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Note:

A criminal complaint is a written statement of the essential facts constituting the offense charged made under oath before a magistrate judge or, if none is reasonably available, before a state or local judicial officer. The criminal complaint and the affidavit must establish probable cause. Normally an FBI agent prepares and signs all three of these documents and this is the best way to do it. However, anyone can prepare and go before a magistrate or judge and sign them. The below complaint is modeled after the combined Criminal Complaint, Affidavit and Application for a Warrant used to have former Governor Blagojevich arrested. After an individual is arrested or summoned additional crimes can be investigated and added to the indictment.


-----------------------------------------


Format for a Combination Multi-Count Criminal Complaint,

Affidavit in Support of a Criminal Complaint

and Application for a Warrant

(Updated March 3, 2015)

 

UNITED STATES DISTRICT COURT


___________ DISTRICT OF _________



UNITED STATES OF AMERICA,

 v.                                                                                              CRIMINAL COMPLAINT


JOHN DOE and

JANE DOE


CRIMINAL COMPLAINT


I, the undersigned complainant being duly sworn state the following is true and correct to the best of my knowledge and belief.


[PLEASE NOTE THAT COUNTS CAN BE DELETED FROM THIS DOCUMENT AND USED LATER IN THE INDICTMENT]


Count One


From on or about______________ 2009 to the present, in __________ in the ________________, defendants did, conspire with each other and with others to devise and participate in a scheme to defraud the United States and the people of the United States of the honest services of JANE DOE and JOHN DOE, in furtherance of which the mails and interstate wire communications would be used, in violation of Title 18, United States Code, Sections 1341,1343, and 1346; all in violation of Title 18 United States Code, Section 1349.


Count Two


Beginning no later than ____________ to the present, in ______ in the _________of _______, defendants JANE DOE and JOHN DOE, being agents of the United States, received federal benefits in excess of $10,000, corruptly solicited and demanded a thing of value, namely, _________________, intending to be influenced and rewarded in connection with business and transactions of the United States involving a thing of value of $5,000 or more, namely, the provision of millions of dollars in financial assistance by the United States, including through the Department of XYZ, an agency of the United States, to the ______company or individual___________; in violation of Title 18, United States Code, Sections 666(a)(1)(B) and 2.


Count Three


From on or about______________ 2009 to the present, in __________, in the ________________, defendants JANE DOE and JOHN DOE directly or indirectly, corruptly gave, offered or promised something of value to a public official or person who has been selected to be a public official, or offers or promises any public official or any person who has been selected to be a public official to give anything of value to any other person or entity, with intent, in violation of 18 U.S.C. 201(b)(1)

 

Count Four

 

From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE being a public official or person selected to be a public official, directly or indirectly, corruptly demands, seeks, receives, accepts, or agrees to receive or accept anything of value personally or for any other person or entity, in return for:

          a.        being influenced in the performance of any official act;

          b.        being influenced to commit or aid in committing, or to collude in, or allow, any fraud, or make opportunity for the commission of any fraud, on the United States; or

          c.         being induced to do or omit to do any act in violation of the official duty of such official or person; Directly or indirectly, corruptly demanded, sought, received, accepted, or agreed to receive in return for being influenced in the performance of any official act 18 U.S.C. 201(b)(2)

2.        From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE conspired to commit the murder of the late _________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1117.

3.        From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE murdered the late _____________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1111.

4.        From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE aided and abetted in the commission of the murder of the late _____________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1111.

5.        Aided and abetted in a conspiracy to commit the murder of the late ________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1117.

6.        Engaged in a conspiracy, to deprive _______________________ of his rights in violation of Title 18, United States Code, Section 241.

7.        Deprived ________________ of rights under color of law in violation of Title 18, United States Code, Section 242.

8.        From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE violated the War Crimes Act of 1996, as amended, Title 18, United States Code, Section 2441.

9.        From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE conspired to violate the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment as implemented by Title 18, United States Code, Section 2340-2340A.

10.      From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE engaged in a conspiracy to defraud the United States in violation of Title 18, United States Code, Section 371.

11.      From on or about______________ 2009 to the present, in __________ , in the ________________, defendants JANE DOE and JOHN DOE Violated Title 18, United States Code, Section 4, Misprision of a Felony.

I further state __________________ and that this complaint is based on the following facts:

 

SEE ATTACHED AFFIDAVIT

 

Continued on the attached sheet and made a part here of:      X Yes No

 

                                                     _________________________

                                                     JD Investigator, Special Agent

                                                     Federal Bureau of Investigation

 


 

                                IF PREPARED BY OTHER THAN AN FBI AGENT


 

 

 

                                                     Signature: _________________________

Printed Name: Bill Doe

                                                     Address: 

                                                     Phone No: 

 

Sworn to before me and subscribed in my presence,

Date _______ at City ________and State__________

 

______________, United States Magistrate Judge _______________________

 

 

                                Name & Title of Judicial Officer

 

                                Signature of Judicial Officer _______ District of __________

                                County of _______ City of __________ )

 

AFFIDAVIT IN SUPPORT OF APPLICATION

 

I. INTRODUCTION

 


 

IF PREPARED BY AN FBI AGENT


 

 

1. I am a Special Agent with the Federal Bureau of Investigation (FBI) assigned to the ____________________. I have been a Special Agent with the FBI for over ________ years. I am presently assigned to the _________ Agency of the FBI's ________ Field office. My duties include investigating corruption of public officials, mail fraud, wire fraud, and other white collar crimes. I have been involved in white collar crime investigations for a majority of my career as a Special Agent with the FBI.

 

2. I have participated in and am familiar with this investigation through interviews and analysis of reports submitted by other Special Agents of the FBI, the Internal Revenue Service (IRS), the U.S. Postal Inspection Service (USPIS), and the U.S. Department of Labor's Office of Inspector General (DOLIG); personal interviews conducted with witnesses; my review of consensually-recorded conversations; a review of pen register information, trap and trace information, and telephone toll record information; and a review of information derived from the interception of wire communications occurring to and from certain telephones. I also am familiar with information derived from the interception of oral communications occurring in the offices of __________________________________________. In addition, I am familiar with testimony given during the trial of _______ from ___ to___.

 

3. This affidavit is submitted in support of an application for a criminal complaint and corresponding arrest warrants charging JANE DOE and JOHN DOE, with:

 


 

IF PREPARED BY OTHER THAN AN FBI AGENT


 

 

I, BILL DOE, hereinafter referred to as “Affiant,” being duly sworn, state as follows:

 

I. INTRODUCTION

 

1. I am a Citizen of the United States and a resident of Virginia.

 

2. This affidavit contains information necessary to support probable cause for a Criminal Complaint. It is not intended to include every fact or matter observed or known to the government or me. The information provided is based on my personal knowledge and observations, information conveyed to me by others, and my review of records, documents, and other physical evidence.

 

3. This affidavit is submitted in support of an application for a criminal complaint and corresponding arrest warrants charging JANE DOE and JOHN DOE, with:

 

[PLEASE NOTE: CHARGES HERE SHOULD MATCH THOSE INCLUDED IN THE CRIMINAL COMPLAINT AND IN PARAGRAPH 3 ABOVE.]

 

          a. conspiring with each other and with others to devise and participate in a scheme to defraud the United States and the people of the United States of the honest services of JANE DOE and JOHN DOE, in furtherance of which the mails and interstate wire communications would be used, in violation of Title 18, United States Code, Sections 1341, 1343 and 1346; all in violation of Title 18, United States Code, Section 1349; and

 

          b. being agents of the United States, received federal benefits in excess of $10,000, corruptly solicited and demanded a thing of value, namely, _________________, intending to be influenced and rewarded in connection with business and transactions of the United States involving a thing of value of $5,000 or more, namely, the provision of millions of dollars in financial assistance by the United States, including through the Department of XYZ, an agency of the United States, to the ______company or individual___________; in violation of Title 18, United States Code, Sections 666(a)(1)(B) and 2.

 

          c. One or more of the following as shown under Count Three - Count ____ above:

 

(1) Conspired to commit the murder of the late _________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1117.

 

(2) Murdered the late _____________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1111.

 

(3) Aided and abetted in the commission of the murder of the late _____________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1111.

 

(4) Aided and abetted in a conspiracy to commit the murder of the late ________________________ as well as several thousand other deceased U. S. service members, in violation of Title 18, United States Code, Section 1117.

 

(5) Engaged in a conspiracy, to deprive _______________________ of his rights in violation of Title 18, United States Code, Section 241.

 

(6) Deprived ________________ of rights under color of law in violation of Title 18, United States Code, Section 242.

 

(7) Violated the War Crimes Act of 1996, as amended, Title 18, United States Code, Section 2441.

 

(8) Conspired to violate the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment as implemented by Title 18, United States Code, Section 2340-2340A.

 

(9) Engaged in a conspiracy to defraud the United States in violation of Title 18, United States Code, Section 371.

 

(10) Violated Title 18, United States Code, Section 4, Misprision of a Felony.

 

4. Defendant JANE DOE is ______________. She

was elected __________ in _____ and was reelected ___________ in ______.

 

5. Defendant JOHN DOE is employed by __________ as the chief of

staff to the _______________

 

6. As officials of ___________, JANE DOE and JOHN DOE

each owe a duty of honest services to the United States and the people of the United States in the performance of their public duties.

 

7. Because this affidavit is submitted for the limited purpose of securing a criminal complaint and corresponding arrest warrants, I have not included each and every fact known to me concerning this investigation.

 

II. SUMMARY OF PROBABLE CAUSE

 

[Normally a chronology of events including date(s), time(s), and location(s) of incident(s) in numbered paragraphs with numbered exhibits and descriptions of other evidence as appropriate. Hearsay may be used in this document.]

 

8.

 

9.

 

III. FACTS ESTABLISHING PROBABLE CAUSE

 

A. Evidence Concerning the Solicitation and Receipt of Campaign Contributions in Return for Official Acts by JANE DOE Prior to October 2008

__________1. Information Provided by JOE WITNESS

16. As described in more detail in the following paragraphs, JOE WITNESS testified_______________________

 

B. Evidence Concerning Corrupt Conduct by JANE DOE and JOHN DOE in and After October 2008

___________1. Evidence Concerning Efforts to Obtain Campaign Contributions

In Exchange for Official Acts

                                a. Information Obtained From Individual A

10. Since ____

 

III. CONCLUSION

 

11. Based upon the facts set forth in this affidavit, I believe that there is probable cause to believe that:

Please Note: Charges here should match those included in the Criminal Complaint and in paragraph 3 above. Counts One and Two are shown here as examples.

 

          a. JANE DOE and JOHN DOE, and others have conspired with each other and with others to commit offenses against the United States, namely to devise and participate in a scheme to defraud the United States and the people of the United States of the honest services of JANE DOE and JOHN DOE, in furtherance of which the mails and interstate wire communications would be used, in violation of Title 18, United States Code, Sections 1341, 1343, and 1346; all in violation of Title 18, United States Code, Section 1349; and

 

          b. JANE DOE and JOHN DOE, being agents of the United States, received federal benefits in excess of $10,000, corruptly solicited and demanded a thing of value, namely, _________________, intending to be influenced and rewarded in connection with business and transactions of the United States involving a thing of value of $5,000 or more, namely, the provision of millions of dollars in financial assistance by the United States, including through the Department of XYZ, an agency of the United States, to the ______company or individual___________; in violation of Title 18, United States Code, Sections 666(a)(1)(B) and

 

                                                                Signature _________________________

                                                                Printed Name ______________________

                                                                Address ___________________________

                                                                Phone No.__________________________

 

 

Or if completed by an FBI agent:

                                                                Signature____________________________

Ivan Investigator

Special Agent

Federal Bureau of Investigation

 

 

Sworn to before me

 

this ____ day of ________ , 2010.

__________________________

(Signature of Judicial Officer)

 

HONORABLE _____________

 

Magistrate Judge

 

_________ District of ________