United States Department of Justice

United States Department of Justice Office of the Inspector General Consent to Search Computer/Electronic Equipment 1, AA ( dill chi) c 'l Nil ave been asked to give my consent to the search of my computer/electronic equipment. I have also been informed of my right to refuse to consent to such a search. I have been informed that I have a right not to have my computer/electronic equipment searched without a search warrant. I, hereby authorize and any other person(s) designated by the Department of Justice Office of the Inspector General to conduct at any time a complete search of: F All computer/electronic equipment located at These persons are authorized by me to take from the above location: any computer hardware and storage media, including internal hard disk drive(s), floppy diskettes, compact disks, scanners, printers, other computer/electronic hardware or software and related manuals; any other electronic storage devices, including but not limited to, personal digital assistants, cellular telephones, and electronic pagers; and any other media or materials necessary to assist in accessing the stored electronic data. The following electronic devices: Description of computer, data storage device, cellular telephone, or other device (make, model, and serial number, if available) kte Or\CIA-Q I certify that I own, possess, control, and/or have a right of access to use these devices and all information found in them. I understand that any contraband or evidence on these devices may be used against me in a criminal, civil, or administrative proceeding. I relinquish any constitutional right to privacy in these electronic devices and any information stored on them. I authorize the Department of Justice Office of the Inspector General to make and keep a copy of any information stored on these devices. I understand that any copy made by the Department of Justice Office of the Inspector General will become the property of the Department of Justice Office of the Inspector General and that I will have no privacy or possessory interest in the copy. This written permission is given by me voluntarily. I have not been threatened, placed under duress, or prpirtised anything in exchange for my consent. I have read this form; it has been read by me; and I understand it. I understand the DI I /5 \ • language and have been able to communicate with agents/officers. understa t I may withdraw my consent at any time. I may also ask for a receipt for all things turned over. Signed: Date and Time: Signature of Witnesses: Fi 26/i 9 O1(-7 OIG FORM 233/4 (03/23/2012) EFTA00072535