Criminal Code (R.S.C., 1985, c. C-46)

Elizabeth II by the Grace of God, etc.

To the sheriff of (territorial division), GREETING.

You are hereby commanded to levy of the goods and chattels, lands and tenements of each of the following persons the amount set opposite the name of each:

Name Address Occupation Amount

And you are further commanded to make a return of what you have done in execution of this writ.

Dated this day of A.D. , at .

Clerk of the

(Seal)