Criminal Code (R.S.C., 1985, c. C-46)

Canada

Province of

(territorial division)

To the peace officers in (territorial division):

This warrant is issued for the arrest of A.B., of , (occupation), in this warrant called the “offender”.

Whereas the offender failed to appear at the place, day and time set out in an order made under subsection 487.051(4) or 487.055(3.11), or in a summons referred to in subsection 487.055(4) or 487.091(3), of the Criminal Code to submit to the taking of samples of bodily substances;

This is, therefore, to command you, in Her Majesty’s name, to arrest the offender without delay in order to allow the samples of bodily substances to be taken.

Dated this day of A.D. , at .

A Justice of the Peace in and for