ty as an expert witness for the purpose of testifying regarding the presence and identity in the blood or urine of a person of a controlled substance the use or possession of which is regulated by chapter 453 of NRS or a chemical, poison, organic solvent or another prohibited substance, or the identity of a controlled substance alleged to have been in the possession of a person; That on ......................... (date) I obtained certain evidence from ................ (person, or evidence vault in sealed container), the evidence bearing Identification No. ..... of ................ (agency) and consisting of ................ for the purpose of performing a chemical analysis on the contents thereof; That on ......................... (date) I analyzed the sample or substance and determined it to be or contain ................ (name of controlled substance, chemical, poison, organic solvent or another prohibited substance); That on ......................... (date) I replaced the sample or substance in its container and sealed the container with a seal bearing my initials .....; That the evidence was in my sole custody or control from the time I obtained it until I resealed its container, at which time it was in substantially the same condition as when I first obtained it; and That on ......................... (date) I returned the evidence to ................ (person or evidence vault) or that I still have the evidence in my possession. I declare under penalty of perjury that the foregoing is true and correct. Executed on ... (Date) (Declarant’s Signature) (Declarant’s Title) 2. If the sample contained alcohol: I, .........................................., hereby declare: That I am ................ (occupation) employed by ................ (employer); That on ......................... (date) I first qualified in the District Court of ................ County as an expert witness for the purpose of testifying regarding the presence and amount of alcohol in the blood or urine of a person; That on ......................... (date) I obtained evidence from ................ (person, or evidence vault in sealed container), the evidence bearing Identification No. ..... of ................ (agency) and consisting of a sample of ........ (blood or urine); That on ......................... (date) I analyzed the sample and determined that the blood of the person from whom the sample was taken contained a concentration of alcohol of ..... (grams per 100 milliliters of blood); That on ......................... (date) I replaced the sample in its container and sealed the container with a seal bearing my initials .....; That the evidence was in my sole custody or control from the time I first obtained it until I resealed its container, at which time it was in substantially the same condition as when I first obtained it; and That on ......................... (date) I returned the evidence to ................ (person or evidence vault) or that I still have the evidence in my possession. I declare under penalty of perjury that the foregoing is true and correct. Executed on ... (Date) (Declarant’s Signature) (Declarant’s Title) (Added to NAC by Com. on Testing for Intoxication by R112-97, eff. 5?26?98; A by R137?99, 12?13?99) NAC 50.020 Form of affidavit regarding competence of person to operate certified breath-testing device and regarding identity of person from whom affiant obtained sample. (NRS 50.315) An affidavit which is referred to in subsection 1 of NRS 50.315 must be in substantially the following form: State of Nevada } }ss. County of } I, .............................., being first duly sworn, depose and say: That I am ................ (occupation) employed by ............. (employer); That I was certified on ......................... (date) by the director of the department of public safety as being competent to operate a ................ (name of breath-testing device), a device of a type which, as designed and manufactured, has been certified by the committee on testing for intoxication to be accurate and reliable for testing a person’s breath to determine the concentration of alcohol in his breath; That on ......................... (date) I obtained a sample of the breath of ................ (name of person tested) and tested it in accordance with the prescribed checklist on a ................ (name of device) which was functioning properly; and That the tests indicated the breath of the person tested contained the following concentrations of alcohol (grams per 210 liters of breath): 1st test …….. 2nd test …….. 3rd test …….. Affiant’s Signature Affiant’s Title Subscribed and sworn to before me this ............. day of the month of ........... of the year ............... ....................... Notary Public (Added to NAC by Com. on Testing for Intoxication, eff. 10?26?83; A 11?23?93; 9?9?94; R112?97, 5?26?98; R137?99, 12?13?99) NAC 50.025 Form of declaration regarding competence of person to operate certified breath-testing device and regarding identity of person from whom affiant obtained sample. (NRS 50.315) A declaration which is referred to in subsection 1 of NRS 50.315 must be in substantially the following form: I, ..........................................., hereby declare: That I am ................ (occupation) employed by ............. (employer); That I was certified on ......................... (date) by the director of the department of public safety as being competent to operate a ................ (name of breath-testing device), a device of a type which, as designed and manufactured, has been certified by the committee on testing for intoxication to be accurate and reliable for testing a person’s breath to determine the concentration of alcohol in his breath; That on ......................... (date) I obtained a sample of the breath of ................ (name of person tested) and tested it in accordance with the prescribed checklist on a ................ (name of device) which was functioning properly; and That the tests indicated the breath of the person tested contained the following concentrations of alcohol (grams per 210 liters of breath): 1st test ……… 2nd test ……… 3rd test ……… I declare under penalty of perjury that the foregoing is true and correct. Executed on ... (Date) (Declarant’s Signature) (Declarant’s Title) (Added to NAC by Com. on Testing for Intoxication by R112-97, eff. 5?26?98; A by R137?99, 12?13?99) NAC 50.030 Form of affidavit regarding preparation of solution or gas used in calibrating breath-testing device. (NRS 50.315) An affidavit which is referred to in subsection 2 of NRS 50.315 must be in substantially the following form: State of Nevada } }ss. County of } I, ........................., being first duly sworn, depose and say: That I am a ............... (occupation) employed by ................ (employer); That on ......................... (date) I prepared a ............... (chemical solution or gas) consisting of ................ (description and composition of solution or gas) as necessary for accurately calibrating the ................ (name of device). I do hereby swear under penalty of perjury that the assertions of this affidavit are true. Affiant’s Signature Affiant’s Title Subscribed and sworn to before me this ............. day of

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