* I am a member of the Garda Síochána.

* I am an authorised person for the purposes of the above-mentioned Act, having been duly so appointed in writing pursuant to section 72 (1) of that Act.

I believe there are reasonable grounds for suspecting that a person is in possession on the *premises *land at ........ in the court (area and) district aforesaid, of

* a protected wild bird,

* a protected wild animal,

* the eggs of a protected wild bird,

* /the carcase or any other part/ a product/ *of a protected wild bird, *of a protected wild animal, namely, .................

* /a plant/ part of a plant/ a product of a plant/, namely ..............

which is of a species to which an order under section 21 of the said Act applies, and that as regards the *bird *animal *plant *part *product * .......... an offence under the said Act has been or is being committed.

The basis for the said belief is as follows:-

and I hereby apply for the issue of a search warrant under section 73 of the said Act.

Signed ..........

Informant

SWORN before me this ... day of ..... 19..

at .............

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

Judge of the District Court

(or)

Peace Commissioner

* Delete words and clauses which do not apply