Affiant being duly sworn according to law, deposes and says that on Month, Day* 20 Year 2 digit at Time o'clock Affiant arrested First Name Last Name for the following criminal offenses: Offenses
which occurred in Darke County, Ohio on or about Month, Day* , 20 Year 2 digit . Affiant has good cause to believe and does believe the following facts are true, and offers the following on support of this request for a determination of probable cause for such arrest, the issuance of an arrest warrant, and the continued detention of said individual:
Open Victims Rights Form