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3 <br /> 11 OFFICE OF THE ORANGE COUNTY SHERIFF " <br /> hJ Sheriff Charles S. Blackwood <br /> , 106 East Margaret Lane,Hillsborough,North Carolina 27278 <br /> TO, Vopot, <br /> 919-245-2900 <br /> t <br /> Consent to Search Form <br /> Person to be Searched <br /> ❑ Person <br /> I , agree to allow law enforcement to perform a complete search of my person, <br /> including all property on my person. <br /> Property to be Searched <br /> ❑ Vehicle Plate: VIN: <br /> Make: Model: <br /> ❑ Premises Address: <br /> Description: <br /> ❑ Electronic Device Type of Device: <br /> Make: Model: <br /> Serial Number: <br /> Passwords/log-ins/specific directions for entry: <br /> ❑ Other(Describe property): <br /> I , own,possess, or have authority over the property described above <br /> and do hereby agree to allow law enforcement to perform a complete search of the property listed above, to <br /> include all property located on or within the vehicle,premise, electronic device, or other property listed above. <br /> I have been advised of my right to refuse to consent to this search. I give this consent voluntarily,without any <br /> promises made to me or threats of any kind any kind made against me. I understand any evidence of a crime <br /> may be seized as a result of this search. <br /> Signature: Date/Time: <br /> ❑ Check if consent denied <br /> Person Authorizing <br /> Name: <br /> Date of Birth: Age: Phone Number: <br /> Address: <br /> Officer Name: Employee ID#: <br /> Officer Signature: Date/Time: <br />