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New York Codes Rules Regulations (Last Updated: March 27,2024) |
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TITLE 22. Judiciary |
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Subtitle D. Forms |
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Chapter VI. Forms for Use in Courts Exercising Criminal Jurisdiction |
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5a Nav. L. chemical tests—order |
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Sec. 49 Nav. L. Form 5A (Nav. L. Chemical Tests – Order) 9/89 __ Court of __ County of __ ___________ x In the Matter of the Application of _______ , Indictment/Docket [name of applicant] No. __ for an order to compel ORDER COMPELLING SUBMISSION TO A _______ to CHEMICAL TEST [name of arrestee] submit to a chemical test, pursuant to Nav. L. § 49 ___________ x Upon the application [affidavit] of sworn to [dated] __, 19 , [name of applicant] for an order pursuant to section 49 of the Navigation Law to require to submit [name of arrestee] to a chemical test, and sufficient reason appearing therefor, it is ORDERED that the arrestee submit to a chemical test of the alcoholic or drug content of his/her blood, and it is further ORDERED that a person authorized pursuant to section 49(4)(e)(1) of the Navigation Law, em- ployed at withdraw a proper amount of blood from the arrestee, for the purpose of [name of facility] conducting such chemical test. E N T E R , New York [location] Date: , 19 Time: [a.m.] [p.m.] Judge [Justice] Applicant (if order issued orally) |