Criminal Code

Canada,

Province of ................,

(territorial division).

This is the information of A.B., of ................ in the said (territorial division), (occupation), hereinafter called the informant, taken before me.

The informant says that (describe things to be searched for and offence in respect of which search is to be made), and that he believes on reasonable grounds that the said things, or some part of them, are in the (dwelling-house, etc.) of C.D., of ................, in the said (territorial division). (Here add the grounds of belief, whatever they may be.)

Wherefore the informant prays that a search warrant may be granted to search the said (dwelling-house, etc.) for the said things.

Sworn before me this .......... day of .........., A.D. .........., at ...... .
		(Signature of Informant)
A Justice of the Peace in and for

Canada,

Province of ................,

(territorial division).

This is the information of C.D., of ................, (occupation), hereinafter called the informant.

The informant says that (if the informant has no personal knowledge state that he believes on reasonable grounds and state the offence).

Sworn before me this .......... day of .........., A.D. .........., at ...... .
		(Signature of Informant)
A Justice of the Peace in and for

Note: The date of birth of the accused may be mentioned on the information or indictment.

[Repealed, R.S., 1985, c. 27 (1st Supp.), s. 184]

Canada,

Province of ................,

(territorial division).

In the (set out name of the court)

Her Majesty the Queen

against

(name of accused)

(Name of accused) stands charged

• 1 That he (state offence).

• 2 That he (state offence).

Dated this ................ day of ................ A.D. ........, at ................ .

	(Signature of signing officer, Agent of Attorney General, etc., as the case may be)

Note: The date of birth of the accused may be mentioned on the information or indictment.

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division) or to the (named public officers):

Whereas it appears on the oath of A.B., of ................ that there are reasonable grounds for believing that (describe things to be searched for and offence in respect of which search is to be made) are in ................ at ................, hereinafter called the premises;

This is, therefore, to authorize and require you between the hours of (as the justice may direct) to enter into the said premises and to search for the said things and to bring them before me or some other justice.

Dated this ................ day of ................ A.D. ........, at ................ .

....................................

A Justice of the Peace in

and for .........................

Canada,

Province of ................

(territorial division)

This is the information of (name of peace officer), (occupation), of ....... in the said (territorial division), hereinafter called the informant, taken before me.

The informant says that he or she has reasonable grounds to believe

• (a) that (offence), a designated offence within the meaning of section 487.04 of the Criminal Code, has been committed;

• (b) that a bodily substance has been found

  • (i) at the place where the offence was committed,

  • (ii) on or within the body of the victim of the offence,

  • (iii) on anything worn or carried by the victim at the time when the offence was committed, or

  • (iv) on or within the body of any person or thing or at any place associated with the commission of the offence;

• (c) that (name of person) was a party to the offence; and

• (d) that forensic DNA analysis of a bodily substance from (name of person) will provide evidence about whether the bodily substance referred to in paragraph (b) was from that person.

The reasonable grounds are:

The informant therefore requests that a warrant be issued authorizing the taking from (name of person) of the number of samples of bodily substances that are reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

Sworn to before me this .......... day of .........., A.D. .........., at ...... .
(Signature of informant)
(Signature of provincial court judge)

Canada,

Province of ................

(territorial division)

To the peace officers in (territorial division):

Whereas it appears on the oath of (name of peace officer) of ...... in the said (territorial division), that there are reasonable grounds to believe

• (a) that (offence), a designated offence within the meaning of section 487.04 of the Criminal Code, has been committed,

• (b) that a bodily substance has been found

  • (i) at the place where the offence was committed,

  • (ii) on or within the body of the victim of the offence,

  • (iii) on anything worn or carried by the victim at the time when the offence was committed, or

  • (iv) on or within the body of any person or thing or at any place associated with the commission of the offence,

• (c) that (name of person) was a party to the offence, and

• (d) that forensic DNA analysis of a bodily substance from (name of person) will provide evidence about whether the bodily substance referred to in paragraph (b) was from that person;

And whereas I am satisfied that it is in the best interests of the administration of justice to issue this warrant;

This is therefore to authorize and require you to take from (name of person) or cause to be taken by a person acting under your direction, the number of samples of bodily substances that are reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer. This warrant is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:

Dated this ................ day of ................ A.D. ........, at ................ .

........................................

(Signature of provincial court judge)

Canada,

Province of ................

(territorial division)

To the peace officers in (territorial division):

Whereas (name of offender) has been convicted, discharged under section 730 of the Criminal Code or, in the case of a young person, found guilty under the Young Offenders Act, chapter Y-1 of the Revised Statutes of Canada, 1985, or the Youth Criminal Justice Act of (offence), an offence that is a primary designated offence within the meaning of section 487.04 of the Criminal Code;

Therefore, you are authorized to take from (name of offender) or cause to be taken by a person acting under your direction, the number of samples of bodily substances that are reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

This order is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:

Dated this ................ day of ................ A.D. ........, at ................ .

...................................................

(Signature of judge of the court)

Canada,

Province of .................

(territorial division)

To the peace officers in (territorial division):

 Whereas (name of offender), in this order called the “offender”, has been convicted, discharged under section 730 of the Criminal Code or, in the case of a young person, found guilty under the Young Offenders Act, chapter Y-1 of the Revised Statutes of Canada, 1985, or the Youth Criminal Justice Act of (offence), an offence that is

• (a) a secondary designated offence within the meaning of section 487.04 of the Criminal Code, or

• (b) a designated offence within the meaning of section 487.04 of the Criminal Code committed before subsection 5(1) of the DNA Identification Act came into force;

Whereas I have considered the offender’s criminal record, the nature of the offence and the circumstances surrounding its commission and the impact that this order would have on the offender’s privacy and security of the person;

And whereas I am satisfied that it is in the best interests of the administration of justice to make this order;

Therefore, you are authorized to take from (name of offender) or cause to be taken by a person acting under your direction, the number of samples of bodily substances that are reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

This order is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:

Dated this ................ day of ................ A.D. ........, at ................ .

...................................................

(Signature of judge of the court)

Canada,

Province of ................,

(territorial division)

I, (name of peace officer), (occupation), of .......... in the said (territorial division), apply for an authorization to take bodily substances for forensic DNA analysis. A certificate referred to in paragraph 667(1)(a) of the Criminal Code is filed with this application.

Whereas (name of offender)

• (a) before subsection 487.055(1) of the Criminal Code came into force, had been declared a dangerous offender under Part XXIV of that Act,

• (b) before subsection 487.055(1) of the Criminal Code came into force, had been convicted of more than one murder committed at different times, or

• (c) before subsection 487.055(1) of the Criminal Code came into force, had been convicted of more than one sexual offence within the meaning of subsection 487.055(3) of the Criminal Code and is currently serving a sentence of at least two years imprisonment for one or more of those offences;

And whereas I have considered the offender’s criminal record, the nature of the offence and the circumstances surrounding its commission and the impact that this authorization would have on the offender’s privacy and security of the person;

Therefore, I request that an authorization be granted under subsection 487.055(1) of the Criminal Code to take from (name of offender) the number of samples of bodily substances that is reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

Dated this ... day of ........, A.D. ......, at ............... .

.........................................

(Signature of applicant)

Canada,

Province of ................,

(territorial division)

To the

peace officers in (territorial division):

Whereas (name of offender)

• (a) before subsection 487.055(1) of the Criminal Code came into force, had been declared a dangerous offender under Part XXIV of that Act,

• (b) before subsection 487.055(1) of the Criminal Code came into force, had been convicted of more than one murder committed at different times, or

• (c) before subsection 487.055(1) of the Criminal Code came into force, had been convicted of more than one sexual offence within the meaning of subsection 487.055(3) of the Criminal Code and is currently serving a sentence of at least two years imprisonment for one or more of those offences;

Whereas (name of peace officer), a peace officer of the said territorial division, has applied for an authorization for the taking of the number of samples of bodily substances from (name of offender) that is reasonably required for forensic DNA analysis by means of the investigative procedures described in subsection 487.06(1) of that Act;

And whereas I have considered the offender’s criminal record, the nature of the offence and the circumstances surrounding its commission and the impact that this authorization would have on the offender’s privacy and security of the person;

Therefore, the peace officers of the said territorial division, are authorized to take from (name of offender) or cause to be taken by a person acting under their direction those samples, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

This authorization is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:

Dated this ................ day of ................ A.D., at ................ .

....................................................

(Signature of provincial court judge)

Canada,

Province of ................,

(territorial division)

Canada,

Province of ................,

(territorial division)

I, (name of peace officer), (occupation), of .......... in the said (territorial division), apply for an authorization to take additional samples of bodily substances for forensic DNA analysis.

Whereas samples of bodily substances were taken from (name of offender) for the purpose of forensic DNA analysis, in execution of an order made under section 487.051 or 487.052 of the Criminal Code or an authorization granted under section 487.055 of the Criminal Code (attach a copy of the order or authorization);

And whereas on (day/month/year) it was determined that a DNA profile could not be derived from the samples for the following reasons:

Therefore, I request that an authorization be granted under subsection 487.091(1) of the Criminal Code to take from (name of offender) the number of additional samples of bodily substances that is reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

Dated this ... day of ........, A.D. ......, at ............... .

.........................................

(Signature of applicant)

Canada,

Province of ................,

(territorial division)

To the peace officers in (territorial division):

Whereas samples of bodily substances were taken from (name of offender) for the purpose of forensic DNA analysis, in execution of an order made under section 487.051 or 487.052 of the Criminal Code or an authorization granted under section 487.055 of the Criminal Code;

Whereas on (day/month/year) it was determined that a DNA profile could not be derived from the samples for the following reasons:

And whereas (name of peace officer), a peace officer of the said territorial division, has applied for an authorization for the taking of the number of additional samples of bodily substances from (name of offender) that is reasonably required for forensic DNA analysis by means of the investigative procedures described in subsection 487.06(1) of that Act;

Therefore, the peace officers of the said territorial division are authorized to take from (name of offender) or cause to be taken by a person acting under their direction those additional samples, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

This authorization is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:

Dated this ................ day of ................ A.D. ........, at ................ .

........................................................

(Signature of provincial court judge)

Canada,

Province of [specify province].

To A.B. and other peace officers in the [territorial division in which the warrant is intended for execution]:

Whereas it appears on the oath of A.B., a peace officer in the [territorial division in which the warrant is intended for execution], that there are reasonable grounds for dispensing with an information presented personally and in writing; and that there are reasonable grounds for believing that the following things

[describe things to be searched for]

relevant to the investigation of the following indictable offence

[describe offence in respect of which search is to be made]

are to be found in the following place or premises

[describe place or premises to be searched]:

This is, therefore, to authorize you to enter the said place or premises between the hours of [as the justice may direct] and to search for and seize the said things and to report thereon as soon as practicable but within a period not exceeding seven days after the execution of the warrant to the clerk of the court for the [territorial division in which the warrant is intended for execution].

Issued at [time] on the [day] of [month] A.D. [year], at [place].

	A Judge of the Provincial Court in and for the Province of [specify province].

To the Occupant: This search warrant was issued by telephone or other means of telecommunication. If you wish to know the basis on which this warrant was issued, you may apply to the clerk of the court for the territorial division in which the warrant was executed, at [address], to obtain a copy of the information on oath.

You may obtain from the clerk of the court a copy of the report filed by the peace officer who executed this warrant. That report will indicate the things, if any, that were seized and the location where they are being held.

Canada,

Province of ............,

(territorial division).

To the justice who issued a warrant to the undersigned pursuant to section 256, 487 or 487.1 of the Criminal Code (or another justice for the same territorial division or, if no warrant was issued, any justice having jurisdiction in respect of the matter).

I, (name of the peace officer or other person) have (state here whether you have acted under a warrant issued pursuant to section 256, 487 or 487.1 of theCriminal Codeor under section 489 of theCriminal Codeor otherwise in the execution of duties under theCriminal Codeor other Act of Parliament to be specified)

• 1 searched the premises situated at .....................................; and

• 2 seized the following things and dealt with them as follows:

Property Seized			Disposition
(describe each thing seized)			(state, in respect of each thing seized, whether
			(a) it was returned to the person lawfully entitled to its possession, in which case the receipt therefor shall be attached hereto, or
			(b) it is being detained to be dealt with according to law, and the location and manner in which, or where applicable, the person by whom it is being detained).
1.
2.
3.
4.

In the case of a warrant issued by telephone or other means of telecommunication, the statements referred to in subsection 487.1(9) of the Criminal Code shall be specified in the report.

Dated this ........ day of ............ A.D. ........, at ............. .

	Signature of peace officer or other person

Canada,

Province of ...............,

(territorial division).

To a judge of the court from which the warrant was issued (specify court):

I, (name of the peace officer or other person) have acted under a warrant issued under section 462.32 of the Criminal Code and have

• 1 searched the premises situated at ............; and

• 2 seized the following property:

Property Seized		Location
(describe each item of property seized)		(state, in respect of each item of property seized, the location where it is being detained).
1.
2.
3.
4.

Dated this ...... day of ............ A.D. ........, at ................. .

	Signature of peace officer or other person

Canada,

Province of ................,

(territorial division).

To A.B., of ................, (occupation):

Whereas you have this day been charged before me that (set out briefly the offence in respect of which the accused is charged);

This is therefore to command you, in Her Majesty’s name:

• (a) to attend court on ................, the ................ day of ................ A.D. ........, at ............ o’clock in the ........ noon, at ................ or before any justice for the said (territorial division) who is there, and to attend thereafter as required by the court, in order to be dealt with according to law; and

• (b) to appear on ................, the ................ day of ................ A.D. ........, at ............ o’clock in the ........ noon, at ................, for the purposes of the Identification of Criminals Act. (Ignore, if not filled in).

You are warned that failure without lawful excuse to attend court in accordance with this summons is an offence under subsection 145(4) of the Criminal Code.

Subsection 145(4) of the Criminal Code states as follows:

• “(4) Every one who is served with a summons and who fails, without lawful excuse, the proof of which lies on him, to appear at a time and place stated therein, if any, for the purposes of the Identification of Criminals Act or to attend court in accordance therewith, is guilty of

  • (a) an indictable offence and is liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.”

Section 510 of the Criminal Code states as follows:

• “510  Where an accused who is required by a summons to appear at a time and place stated therein for the purposes of the Identification of Criminals Act does not appear at that time and place, a justice may issue a warrant for the arrest of the accused for the offence with which he is charged.”

Dated this ................ day of ................ A.D. ........, at ................ .

......................................

A Justice of the Peace in

and for ............ or Judge

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division):

This warrant is issued for the arrest of A.B., of ................, (occupation), hereinafter called the accused.

Whereas the accused has been charged that (set out briefly the offence in respect of which the accused is charged);

And whereas:*

• (a) there are reasonable grounds to believe that it is necessary in the public interest to issue this warrant for the arrest of the accused [507(4), 512(1)];

• (b) the accused failed to attend court in accordance with the summons served on him [512(2)];

• (c) (an appearance notice or a promise to appear or a recognizance entered into before an officer in charge) was confirmed and the accused failed to attend court in accordance therewith [512(2)];

• (d) it appears that a summons cannot be served because the accused is evading service [512(2)];

• (e) the accused was ordered to be present at the hearing of an application for a review of an order made by a justice and did not attend the hearing [520(5), 521(5)];

• (f) there are reasonable grounds to believe that the accused has contravened or is about to contravene the (promise to appear or undertaking or recognizance) on which he was released [524(1), 525(5), 679(6)];

• (g) there are reasonable grounds to believe that the accused has since his release from custody on (a promise to appear or an undertaking or a recognizance) committed an indictable offence [524(1), 525(5), 679(6)];

• (h) the accused was required by (an appearance notice or a promise to appear or a recognizance entered into before an officer in charge or a summons) to attend at a time and place stated therein for the purposes of the Identification of Criminals Act and did not appear at that time and place [502, 510];

• (i) an indictment has been found against the accused and the accused has not appeared or remained in attendance before the court for his trial [597];

• (j) **

This is, therefore, to command you, in Her Majesty’s name, forthwith to arrest the said accused and to bring him before (state court, judge or justice), to be dealt with according to law.

(Add where applicable) Whereas there are reasonable grounds to believe that the accused is or will be present in (here describe dwelling-house);

This warrant is also issued to authorize you to enter the dwelling-house for the purpose of arresting or apprehending the accused, subject to the condition that you may not enter the dwelling-house unless you have, immediately before entering the dwelling-house, reasonable grounds to believe that the person to be arrested or apprehended is present in the dwelling-house.

Dated this ................ day of ................ A.D. ........, at ................ .

........................................

Judge, Clerk of the Court,

Provincial Court Judge or Justice

*Initial applicable recital.

**For any case not covered by recitals (a) to (i), insert recital in the words of the statute authorizing the warrant.

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division):

This warrant is issued in respect of the arrest of A.B., or a person with the following description (       ), of ..............., (occupation).

Whereas there are reasonable grounds to believe:*

• (a) a warrant referred to in this or any other Act of Parliament to arrest or apprehend the person is in force anywhere in Canada;

• (b) grounds exist to arrest the person without warrant under paragraph 495(1)(a) or (b) or section 672.91 of the Criminal Code; or

• (c) grounds exist to arrest or apprehend without warrant the person under an Act of Parliament, other than this Act;

And whereas there are reasonable grounds to believe that the person is or will be present in (here describe dwelling-house);

This warrant is issued to authorize you to enter the dwelling-house for the purpose of arresting or apprehending the person.

Dated this ................ day of ................ A.D. ........, at ................ .

........................................

Judge, Clerk of the Court,

Provincial Court Judge or Justice

*Initial applicable recital.

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division) and to the keeper of the (prison) at ................:

This warrant is issued for the committal of A.B., of ................, (occupation), hereinafter called the accused.

Whereas the accused has been charged that (set out briefly the offence in respect of which the accused is charged);

And whereas:*

• (a) the prosecutor has shown cause why the detention of the accused in custody is justified [515(5)];

• (b) an order has been made that the accused be released on (giving an undertaking or entering into a recognizance) but the accused has not yet complied with the order [519(1), 520(9), 521(10), 524(12), 525(8)];**

• (c) the application by the prosecutor for a review of the order of a justice in respect of the interim release of the accused has been allowed and that order has been vacated, and the prosecutor has shown cause why the detention of the accused in custody is justified [521];

• (d) the accused has contravened or was about to contravene his (promise to appear or undertaking or recognizance) and the same was cancelled, and the detention of the accused in custody is justified or seems proper in the circumstances [524(4), 524(8)];

• (e) there are reasonable grounds to believe that the accused has after his release from custody on (a promise to appear or an undertaking or a recognizance) committed an indictable offence and the detention of the accused in custody is justified or seems proper in the circumstances [524(4), 524(8)];

• (f) the accused has contravened or was about to contravene the (undertaking or recognizance) on which he was released and the detention of the accused in custody seems proper in the circumstances [525(7), 679(6)];

• (g) there are reasonable grounds to believe that the accused has after his release from custody on (an undertaking or a recognizance) committed an indictable offence and the detention of the accused in custody seems proper in the circumstances [525(7), 679(6)];

• (h) ***

This is, therefore, to command you, in Her Majesty’s name, to arrest, if necessary, and take the accused and convey him safely to the (prison) at ................, and there deliver him to the keeper thereof, with the following precept:

I do hereby command you the said keeper to receive the accused in your custody in the said prison and keep him safely there until he is delivered by due course of law.

Dated this ................ day of ................ A.D. ........, at ................ .

...............................................................

Judge, Clerk of the Court, Provincial Court

Judge or Justice

*Initial applicable recital.

**If the person having custody of the accused is authorized under paragraph 519(1)(b) to release him on his complying with an order, endorse the authorization on this warrant and attach a copy of the order.

***For any case not covered by recitals (a) to (g), insert recital in the words of the statute authorizing the warrant.

Canada, Province of ...................., (territorial division).

To A.B., of ................, (occupation):

You are alleged to have committed (set out substance of offence).

• 1 You are required to attend court on ....... day, the ....... day of ................ A.D. ......., at ............ o’clock in the ........ noon, in courtroom No. ........, at ................ court, in the municipality of ................, and to attend thereafter as required by the court, in order to be dealt with according to law.

• 2 You are also required to appear on ....... day, the ....... day of ................ A.D. ......., at ............ o’clock in the ........ noon, at .......................... (police station), (address), for the purposes of the Identification of Criminals Act. (Ignore if not filled in.)

You are warned that failure to attend court in accordance with this appearance notice is an offence under subsection 145(5) of the Criminal Code.

Subsections 145(5) and (6) of the Criminal Code state as follows:

• “(5) Every person who is named in an appearance notice or promise to appear, or in a recognizance entered into before an officer in charge or another peace officer, that has been confirmed by a justice under section 508 and who fails, without lawful excuse, the proof of which lies on the person, to appear at the time and place stated therein, if any, for the purposes of the Identification of Criminals Act or to attend court in accordance therewith, is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.

• (6) For the purposes of subsection (5), it is not a lawful excuse that an appearance notice, promise to appear or recognizance states defectively the substance of the alleged offence.”

Section 502 of the Criminal Code states as follows:

• “502 Where an accused who is required by an appearance notice or promise to appear or by a recognizance entered into before an officer in charge or another peace officer to appear at a time and place stated therein for the purposes of the Identification of Criminals Act does not appear at that time and place, a justice may, where the appearance notice, promise to appear or recognizance has been confirmed by a justice under section 508, issue a warrant for the arrest of the accused for the offence with which the accused is charged.”

Issued at ........ a.m./p.m. this ................ day of ....... A.D. ........, at ................. .

................................................

(Signature of peace officer)

................................................

(Signature of accused)

Canada, Province of ...................., (territorial division).

I, A.B., of ................, (occupation), understand that it is alleged that I have committed (set out substance of offence).

In order that I may be released from custody,

• 1 I promise to attend court on .......... day, the .......... day of ................ A.D. ........, at ............ o’clock in the ........ noon, in courtroom No. ........, at ............ court, in the municipality of ................, and to attend thereafter as required by the court, in order to be dealt with according to law.

• 2 I also promise to appear on ............ day, the .......... day of ................ A.D. ........, at ............. o’clock in the ........ noon, at ................... (police station), (address), for the purposes of the Identification of Criminals Act. (Ignore if not filled in.)

I understand that failure without lawful excuse to attend court in accordance with this promise to appear is an offence under subsection 145(5) of the Criminal Code.

Subsections 145(5) and (6) of the Criminal Code state as follows:

• “(5) Every person who is named in an appearance notice or promise to appear, or in a recognizance entered into before an officer in charge or another peace officer, that has been confirmed by a justice under section 508 and who fails, without lawful excuse, the proof of which lies on the person, to appear at the time and place stated therein, if any, for the purposes of the Identification of Criminals Act or to attend court in accordance therewith, is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.

• (6) For the purposes of subsection (5), it is not a lawful excuse that an appearance notice, promise to appear or recognizance states defectively the substance of the alleged offence.”

Section 502 of the Criminal Code states as follows:

• “502 Where an accused who is required by an appearance notice or promise to appear or by a recognizance entered into before an officer in charge or another peace officer to appear at a time and place stated therein for the purposes of the Identification of Criminals Act does not appear at that time and place, a justice may, where the appearance notice, promise to appear or recognizance has been confirmed by a justice under section 508, issue a warrant for the arrest of the accused for the offence with which the accused is charged.”

Dated this ............. day of ................ A.D. ........, at ................. .

...........................................

(Signature of accused)

Canada, Province of ...................., (territorial division).

I, A.B., of ................, (occupation), understand that it is alleged that I have committed (set out substance of offence).

In order that I may be released from custody, I hereby acknowledge that I owe $ (not exceeding $500) to Her Majesty the Queen to be levied on my real and personal property if I fail to attend court as hereinafter required.

(or, for a person not ordinarily resident in the province in which the person is in custody or within two hundred kilometres of the place in which the person is in custody)

In order that I may be released from custody, I hereby acknowledge that I owe $ (not exceeding $500) to Her Majesty the Queen and deposit herewith (money or other valuable security not exceeding in amount or value $500) to be forfeited if I fail to attend court as hereinafter required.

• 1 I acknowledge that I am required to attend court on .......... day, the .......... day of .......... A.D. ........, at .......... o’clock in the ............. noon, in courtroom No. ............., at ................ court, in the municipality of ................, and to attend thereafter as required by the court, in order to be dealt with according to law.

• 2 I acknowledge that I am also required to appear on ........... day, the ................ day of ................ A.D. ........., at ............ o’clock in the ........ noon, at .................. (police station), (address), for the purposes of the Identification of Criminals Act. (Ignore if not filled in.)

I understand that failure without lawful excuse to attend court in accordance with this recognizance to appear is an offence under subsection 145(5) of the Criminal Code.

Subsections 145(5) and (6) of the Criminal Code state as follows:

• “(5) Every person who is named in an appearance notice or promise to appear, or in a recognizance entered into before an officer in charge or another peace officer, that has been confirmed by a justice under section 508 and who fails, without lawful excuse, the proof of which lies on the person, to appear at the time and place stated therein, if any, for the purposes of the Identification of Criminals Act or to attend court in accordance therewith, is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.

• (6) For the purposes of subsection (5), it is not a lawful excuse that an appearance notice, promise to appear or recognizance states defectively the substance of the alleged offence.”

Section 502 of the Criminal Code states as follows:

• “502 Where an accused who is required by an appearance notice or promise to appear or by a recognizance entered into before an officer in charge or another peace officer to appear at a time and place stated therein for the purposes of the Identification of Criminals Act does not appear at that time and place, a justice may, where the appearance notice, promise to appear or recognizance has been confirmed by a justice under section 508, issue a warrant for the arrest of the accused for the offence with which the accused is charged.”

Dated this ............... day of ................ A.D. ........, at ................ .

.......................................

(Signature of accused)

Canada, Province of ...................., (territorial division).

I, A.B., of ................, (occupation), understand that it is alleged that I have committed (set out substance of the offence).

In order that I may be released from custody by way of (a promise to appear or a recognizance), I undertake to (insert any conditions that are directed):

• (a) remain within (designated territorial jurisdiction);

• (b) notify (name of peace officer or other person designated) of any change in my address, employment or occupation;

• (c) abstain from communicating, directly or indirectly, with (identification of victim, witness or other person) or from going to (name or description of place) except in accordance with the following conditions: (as the peace officer or other person designated specifies);

• (d) deposit my passport with (name of peace officer or other person designated);

• (e) to abstain from possessing a firearm and to surrender to (name of peace officer or other person designated) any firearm in my possession and any authorization, licence or registration certificate or other document enabling the acquisition or possession of a firearm;

• (f) report at (state times) to (name of peace officer or other person designated);

• (g) to abstain from

  • (i) the consumption of alcohol or other intoxicating substances, or

  • (ii) the consumption of drugs except in accordance with a medical prescription; and

• (h) comply with any other conditions that the peace officer or officer in charge considers necessary to ensure the safety and security of any victim of or witness to the offence.

I understand that I am not required to give an undertaking to abide by the conditions specified above, but that if I do not, I may be kept in custody and brought before a justice so that the prosecutor may be given a reasonable opportunity to show cause why I should not be released on giving an undertaking without conditions.

I understand that if I give an undertaking to abide by the conditions specified above, then I may apply, at any time before I appear, or when I appear, before a justice pursuant to (a promise to appear or a recognizance entered into before an officer in charge or another peace officer), to have this undertaking vacated or varied and that my application will be considered as if I were before a justice pursuant to section 515 of the Criminal Code.

I also understand that this undertaking remains in effect until it is vacated or varied.

I also understand that failure without lawful excuse to abide by any of the conditions specified above is an offence under subsection 145(5.1) of the Criminal Code.

Subsection 145(5.1) of the Criminal Code states as follows:

• “(5.1) Every person who, without lawful excuse, the proof of which lies on the person, fails to comply with any condition of an undertaking entered into pursuant to subsection 499(2) or 503(2.1)

  • (a) is guilty of an indictable offence and is liable to imprisonment for a term not exceeding two years; or

  • (b) is guilty of an offence punishable on summary conviction.”

Dated this .............. day of ................ A.D. ........, at ................ .

......................................

(Signature of accused)

Canada,

Province of ....................,

(territorial division).

I, A.B., of ................, (occupation), understand that I have been charged that (set out briefly the offence in respect of which accused is charged).

In order that I may be released from custody, I undertake to attend court on ........... day, the ................ day of ................ A.D. ........, and to attend thereafter as required by the court in order to be dealt with according to law (or, where date and place of appearance before court are not known at the time undertaking is given, to attend at the time and place fixed by the court and thereafter as required by the court in order to be dealt with according to law).

(and, where applicable)

I also undertake to (insert any conditions that are directed)

• (a) report at (state times) to (name of peace officer or other person designated);

• (b) remain within (designated territorial jurisdiction);

• (c) notify (name of peace officer or other person designated) of any change in my address, employment or occupation;

• (d) abstain from communicating, directly or indirectly, with (identification of victim, witness or other person) except in accordance with the following conditions: (as the justice or judge specifies);

• (e) deposit my passport (as the justice or judge directs); and

• (f) (any other reasonable conditions).

I understand that failure without lawful excuse to attend court in accordance with this undertaking is an offence under subsection 145(2) of the Criminal Code.

Subsections 145(2) and (3) of the Criminal Code state as follows:

• “(2) Every one who,

  • (a) being at large on his undertaking or recognizance given to or entered into before a justice or judge, fails, without lawful excuse, the proof of which lies on him, to attend court in accordance with the undertaking or recognizance, or

  • (b) having appeared before a court, justice or judge, fails, without lawful excuse, the proof of which lies on him, to attend court as thereafter required by the court, justice or judge,

  or to surrender himself in accordance with an order of the court, justice or judge, as the case may be, is guilty of an indictable offence and liable to imprisonment for a term not exceeding two years or is guilty of an offence punishable on summary conviction.

• (3) Every person who is at large on an undertaking or recognizance given to or entered into before a justice or judge and is bound to comply with a condition of that undertaking or recognizance directed by a justice or judge, and every person who is bound to comply with a direction ordered under subsection 515(12) or 522(2.1), and who fails, without lawful excuse, the proof of which lies on that person, to comply with that condition or direction, is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.”

Dated this ................ day of ................ A.D. ........, at ................ .

......................................

(Signature of accused)

Canada,

Province of ................,

(territorial division).

I, A.B., of ................, (occupation), being the appellant against conviction (or against sentence or against an order or by way of stated case) in respect of the following matter (set out the offence, subject-matter of order or question of law) undertake to appear personally at the sittings of the appeal court at which the appeal is to be heard.

(and where applicable)

I also undertake to (insert any conditions that are directed)

• (a) report at (state times) to (name of peace officer or other person designated);

• (b) remain within (designated territorial jurisdiction);

• (c) notify (name of peace officer or other person designated) of any change in my address, employment or occupation;

• (d) abstain from communicating, directly or indirectly, with (identification of victim, witness or other person) except in accordance with the following conditions: (as the justice or judge specifies);

• (e) deposit my passport (as the justice or judge directs); and

• (f) (any other reasonable conditions).

Dated this ................ day of ................ A.D. ........, at ................ .

.......................................

(Signature of appellant)

Canada,

Province of ................,

(territorial division).

I, A.B., of ................, (occupation), being the appellant against an order of dismissal (or against sentence) in respect of the following charge (set out the name of the defendant and the offence, subject-matter of order or question of law) undertake to appear personally or by counsel at the sittings of the appeal court at which the appeal is to be heard.

Dated this ................ day of ................ A.D. ........, at ................ .

	(Signature of appellant)

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division):

Whereas A.B., of ................ hereinafter called the accused, has been charged that (state place of offence and charge);

And Whereas I have taken the deposition of X.Y. in respect of the said charge;

And Whereas the charge is for an offence committed in the (territorial division);

This is to command you, in Her Majesty’s name, to convey the said A.B., before a justice of the (last mentioned territorial division).

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for .................................

Canada,

Province of ................,

(territorial division).

To E.F., of ................, (occupation);

Whereas A.B. has been charged that (state offence as in the information), and it has been made to appear that you are likely to give material evidence for (the prosecution or the defence);

This is therefore to command you to attend before (set out court or justice), on ................ the ................ day of ................ A.D. ......., at ............ o’clock in the ........ noon at ................ to give evidence concerning the said charge.*

*Where a witness is required to produce anything, add the following:

and to bring with you anything in your possession or under your control that relates to the said charge, and more particularly the following: (specify any documents, objects or other things required).

Dated this ................ day of ................ A.D. ........, at ................ .

........................................

A Judge, Justice or Clerk of

the court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To E.F., of ................, (occupation);

Whereas A.B. has been charged that (state offence as in the information), and it has been made to appear that you are likely to give material evidence for (the prosecution or the defence);

This is therefore to command you to attend before (set out court or justice), on ................ the ................ day of ................ A.D. ......., at ............ o’clock in the ........ noon at ................ to give evidence concerning the said charge, and to bring with you anything in your possession or under your control that relates to the said charge, and more particularly the following: (specify any documents, objects or other things required).

TAKE NOTE

You are only required to bring the things specified above to the court on the date and at the time indicated, and you are not required to provide the things specified to any person or to discuss their contents with any person unless and until ordered by the court to do so.

If anything specified above is a “record” as defined in section 278.1 of the Criminal Code, it may be subject to a determination by the court in accordance with sections 278.1 to 278.91 of the Criminal Code as to whether and to what extent it should be produced.

If anything specified above is a “record” as defined in section 278.1 of the Criminal Code, the production of which is governed by sections 278.1 to 278.91 of the Criminal Code, this subpoena must be accompanied by a copy of an application for the production of the record made pursuant to section 278.3 of the Criminal Code, and you will have an opportunity to make submissions to the court concerning the production of the record.

If anything specified above is a “record” as defined in section 278.1 of the Criminal Code, the production of which is governed by sections 278.1 to 278.91 of the Criminal Code, you are not required to bring it with you until a determination is made in accordance with those sections as to whether and to what extent it should be produced.

As defined in section 278.1 of the Criminal Code, “record” means any form of record that contains personal information for which there is a reasonable expectation of privacy and includes, without limiting the generality of the foregoing, medical, psychiatric, therapeutic, counselling, education, employment, child welfare, adoption and social services records, personal journals and diaries, and records containing personal information the production or disclosure of which is protected by any other Act of Parliament or a provincial legislature, but does not include records made by persons responsible for the investigation or prosecution of the offence.

Dated this ..................... day of ..................... A.D. ........, at ................ .

........................................

Judge,

Clerk of the Court,

Provincial Court Judge or Justice

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division):

Whereas A.B. of ................, has been charged that (state offence as in the information);

And Whereas it has been made to appear that E.F. of ................, hereinafter called the witness, is likely to give material evidence for (the prosecution or the defence) and that*

*Insert whichever of the following is appropriate:

• (a) the said E.F. will not attend unless compelled to do so;

• (b) the said E.F. is evading service of a subpoena;

• (c) the said E.F. was duly served with a subpoena and has neglected (to attend at the time and place appointed therein or to remain in attendance);

• (d) the said E.F. was bound by a recognizance to attend and give evidence and has neglected (to attend or to remain in attendance).

This is therefore to command you, in Her Majesty’s name, to arrest and bring the witness forthwith before (set out court or justice) to be dealt with in accordance with section 706 of the Criminal Code.

Dated this ................ day of ................ A.D. ........, at ................ .

....................................

A Justice or Clerk of

the Court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division):

Whereas A.B., of ................, has been charged that (state offence as in the information);

And Whereas I am satisfied by information in writing and under oath that C.D., of ................, hereinafter called the witness, is bound by recognizance to give evidence on the trial of the accused on the said charge, and that the witness (has absconded or is about to abscond);

This is therefore to command you, in Her Majesty’s name, to arrest the witness and bring him forthwith before (the court, judge, justice or provincial court judge before whom the witness is bound to appear) to be dealt with in accordance with section 706 of the Criminal Code.

Dated this ................ day of ................ A.D. ........, at ................ .

..........................................

A Justice of the Peace in

and for...............................

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division):

You are hereby commanded forthwith to arrest, if necessary, and convey to the (prison) at ................ the persons named in the following schedule each of whom has been remanded to the time mentioned in the schedule:

And I hereby command you, the keeper of the said prison, to receive each of the said persons into your custody in the prison and keep him safely until the day when his remand expires and then to have him before me or any other justice at ................. at ............ o’clock in the ........ noon of the said day, there to answer to the charge and to be dealt with according to law, unless you are otherwise ordered before that time.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for...............................

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division):

Whereas A.B. of ................, hereinafter called the accused, has been charged that (set out offence as in the information);

And Whereas E.F. of ................, hereinafter called the witness, attending before me to give evidence for (the prosecution or the defence) concerning the charge against the accused (refused to be sworn or being duly sworn as a witness refused to answer certain questions concerning the charge that were put to him or refused or neglected to produce the following writings, namely ................ or refused to sign his deposition) having been ordered to do so, without offering any just excuse for such refusal or neglect;

This is therefore to command you, in Her Majesty’s name, to arrest, if necessary, and take the witness and convey him safely to the prison at ................, and there deliver him to the keeper thereof, together with the following precept:

I do hereby command you, the said keeper, to receive the said witness into your custody in the said prison and safely keep him there for the term of ................ days, unless he sooner consents to do what was required of him, and for so doing this is a sufficient warrant.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for...............................

Canada,

Province of ............,

(territorial division).

To the peace officers in the territorial division of (name) and to the keeper of a federal penitentiary (or provincial correctional institution for the province of ............, as the case may be)

Whereas (name), hereinafter called the offender was on the ........ day of ........ 19........, convicted by (name of judge and court) of having committed the following offence(s) and it was adjudged that the offender be sentenced as follows:

Offence	Sentence	Remarks
(state offence of which offender was convicted)	(state term of imprisonment for the offence and, in case of imprisonment for default of payment of fine, so indicate together with the amount thereof and costs applicable and whether payable forthwith or within a time fixed)	(state whether the sentence is consecutive or concurrent, and specify consecutive or concurrent to/with what other sentence)
1.
2.
3.
4.

You are hereby commanded, in her Majesty’s name, to arrest the offender if it is necessary to do so in order to take the offender into custody, and to take and convey him safely to a federal penitentiary (or provincial correctional institution for the province of ........, as the case may be) and deliver him to the keeper thereof, who is hereby commanded to receive the accused into custody and to imprison him there for the term(s) of his sentence, unless, where a term of imprisonment was imposed only in default of payment of a fine or costs, the said amounts and the costs and charges of the committal and of conveying the offender to the said prison are sooner paid, and this is a sufficient warrant for so doing.

Dated this ........ day of ............ A.D. ........, at .............

	Clerk of the Court, Justice, Judge or Provincial Court Judge

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division) and to the keeper of the (prison) at ....................:

Whereas A.B., hereinafter called the defendant, was tried on an information alleging that (set out matter of complaint), and it was ordered that (set out the order made), and in default that the defendant be imprisoned in the (prison) at ................ for a term of ....................;

I hereby command you, in Her Majesty’s name, to arrest, if necessary, and take the defendant and convey him safely to the (prison) at ................, and deliver him to the keeper thereof, together with the following precept:

I hereby command you, the keeper of the said prison, to receive the defendant into your custody in the said prison and imprison him there for the term of ................, unless the said amounts and the costs and charges of the committal and of conveying the defendant to the said prison are sooner paid, and for so doing this is a sufficient warrant.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for...............................

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division) and to the keeper of the (prison) at ....................:

Whereas A.B., hereinafter called the accused, has been ordered to enter into a recognizance to keep the peace and be of good behaviour, and has (refused or failed) to enter into a recognizance accordingly;

You are hereby commanded, in Her Majesty’s name, to arrest, if necessary, and take the accused and convey him safely to the (prison) at ................ and deliver him to the keeper thereof, together with the following precept:

You, the said keeper, are hereby commanded to receive the accused into your custody in the said prison and imprison him there until he enters into a recognizance as aforesaid or until he is discharged in due course of law.

Dated this ................ day of ................ A.D. ........, at ................ .

	Clerk of the Court, Justice or Provincial Court Judge

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To the peace officers in the (territorial division) and to the keeper of the (prison) at ....................:

Whereas A.B., hereinafter called the accused, was committed for trial on a charge that (state offence as in the information);

And Whereas E.F., hereinafter called the witness, having appeared as a witness on the preliminary inquiry into the said charge, and being required to enter into a recognizance to appear as a witness on the trial of the accused on the said charge, has (failed or refused) to do so;

This is therefore to command you, in Her Majesty’s name, to arrest, if necessary, and take and safely convey the said witness to the (prison) at ................ and there deliver him to the keeper thereof, together with the following precept:

I do hereby command you, the said keeper, to receive the witness into your custody in the said prison and keep him there safely until the trial of the accused on the said charge, unless before that time the witness enters into the said recognizance.

Dated this ................ day of ................ A.D. ........, at ................ .

.......................................

A Justice of the Peace in

and for...............................

Canada,

Province of ................,

(territorial division).

To the peace officers in the said (territorial division) and to the keeper of the (prison) at ....................:

Whereas E.F. of ................, hereinafter called the defaulter, was on the ................ day of ................ A.D. ........, at ................., convicted before ................ for contempt in that he did not attend before ................ to give evidence on the trial of a charge that (state offence as in the information) against A.B. of ................, although (duly subpoenaed or bound by recognizance to appear and give evidence in that behalf, as the case may be) and did not show any sufficient excuse for his default;

And Whereas in and by the said conviction it was adjudged that the defaulter (set out punishment adjudged);

And Whereas the defaulter has not paid the amounts adjudged to be paid; (delete if not applicable)

This is therefore to command you, in Her Majesty’s name, to arrest, if necessary, and take the defaulter and convey him safely to the prison at ................ and there deliver him to the keeper thereof, together with the following precept:

I do hereby command you, the said keeper, to receive the defaulter into your custody in the said prison and imprison him there* and for so doing this is a sufficient warrant.

*Insert whichever of the following is applicable:

• (a) for the term of ................;

• (b) for the term of ................ unless the said sums and the costs and charges of the committal and of conveying the defaulter to the said prison are sooner paid;

• (c) for the term of ................ and for the term of (if consecutive so state) unless the said sums and the costs and charges of the committal and of conveying the defaulter to the said prison are sooner paid.

Dated this ................ day of ............... A.D. ........, at ................ .

..........................................

A Justice or Clerk of

the Court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To the peace officers of (territorial division) and to the keeper of the (prison) at ....................:

Whereas it appears that on the hearing of an appeal before the (set out court) it was adjudged that A.B., of ................, hereinafter called the defaulter, should pay to the Clerk of the Court the sum of ................ dollars in respect of costs;

And Whereas the Clerk of the Court has certified that the defaulter has not paid the sum within the time limited therefor;

I do hereby command you, the said peace officers, in Her Majesty’s name, to take the defaulter and safely convey him to the (prison) at ................ and deliver him to the keeper thereof, together with the following precept:

I do hereby command you, the said keeper, to receive the defaulter into your custody in the said prison and imprison him for the term of ................, unless the said sum and the costs and charges of the committal and of conveying the defaulter to the said prison are sooner paid, and for so doing this is a sufficient warrant.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for...............................

Canada,

Province of ................,

(territorial division).

To the sheriff of (territorial division) and to the keeper of the (prison) at ................:

You are hereby commanded to arrest, if necessary, and take (A.B. and C.D. as the case may be) hereinafter called the defaulters, and to convey them safely to the (prison) at ................ and deliver them to the keeper thereof, together with the following precept:

You, the said keeper, are hereby commanded to receive the defaulters into your custody in the said prison and imprison them for a period of ................ or until satisfaction is made of a judgment debt of ............ dollars due to Her Majesty the Queen in respect of the forfeiture of a recognizance entered into by ................ on the ................ day of ................ A.D. ........ .

Dated this ................ day of ................ A.D. ........ .

	Clerk of the ..........

(Seal)

Canada,

Province of ............,

(territorial division).

Pursuant to application this day made to me, I hereby authorize the arrest of the accused (or defendant) (or execution of this warrant in the case of a warrant issued pursuant to section 487), within the said (territorial division).

Dated this ........ day of ............ A.D. ........, at .............

	A Justice of the Peace in and for...............

Canada,

Province of ............,

(territorial division).

Pursuant to application this day made to me, I hereby authorize the execution of this order, in the case of an order issued under section 487.051 or 487.052 (or execution of this authorization in the case of an authorization issued under section 487.055 or 487.091), within the said (territorial division).

Dated this ........ day of ......... A.D. ........, at ............

.........................................

Judge of the Provincial Court

Canada,

Province of ................,

(territorial division).

Whereas this warrant is issued under section 507, 508 or 512 of the Criminal Code in respect of an offence other than an offence mentioned in section 522 of the Criminal Code, I hereby authorize the release of the accused pursuant to section 499 of that Act.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for ..............................

Canada,

Province of ................,

(territorial division).

To the keeper of the (prison) at ................:

Whereas by warrant dated the ................ day of ................ A.D. ........, I committed A.B., hereinafter called the accused, to your custody and required you safely to keep until the ................ day of ................ A.D. ........, and then to have him before me or any other justice at ................ at ............ o’clock in the ........ noon to answer to the charge against him and to be dealt with according to law unless you should be ordered otherwise before that time;

Now, therefore, I order and direct you to have the accused before ................ at ................ at ............ o’clock in the ........ noon to answer to the charge against him and to be dealt with according to law.

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice of the Peace in and for...............................

Canada,

Province of ................,

(territorial division).

These are the depositions of X.Y., of ................, and M.N., of ................, taken before me, this .................... day of ................ A.D., ........ at ................, in the presence and hearing of A.B., hereinafter called the accused, who stands charged (state offence as in the information).

X.Y., having been duly sworn, deposes as follows: (insert deposition as nearly as possible in words of witness).

M.N., having been duly sworn, deposes as follows:

I certify that the depositions of X.Y., and M.N., written on the several sheets of paper hereto annexed to which my signature is affixed, were taken in the presence and hearing of the accused (and signed by them respectively, in his presence where they are required to be signed by witness). In witness whereof I have hereto signed my name.

	A Justice of the Peace in and for...............................

Canada,

Province of ................,

(territorial division).

Be it remembered that on this day the persons named in the following schedule personally came before me and severally acknowledged themselves to owe to Her Majesty the Queen the several amounts set opposite their respective names, namely,

to be made and levied of their several goods and chattels, lands and tenements, respectively, to the use of Her Majesty the Queen, if the said A.B. fails in any of the conditions hereunder written.

Taken and acknowledged before me on the ................ day of ................ A.D. ........, at ................ .

	Judge, Clerk of the Court, Provincial Court Judge or Justice

• 1 Whereas the said ................, hereinafter called the accused, has been charged that (set out the offence in respect of which the accused has been charged);

Now, therefore, the condition of this recognizance is that if the accused attends court on .............. day, the .................. day of ........................ A.D. ...................., at ......................... o’clock in the ................... noon and attends thereafter as required by the court in order to be dealt with according to law (or, where date and place of appearance before court are not known at the time recognizance is entered into if the accused attends at the time and place fixed by the court and attends thereafter as required by the court in order to be dealt with according to law) [515, 520, 521, 522, 523, 524, 525, 680];

And further, if the accused (insert in Schedule of Conditions any additional conditions that are directed),

the said recognizance is void, otherwise it stands in full force and effect.

• 2 Whereas the said ................, hereinafter called the appellant, is an appellant against his conviction (or against his sentence) in respect of the following charge (set out the offence for which the appellant was convicted) [679, 680];

Now, therefore, the condition of this recognizance is that if the appellant attends as required by the court in order to be dealt with according to law;

And further, if the appellant (insert in Schedule of Conditions any additional conditions that are directed),

the said recognizance is void, otherwise it stands in full force and effect.

• 3 Whereas the said ................, hereinafter called the appellant, is an appellant against his conviction (or against his sentence or against an order or by way of stated case) in respect of the following matter (set out offence, subject-matter of order or question of law) [816, 831, 832, 834];

Now, therefore, the condition of this recognizance is that if the appellant appears personally at the sittings of the appeal court at which the appeal is to be heard;

And further, if the appellant (insert in Schedule of Conditions any additional conditions that are directed),

the said recognizance is void, otherwise it stands in full force and effect.

• 4 Whereas the said ................, hereinafter called the appellant, is an appellant against an order of dismissal (or against sentence) in respect of the following charge (set out the name of the defendant and the offence, subject-matter of order or question of law) [817, 831, 832, 834];

Now, therefore, the condition of this recognizance is that if the appellant appears personally or by counsel at the sittings of the appeal court at which the appeal is to be heard the said recognizance is void, otherwise it stands in full force and effect.

• 5 Whereas the said ................, hereinafter called the accused, was ordered to stand trial on a charge that (set out the offence in respect of which the accused has been charged);

And whereas A.B. appeared as a witness on the preliminary inquiry into the said charge [550, 706, 707];

Now, therefore, the condition of this recognizance is that if the said A.B. appears at the time and place fixed for the trial of the accused to give evidence on the indictment that is found against the accused, the said recognizance is void, otherwise it stands in full force and effect.

• 6 The condition of the above written recognizance is that if A.B. keeps the peace and is of good behaviour for the term of ...... commencing on ......, the said recognizance is void, otherwise it stands in full force and effect [810 and 810.1].

• 7 Whereas a warrant was issued under section 462.32 or a restraint order was made under subsection 462.33(3) of the Criminal Code in relation to any property (set out a description of the property and its location);

Now, therefore, the condition of this recognizance is that A.B. shall not do or cause anything to be done that would result, directly or indirectly, in the disappearance, dissipation or reduction in value of the property or otherwise affect the property so that all or a part thereof could not be subject to an order of forfeiture under section 462.37 or 462.38 of the Criminal Code or any other provision of the Criminal Code or any other Act of Parliament [462.34].

Schedule of Conditions

• (a) reports at (state times) to (name of peace officer or other person designated);

• (b) remains within (designated territorial jurisdiction);

• (c) notifies (name of peace officer or other person designated) of any change in his address, employment or occupation;

• (d) abstains from communicating, directly or indirectly, with (identification of victim, witness or other person) except in accordance with the following conditions: (as the justice or judge specifies);

• (e) deposits his passport (as the justice or judge directs); and

• (f) (any other reasonable conditions).

Note: Section 763 and subsections 764(1) to (3) of the Criminal Code state as follows:

• “763 Where a person is bound by recognizance to appear before a court, justice or provincial court judge for any purpose and the session or sittings of that court or the proceedings are adjourned or an order is made changing the place of trial, that person and his sureties continue to be bound by the recognizance in like manner as if it had been entered into with relation to the resumed proceedings or the trial at the time and place at which the proceedings are ordered to be resumed or the trial is ordered to be held.

• 764. (1)  Where an accused is bound by recognizance to appear for trial, his arraignment or conviction does not discharge the recognizance, but it continues to bind him and his sureties, if any, for his appearance until he is discharged or sentenced, as the case may be.

• (2) Notwithstanding subsection (1), the court, justice or provincial court judge may commit an accused to prison or may require him to furnish new or additional sureties for his appearance until he is discharged or sentenced, as the case may be.

• (3) The sureties of an accused who is bound by recognizance to appear for trial are discharged if he is committed to prison pursuant to subsection (2).”

I hereby certify that A.B. (has not appeared as required by this recognizance or has not complied with a condition of this recognizance) and that by reason thereof the ends of justice have been (defeated or delayed, as the case may be).

The nature of the default is ................................ and the reason for the default is ............. (state reason if known).

The names and addresses of the principal and sureties are as follows:

Dated this ................ day of ................ A.D. ........, at ................ .

	(Signature of justice, judge, provincial court judge, clerk of the court, peace officer or other person, as the case may be) (Seal, if required)

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:

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)

Canada,

Province of ................,

(territorial division).

Be it remembered that on the ................ day of ................ at ................, A.B., (date of birth) hereinafter called the accused, was tried under Part (XIX or XXVII) of the Criminal Code on the charge that (state fully the offence of which accused was convicted), was convicted of the said offence and the following punishment was imposed on him, namely,*

*Use whichever of the following forms of sentence is applicable:

• (a) that the said accused be imprisoned in the (prison) at ................ for the term of ................;

• (b) that the said accused forfeit and pay the sum of ............ dollars to be applied according to law and also pay to ................ the sum of ............ dollars in respect of costs and in default of payment of the said sums forthwith (or within a time fixed, if any), to be imprisoned in the (prison) at ................ for the term of ................ unless the said sums and the costs and charges of the committal and of conveying the accused to the said prison are sooner paid;

• (c) that the said accused be imprisoned in the (prison) at ................ for the term of .................... and in addition forfeit and pay the sum of ............ dollars to be applied according to law and also pay to ................ the sum of ........... dollars in respect of costs and in default of payment of the said sums forthwith (or within a time fixed, if any), to be imprisoned in the (prison) at ................ for the term of ................ (if sentence to be consecutive, state accordingly) unless the said sums and the costs and charges of the committal and of conveying the accused to the said prison are sooner paid.

Dated this ................ day of ................ A.D. ........, at ................ .

..........................................

Clerk of the Court, Justice

or Provincial Court Judge

(Seal, if required)

Canada,

Province of ............,

(territorial division).

Be it remembered that on the ........ day of ............ A.D. ........, at ............, A.B., (date of birth) of ............, was tried on an information (indictment) alleging that (set out matter of complaint or alleged offence), and it was ordered and adjudged that (set out the order made).

Dated this ........ day of ............ A.D. ........, at .............

	Justice or Clerk of the Court

Canada,

Province of ................,

(territorial division).

Be it remembered that on the ................ day of ................ A.D. ........, at ................ A.B., of ................, (occupation), (date of birth) was tried on the charge that (state fully the offence of which accused was acquitted) and was found not guilty of the said offence.

Dated this ................ day of ................ A.D. ........, at ................ .

	Provincial Court Judge or Clerk of the Court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

Be it remembered that on the ................ day of ................ A.D. ........, at ................ in the (territorial division), E.F. of ................, hereinafter called the defaulter, is convicted by me for contempt in that he did not attend before (set out court or justice) to give evidence on the trial of a charge that (state fully offence with which accused was charged), although (duly subpoenaed or bound by recognizance to attend to give evidence, as the case may be) and has not shown before me any sufficient excuse for his default;

Wherefore I adjudge the defaulter for his said default, (set out punishment as authorized and determined in accordance with section 708 of the Criminal Code).

Dated this ................ day of ................ A.D. ........, at ................ .

	A Justice or Clerk of the Court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

To the keeper of the (prison) at ................:

I hereby direct you to release E.F., detained by you under a (warrant of committal or order) dated the ................ day of ................ A.D. ........, if the said E.F. is detained by you for no other cause.

	A Judge, Justice or Clerk of the Court

(Seal, if required)

Canada,

Province of ................,

(territorial division).

The Queen

v.

C.D.

The (prosecutor or accused) challenges the array of the panel on the ground that X.Y., (sheriff or deputy sheriff), who returned the panel, was guilty of (partiality or fraud or wilful misconduct) on returning it.

Dated this ................ day of ................ A.D. ........, at ................ .

	Counsel for (prosecutor or accused)

Canada,

Province of ................,

(territorial division).

The Queen

v.

C.D.

The (prosecutor or accused) challenges G.H. on the ground that (set out ground of challenge in accordance with subsection 638(1) of the Criminal Code).

	Counsel for (prosecutor or accused)

In the Court of ................

(Style of Cause)

I hereby certify that A.B. (the appellant or respondent, as the case may be) in this appeal, having been ordered to pay costs in the sum of ............ dollars, has failed to pay the said costs within the time limited for the payment thereof.

Dated this ................ day of ................ A.D. ........, at ................ .

	Clerk of the Court of..........

(Seal)

I hereby certify that I have received from X.Y., a peace officer for (territorial division), one A.B., together with a (warrant or order) issued by (set out court or justice, as the case may be).*

*Add a statement of the condition of the prisoner

Dated this ................ day of ................ A.D. ........, at ................ .

	Keeper of (prison)

I, (name), a fingerprint examiner designated as such for the purposes of section 667 of the Criminal Code by the Minister of Public Safety and Emergency Preparedness, do hereby certify that (name) also known as (aliases if any), FPS Number ........, whose fingerprints are shown reproduced below (reproduction of fingerprints) or attached hereto, has been convicted, discharged under section 730 of the Criminal Code or convicted and sentenced in Canada as follows:

(record)

Dated this ........ day of ............ A.D. ........, at .............

	Fingerprint Examiner

I, (name), a fingerprint examiner designated as such for the purposes of section 667 of the Criminal Code by the Minister of Public Safety and Emergency Preparedness, do hereby certify that I have compared the fingerprints reproduced in or attached to exhibit A with the fingerprints reproduced in or attached to the certificate in Form 44 marked exhibit B and that they are those of the same person.

Dated this ........ day of ............ A.D. ........, at .............

	Fingerprint Examiner

Canada,

Province of ................,

(territorial division).

Whereas on the ................ day of ................ at ................, A.B., hereinafter called the offender, (pleaded guilty to or was tried under (here insert Part XIX, XX or XXVII, as the case may be) of the Criminal Code and was (here insert convicted or found guilty, as the case may be) on the charge that (here state the offence to which the offender pleaded guilty or for which the offender was convicted or found guilty, as the case may be);

And whereas on the ................ day of ................ the court adjudged*

*Use whichever of the following forms of disposition is applicable:

• (a) that the offender be discharged on the following conditions:

• (b) that the passing of sentence on the offender be suspended and that the said offender be released on the following conditions:

• (c) that the offender forfeit and pay the sum of ................ dollars to be applied according to law and in default of payment of the said sum without delay (or within a time fixed, if any), be imprisoned in the (prison) at ................ for the term of ................ unless the said sum and charges of the committal and of conveying the said offender to the said prison are sooner paid, and in addition thereto, that the said offender comply with the following conditions:

• (d) that the offender be imprisoned in the (prison) at ................ for the term of ................ and, in addition thereto, that the said offender comply with the following conditions:

• (e) that following the expiration of the offender’s conditional sentence order related to this or another offence, that the said offender comply with the following conditions:

• (f) that following the expiration of the offender’s sentence of imprisonment related to another offence, that the said offender comply with the following conditions:

• (g) when the offender is ordered to serve the sentence of imprisonment intermittently, that the said offender comply with the following conditions when not in confinement:

Now therefore the said offender shall, for the period of ................ from the date of this order (or, where paragraph (d), (e) or (f) is applicable, the date of expiration of the offender’s sentence of imprisonment or conditional sentence order) comply with the following conditions, namely, that the said offender shall keep the peace and be of good behaviour, appear before the court when required to do so by the court and notify the court or probation officer in advance of any change of name or address and promptly notify the court or probation officer of any change of employment or occupation, and, in addition,

(here state any additional conditions prescribed pursuant to subsection 732.1(3) of the Criminal Code).

Dated this ................ day of ................ A.D. ........, at ................ .

	Clerk of the Court, Justice or Provincial Court Judge

Canada,

Province of ...............,

(territorial division).

To A.B., of ................, (office or occupation):

Whereas, it appears on the oath of C.D., of ................, that there are reasonable grounds for believing that E.F., of ................, has committed or benefited from the commission of the offence of ................ and that the information or documents (describe information or documents) are likely to be of substantial value to an investigation of that offence or a related matter; and

Whereas there are reasonable grounds for believing that it is in the public interest to allow access to the information or documents, having regard to the benefit likely to accrue to the investigation if the access is obtained;

This is, therefore, to authorize and require you between the hours of (as the judge may direct), during the period commencing on ................ and ending on ................, to produce all the above-mentioned information and documents to one of the following police officers, namely, (here name police officers) and allow the police officer to remove the information or documents, or to allow the police officer access to the above-mentioned information and documents and to examine them, as the judge directs, subject to the following conditions (state conditions): .................

Dated this ........ day of ................ A.D. ........, at .................... .

	Signature of judge

Canada,

Province of

(territorial division)

Whereas I have reasonable grounds to believe that evidence of the mental condition of (name of accused), who has been charged with ...., may be necessary to determine Footnote ^*

• [ ] whether the accused is unfit to stand trial

• [ ] whether the accused suffered from a mental disorder so as to exempt the accused from criminal responsibility by virtue of subsection 16(1) of the Criminal Code at the time of the act or omission charged against the accused

• [ ] whether the balance of the mind of the accused was disturbed at the time of commission of the alleged offence, if the accused is a female person charged with an offence arising out of the death of her newly-born child

• [ ] if a verdict of unfit to stand trial or a verdict of not criminally responsible on account of mental disorder has been rendered in respect of the accused, the appropriate disposition to be made in respect of the accused pursuant to section 672.54 or 672.58 of the Criminal Code

• [ ] if a verdict of unfit to stand trial has been rendered in respect of the accused, whether the court should order a stay of proceedings under section 672.851 of the Criminal Code

I hereby order an assessment of the mental condition of (name of accused) to be conducted by/at (name of person or service by whom or place where assessment is to be made) for a period of .................... days.

This order is to be in force for a total of ............... days, including travelling time, during which time the accused is to remain Footnote ^*

• [ ] in custody at (place where accused is to be detained)

• [ ] out of custody, on the following conditions:

(set out conditions, if applicable)

• Return to footnote ^*Check applicable option.

Dated this ............... day of ............... A.D. ....., at ............... .

........................................

(Signature of justice or judge or clerk

of the court, as the case may be)

Canada,

Province of

(territorial division)

Whereas I have reasonable grounds to believe that evidence of the mental condition of (name of accused), who has been charged with ...., may be necessary to Footnote ^*

• [ ] if a verdict of unfit to stand trial or a verdict of not criminally responsible on account of mental disorder has been rendered in respect of the accused, make a disposition under section 672.54 of the Criminal Code

• [ ] if a verdict of unfit to stand trial has been rendered in respect of the accused, determine whether the Review Board should make a recommendation to the court that has ju­risdiction in respect of the offence charged against the accused to hold an inquiry to determine whether a stay of proceedings should be ordered in accordance with section 672.851 of the Criminal Code

I hereby order an assessment of the mental condition of (name of accused) to be conducted by/at (name of person or service by whom or place where assessment is to be made) for a period of .................... days.

This order is to be in force for a total of ............... days, including travelling time, during which time the accused is to remain Footnote ^*

• [ ] in custody at (place where accused is to be detained)

• [ ] out of custody, on the following conditions:

(set out conditions, if applicable)

• Return to footnote ^*Check applicable option.

Dated this ............... day of ............... A.D. ....., at ............... .

....................................

(Signature of Chairperson

of the Review Board)

DISPOSITION OF DETENTION

Canada,

Province of

(territorial division)

To the peace officers in the said (territorial division) and to the keeper (administrator, warden) of the (prison, hospital or other appropriate place where the accused is detained).

This warrant is issued for the committal of A.B., of ..............., (occupation), hereinafter called the accused.

Whereas the accused has been charged that (set out briefly the offence in respect of which the accused was charged);

And whereas the accused was found*

This is, therefore, to command you, in Her Majesty’s name, to take the accused in custody and convey the accused safely to the (prison, hospital or other appropriate place) at ...., and there deliver the accused to the keeper (administrator, warden) with the following precept:

I do therefore command you the said keeper (administrator, warden) to receive the accused in your custody in the said (prison, hospital or other appropriate place) and to keep the accused safely there until the accused is delivered by due course of law.

The following are the conditions to which the accused shall be subject while in your (prison, hospital or other appropriate place):

The following are the powers regarding the restrictions (and the limits and conditions on those restrictions) on the liberty of the accused that are hereby delegated to you the said keeper (administrator, warden) of the said (prison, hospital or other appropriate place):

*Check applicable option.

Dated this .......... day of .......... A.D. .........., at .......... .

	(Signature of judge, clerk of the court, provincial court judge or chairperson of the Review Board)

PLACEMENT DECISION

Canada,

Province of

(territorial division)

To the peace officers in the said (territorial division) and to the keeper (administrator, warden) of the (prison, hospital or other appropriate place where the accused is detained).

This warrant is issued for the committal of A.B., of ...................., (occupation), hereinafter called the accused.

Whereas the accused has been charged that (set out briefly the offence in respect of which the accused was charged);

And whereas the accused was found*

And whereas the Review Board has held a hearing and decided that the accused shall be detained in custody;

And whereas the accused is required to be detained in custody pursuant to a warrant of committal issued by (set out the name of the Judge, Clerk of the Court, Provincial Court Judge or Justice as well as the name of the court and territorial division), dated the .................. day of ...................., in respect of the offence that (set out briefly the offence in respect of which the accused was charged or convicted);

This is, therefore, to command you, in Her Majesty’s name, to*

* Check applicable option.

Dated this .................. day of .................. A.D. ...................., at ................. .

	(Signature of chairperson of the Review Board)

[Repealed, 2005, c. 22, s. 41]

Canada,

Province of ....................

(territorial division)

To A.B., of ................, (occupation):

You have been convicted of, or found not criminally responsible on account of mental disorder for, ............. (insert description of offence(s)), a designated offence (or if more than one offence, designated offences) within the meaning of subsection 490.011(1) of the Criminal Code, under ......... (insert the applicable designated offence provision(s) of the Criminal Code).

• 1 You must report for the first time, in person, to the registration centre that serves the area in which your main residence is located, whenever required under subsection 4(2) of the Sex Offender Information Registration Act.

• 2 You must subsequently report to the registration centre that serves the area in which your main residence is located whenever required under section 4.1 or 4.3 of the Sex Offender Information Registration Act, for a period of ...... years after this order is made (or if paragraph 490.013(2)(c) or any of subsections 490.013(3) to (5) of the Criminal Code applies, for life).

• 3 Information relating to you will be collected under sections 5 and 6 of the Sex Offender Information Registration Act by a person who collects information at the registration centre.

• 4 Information relating to you will be registered in a database, and may be consulted, disclosed and used in the circumstances set out in the Sex Offender Information Registration Act.

• 5 If you believe that the information registered in the database contains an error or omission, you may ask a person who collects information at the registration centre that serves the area in which your main residence is located to correct the information.

• 6 You have the right to appeal this order.

• 7 You have the right to apply to a court to terminate this order, and the right to appeal any decision of that court.

• 8 If you are found to have contravened this order, you may be subject to a fine or imprisonment, or to both.

• 9 If you are found to have provided false or misleading information, you may be subject to a fine or imprisonment, or to both.

Dated this ................ day of ................, at ................. .

...................................................

(Signature of judge and name of court)

...................................................

(Signature of person subject to order)

Canada,

Province of ....................,

(territorial division).

To A.B., of ............, (occupation), a person referred to in subsection 490.02(1) of the Criminal Code:

Because, on ....... (insert date(s)), you were convicted of, or found not criminally responsible on account of mental disorder for, ......... (insert description of offence(s)), one or more offences referred to in paragraph (a), (c), (d) or (e) of the definition designated offence in subsection 490.011(1) of the Criminal Code, under ....... (insert the applicable offence provision(s) of the Criminal Code), this is provided to give you notice that you are required to comply with the Sex Offender Information Registration Act.

• 1 You must report for the first time, in person, to the registration centre that serves the area in which your main residence is located, whenever required under subsection 4(3) of the Sex Offender Information Registration Act.

• 2 You must subsequently report to the registration centre that serves the area in which your main residence is located whenever required under section 4.1 or 4.3 of the Sex Offender Information Registration Act for a period of ....... years after the day on which you were sentenced, or found not criminally responsible on account of mental disorder, for the offence (or if paragraph 490.022(3)(c) of the Criminal Code applies, for life) or for any shorter period set out in subsection 490.022(2) of the Criminal Code.

• 3 Information relating to you will be collected under sections 5 and 6 of the Sex Offender Information Registration Act by a person who collects information at the registration centre.

• 4 Information relating to you will be registered in a database, and may be consulted, disclosed and used in the circumstances set out in the Sex Offender Information Registration Act.

• 5 If you believe that the information registered in the database contains an error or omission, you may ask a person who collects information at the registration centre that serves the area in which your main residence is located to correct the information.

• 6 You have the right to apply to a court to exempt you from the obligation to comply with the Sex Offender Information Registration Act, and the right to appeal any decision of that court.

• 7 You have the right to apply to a court to terminate the obligation, and the right to appeal any decision of that court.

• 8 If you are found to have contravened the obligation, you may be subject to a fine or imprisonment, or to both.

• 9 If you are found to have provided false or misleading information, you may be subject to a fine or imprisonment, or to both.

Dated this ................ day of ................, at ................. .