State of Illinois
County of McHenry
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In the Circuit Court of the 22nd Judicial Circuit
McHenry County, Illinois
_____________________ GJ _______________________
Police Department Report #_____________________
SWORN APPLICATION FOR ISSUANCE OF
GRAND JURY SUBPOENA DUCES TECUM
I, Detective/Officer _____________________________, of the ______________________________________
Police Department, under oath, request that the Grand Jury authorize and direct the
issuance of a Grand Jury Subpoena Duces Tecum directed to:
This request for subpoena is made to obtain documents and information to further an
investigation being conducted by myself and my department, based on the following facts
and information that establish reasonable suspicion that a criminal felony offense may
have been committed, and that further investigation is appropriate and necessary:
FACTUAL BASIS FOR REQUEST: (Must be typed, and may be supplemented or submitted
on separate addendum sheets).
The following material, documents, and information is requested to be provided through
this Subpoena: (Must be typed and may be supplemented on separate addendum sheet.
Phone Records
Medical Records
Bank Records
Please be specific and precise.)
Employment Records
Other Records (check one)
The requested material, documents and information are relevant to the investigation and
may be useful to this Grand Jury, or another Grand Jury seated in the future, in determining
whether or not a criminal felony has been committed and/or in identifying the persons(s)
responsible for the commission of a criminal felony offense.
It is further requested that the Grand Jury petition the Court to appoint myself/
______________________________________ as Special Investigator for the Grand Jury for the purpose
of serving this Subpoena Duces Tecum, securing the satisfaction of the subpoena and
accepting receipt of the subpoenaed material, documents and information.
I acknowledge that I am and will be, personally responsible to the report back to the Grand
Jury upon satisfaction of the requested subpoena, or concerning further action required of
the Grand Jury in connection with this Subpoena.
I, the undersigned, on oath state that I have prepared and examined the above, of which I
have personal knowledge, and that the contents are true and correct, to the best of my
knowledge, on information and belief thereof.
Signed and sworn before this _________day of_______________20____.
____________________________________
Notary Public
___________________________________________________
Detective/Officer Signature
___________________________________________________
Type name
THE GRAND JURY HAS THE RIGHT TO SUBPOENA AND QUESTION ANY PERSON
AGAINST WHOM THE STATE’S ATTORNEY IS SEEKING A BILL OF INDICTMENT, OR
OTHER PERSON, AND TO OBTAIN AND EXAMINE ANY DOCUMENTS OF TRANSCRIPTS
RELEVENT TO THE MATTER BEING PROSECUTED BY THE STATE’S ATTORNEY’S
OFFICE.
Reviewed & Approved:________________________________, Assistant State’s Attorney on
_________________________, 20______.
The Grand Jury McHenry County has had the opportunity to deliberate upon this sworn
request for issuance of Subpoena Duces Tecum and:
□ Upon the affirmative votes of at least nine (9) of it members, the request for issuance of a
Grand Jury Subpoena Duces Tecum shall issue, and that ___________________________ be
appointed by the Court as Special Investigator to facilitate the service and satisfaction of
that Subpoena.
□ This request for issuance of a Grand Jury Subpoena Duces Tecum is Denied.
______________________________
Foreperson
_______________________
JUDGE
______________________________
Date
The court hereby grants the Petition to Appoint a Special Investigator of the Grand Jury for
the duration of this Grand Jury term.