WT-3, Supplementary Report for Wiretaps Reported in Previous Calendar Years

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WT-3(Rev. 10/15)	
SUPPLEMENTARY REPORT FOR WIRETAPS REPORTED IN
PREVIOUS CALENDAR YEARS	
THIS REPORT IS MADE IN ACCORDANCE WITH TITLE 18, UNITED STATES CODE, SECTION 2519.  DO NOT REPORT ANY COSTS, ARRESTS, TRIALS, MOTIONS OR CONVICTIONS
THAT HAVE BEEN PREVIOUSLY REPORTED ON EITHER THE ORIGINAL FORM 2 OR ON A SUPPLEMENTARY REPORT FORM 3.  IF YOU HAVE NO ADDITIONAL ACTIVITY TO
REPORT, NO REPORT IS REQUIRED.  PLEASE COMPLETE ALL COLUMNS FOR EACH ENTRY.  An example is provided below.  
Completed copies of the form as well as any questions concerning this form may be sent via e-mail to [email protected]	
.
(1)
 Report
Year(2)
 A.O.
Report
Number(3)
Date of
Application ADDITIONAL ACTIVITY DURING CALENDAR YEAR 
(4)  Cost $  (5) Persons Arrested (6)
 Trials 
Completed  (7) Motions to Suppress (8) Persons Convicted
Number Offense(s) Granted Denied Pending Number Offense(s)
Example
06-28-2001 - 3 Gambling, narcotics, conspiracy  2 1 1 - 1 Gambling 2001 6
Name of the person responsible for completion of this form  JurisdictionState Attorney General  Area Code and Phone Number
’Yes
Street AddressCity and State Zip Code Date