been renewed/varied, this form should be modified so that the details of any previous renewals/variations are set out clearly. Applicant’s name (in full): Name of investigating agency to which applicant belongs: Applicant’s rank/position: Application 1. I apply for variation of the warrant issued to me under section 17 of the Surveillance Devices Act 2016 on (insert date of issue) by (insert name of Judge), a Judge of the Supreme Court of South Australia. 2. The warrant conferred the following powers: (a) the power to use (insert number sought) surveillance devices(s) (b) the power to enter or interfere with (provide details (e.g. address, registration number) of any premises, vehicle or thing sought to be entered or interfered with) for
the site of an airport, train station, bus station, tram station or ship or ferry terminal the site of a special event an area that is a public area where persons gather in large numbers (delete whichever is inapplicable) and (b) the declaration is required because of the nature of the site or area and the risk of occurrence of a terrorist act on the following grounds: (set out the grounds upon which the relevant beliefs are held). 5. The grounds set out in this application are verified in the accompanying affidavit, which exhibits the proposed special area declaration. 6. The plaintiff proposes that the Court retain the documents associated with this application for at least ...........years before returning them to the plaintiff or destroying them. Order sought The Plaintiff seeks the following orders: (set out briefly but specifically the orders sought) Accompanying documents This application must be accompanied by an affidavit setting out and verifying the matters set out in and exhibiting the documents referred to in rule 17 of the Supreme Court Special Applications Rules 2014. Plaintiff’s address The Plaintiff’s address for contact is: Place: Email: The Plaintiff’s address is (place of business).