WT-2A Federal, Report of Application and or Order Authorizing Interception of Communications

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WT-2A Federal  
(Rev. 08/2015)	
Page	
Administrative Office of the United States Courts 	
Part 1 (Judge’s Report - Federal) 
Report of Application and/or Order Authorizing Interception of Communica\
tions 	
(To be reported by January 31 for denied applications and for approved \
applications for orders that expired  
during the preceding year, pursuant to 18 U.S.C. § 2519(1))	
1. Judge Authorizing or Denying the Application	
Judge's First Name: Middle Initial:Last Name: Suffix:	
Court Reference No.:
Court Jurisdiction:	
2. Source - Official Making Application	
Telephone No.:	Suffix:
Last Name:
Middle Initial:
Official's First Name:
Title:  (i.e., DA, etc.) Official's Jurisdiction/Agency:	
3. Deputy Assistant Attorney General (DAAG)	
Deputy Assistant Attorney General's Name	Other Deputy Assistant Attorney General's Name	
3A. Prosecution Official Authorizing Application	
Prosecutor's First Name: 
Middle Initial:Last Name: Suffix:	Telephone No.:
Prosecutor Reference No.:
Prosecutor's Jurisdiction:	
3B. Law Enforcement Agency Conducting the Wiretap	
Agency Name (FBI, DEA, etc.)
Suffix:
Last Name:
Middle Initial:
Contact Person's First Name:   Telephone No.:Extension:
Agency Reference No.:	
4. Offense 	(Most Serious)	5. Type of Order 	(Select One)	
Title/Section of Offense:	
Ordinary Specification Order
 (including most cell phone wiretaps)
Roving - Relaxed Specification Order Granted under 18 U.S.C. 2518(11)	
Most Serious Offense: 	
6. Duration of Intercept	
 Order or Extension	No. of 
Days	Date of  
Application	Check One 
Denied     Granted	Date Order  
Denied or Granted	Date that a Granted Order/Extension was   Modified or Amended, if applicable.	
Original Request	Date Modified /Amended	
1st Extension	Date Modified /Amended	
2nd Extension	Date Modified /Amended	
3rd Extension	Date Modified /Amended	
4th Extension	Date Modified /Amended	
5th Extension	Date Modified /Amended	
6th Extension	Date Modified /Amended	
Use the last page  of the form for 
additional extensions.	Total Number of Extensions:	Total Days Authorized:

WT-2A Federal  
(Rev. 08/2015)	
Page	
7. Type of Intercept	 (Check all that apply to this order/authorization)	
Cellular or Mobile Telephone	Microphone / Eavesdrop	
Digital Pager
Fax Machine
Text Messaging
App	
Other (specify)	
Computer (including email)
Other (specify)	
Standard Telephone (land line)
Other (specify)
Phone - check device(s)
Oral - check device(s) Electronic - check device(s)	
8. Location Shown in Intercept Order 	(Check all that apply to this order/authorization)	
Personal Residence  (e.g., single family house, apartment, mobile home, rooming house, dorm\
itory)
Portable Device - Carried by/on Individual  (e.g., cell phone, pager)
Other Location (e.g., motel, prison, jail, vehicle, another specified location not lis\
ted)
No Location Specified in Order  (either "roving" as shown in item 5, or other circumstances)
Business (e.g., store, office, restaurant, gym, hospital, school)
Public Area (e.g., pay telephone, park, station, airport, library, street, cemetery\
)
Specify
Describe	
8A. Judge's Signature 	(Use /s/ or Check Endorsement Box)	
Telephone No.:
Date:	
Judge's Endorsement	
8B. Report Prepared By	
Telephone No.:
Suffix:
Last Name:
Middle Initial:
Report Preparer's First Name:  
Title:   Extension:
Date:	
Instructions
When Part 1 (Judge's Report) is completed, do the following: (1)   Click the "Validate Part 1" button to identify any data quality \
issues with Part 1.
(2)   Save a PDF copy of the completed form by clicking the "Save As" \
button below and assigning a unique file name.
(4)   Provide an electronic copy of the completed Part 1 to the offici\
al making the application.
(5)   Retain a copy of the completed Part 1 for the judge's files.         send to [email protected]. (3)   Click the "Submit by Email" button below to submit this form or \
attach one or more saved PDF forms to an email and	
Additional Instruction
Judges stop here. Prosecutors and Law Enforcement Agencies continue to P\
art 2 of the WT-2 Form.

WT-2A Federal  
(Rev. 08/2015)	
Page	
Administrative Office of the United States Courts 	
Part 2 (Prosecutor's Report - Federal) 
Report of Application and/or Order Authorizing Interception of Communica\
tions 	
(To be reported by March 31 for terminated investigations, pursuant to \
18 U.S.C. § 2519(2))	
Judge Authorizing or Denying the Application	
Judge's First Name: Middle Initial:
Last Name: Suffix:	
Court Reference No.:
Court Jurisdiction:	
Prosecutor's First Name:  Middle Initial:
Last Name: Suffix:	
Prosecution Official Authorizing Application	
Telephone No.:
Prosecutor Reference No.:
NOTE: Items listed above should match information entered in Part 1 of Form \
WT-2. Agency Reference No.:
Application Date (Original Request): 	
9. Installation	
Never Installed	Installed but Not Used	Installed and Used	
10. Description of Intercepts	
10E. No. of Incriminating 
         Comm. Intercepted 
10F. Was Encryption Encountered  
         in this Wiretap?  10D. No. of Persons Whose  
         Comm. Were Intercepted 
10B. No. of Days 
         in Actual Use 10C. No. of Communications 
         Intercepted 	
10G. If Yes, Did Encryption Prevent Law Enforcement from 
         Obtaining the Plain Text of Communications Intercepted?
10A. Termination Date 
         of Interception	Yes	No	No	Yes	
Unknown	Unknown	Unknown	
11. Cost (Rounded to Nearest Dollar)	
11C. Resource Cost (installation fees,  
         supplies, equipment, etc.)	
=	
Check the option that applies:
Reference Number:
Reference Number Type:
11B. Personnel Cost	
+	
11D. Total Cost = Personnel Cost + Resource Cost	
$ $ $	
11A. Nature and Quantity of Personnel Used to Install, Monitor, and Prep\
are TranscriptsCosts for this wiretap are reported below.
Costs for this wiretap are unknown at this time. Costs for this wiretap are included on another wiretap form with the fol\
lowing reference number.	
12. Results	
12A1. No. of Persons Arrested	
Granted
DeniedPending
12B. No. of Motions to Suppress
12C. No. of Persons Convicted 12D. No. of Trials Completed
Check the option that applies:
Results for this wiretap are reported below.
Results for this wiretap are included on another wiretap form with the f\
ollowing reference number.
Results for this wiretap are not known at this time.  (Future results should be reported on the WT-3 Supplementary Report)
12A2. Arrest Offense (Most Serious): 
12E. Conviction Offense (Most Serious): 
Reference Number:
Reference Number Type:
12F. Title/Section of Conviction Offense:

WT-2A Federal  
(Rev. 08/2015)	
Page	
13. Comments and Assessment	
Describe importance of the interceptions, drugs and money seizure amount\
s, impact on community, etc.  DO NOT include target's name, address, 
phone numbers, name of gangs, or other sensitive information.	
13A. Report Prepared By	
Telephone No.: Suffix:
Last Name:
Middle Initial:
Report Preparer's First Name:
 
Title:   Extension:
Date:Suffix:
Last Name:
Middle Initial:
Prosecutor's First Name: 	
Prosecutor Responsible for Part 2	
Report Preparer	
Check if Prosecutor and Report Preparer are the same person.	
Instructions
When Part 2 (Prosecutor's Report) is completed, do the following:
(1)   Click the "Validate Part 2" button to identify any data quality \
issues with Part 2.
(2)   Save a PDF copy of the completed form by clicking the "Save As" \
button below and assigning a unique file name.
(3)   Attach one or more saved PDF forms to an email and send to the F\
ederal Law Enforcement Agency Contact who will 
        review and submit the PDF forms to the DOJ's Office of Enforceme\
nt Operations.
(4)   Retain a copy of the completed form for your files.

WT-2A Federal  
(Rev. 08/2015)	
Page	
6. Duration of Intercept 	(Additional Extensions)	
 Order or Extension	No. of Days	Date of  
Application	Check One 
Denied     Granted	Date Order  
Denied or Granted	Date that a Granted Order/Extension was   Modified or Amended, if applicable.	
7th Extension	Date Modified /Amended	
8th Extension	Date Modified /Amended	
9th Extension	Date Modified /Amended	
10th Extension	Date Modified /Amended	
11th Extension	Date Modified /Amended	
12th Extension	Date Modified /Amended	
13th Extension	Date Modified /Amended	
14th Extension	Date Modified /Amended	
15th Extension	Date Modified /Amended	
16th Extension	Date Modified /Amended	
17th Extension	Date Modified /Amended	
18th Extension	Date Modified /Amended	
19th Extension	Date Modified /Amended	
20th Extension	Date Modified /Amended	
21st Extension	Date Modified /Amended	
22nd Extension	Date Modified /Amended	
23rd Extension	Date Modified /Amended	
24th Extension	Date Modified /Amended	
25th Extension	Date Modified /Amended	
26th Extension	Date Modified /Amended	
27th Extension	Date Modified /Amended	
28th Extension	Date Modified /Amended	
29th Extension	Date Modified /Amended	
30th Extension	Date Modified /Amended	
31st Extension	Date Modified /Amended	
32nd Extension	Date Modified /Amended	
33rd Extension	Date Modified /Amended	
34th Extension	Date Modified /Amended	
35th Extension	Date Modified /Amended	
36th Extension	Date Modified /Amended