Form S.P.374A Annex 1 "Consent to Obtain and Test Urine" - New Jersey

What Is Form S.P.374A Annex 1?

This is a legal form that was released by the New Jersey State Police - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2015;
  • The latest edition provided by the New Jersey State Police;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form S.P.374A Annex 1 by clicking the link below or browse more documents and templates provided by the New Jersey State Police.

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Download Form S.P.374A Annex 1 "Consent to Obtain and Test Urine" - New Jersey

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S.O.P. F26
ANNEX I
NEW JERSEY STATE POLICE
Consent to Obtain and Test Urine
Case Number
I, __________________________________________, hereby voluntarily consent to provide a
(Name of Consenting Party)
urine sample(s) to_______________________, a member of ___________________________,
(Name of Person Requesting Urine Sample)
(Name of Agency)
and any other representative designated to assist, and I voluntarily consent to the testing of
my urine sample(s).
I have been advised by ______________________________ and fully understand that I have
(Name & Badge Number of Trooper)
the right to refuse giving my consent to the providing and testing of my urine sample(s).
I have been further advised that I may withdraw my consent at any time and for any reason
up until the time that I give my urine sample(s) to ___________________________________.
(Name of Person Collecting Sample)
or any other representative designated to assist.
I have knowingly and voluntarily given my written consent to the providing and testing of
my urine sample(s).
Signature of Consenting Party
Date
Time
Witness
Print Name
Signature
[DCJ PS&TB 6/25/15]
I-2
S.P. 374A (11/15) (S.O.P. F26)
S.O.P. F26
ANNEX I
NEW JERSEY STATE POLICE
Consent to Obtain and Test Urine
Case Number
I, __________________________________________, hereby voluntarily consent to provide a
(Name of Consenting Party)
urine sample(s) to_______________________, a member of ___________________________,
(Name of Person Requesting Urine Sample)
(Name of Agency)
and any other representative designated to assist, and I voluntarily consent to the testing of
my urine sample(s).
I have been advised by ______________________________ and fully understand that I have
(Name & Badge Number of Trooper)
the right to refuse giving my consent to the providing and testing of my urine sample(s).
I have been further advised that I may withdraw my consent at any time and for any reason
up until the time that I give my urine sample(s) to ___________________________________.
(Name of Person Collecting Sample)
or any other representative designated to assist.
I have knowingly and voluntarily given my written consent to the providing and testing of
my urine sample(s).
Signature of Consenting Party
Date
Time
Witness
Print Name
Signature
[DCJ PS&TB 6/25/15]
I-2
S.P. 374A (11/15) (S.O.P. F26)