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

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 *

[ ] 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 *

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

[ ] out of custody, on the following conditions:

(set out conditions, if applicable)

* 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 *

[ ] 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 *

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

[ ] out of custody, on the following conditions:

(set out conditions, if applicable)

* 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 .......... .

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

[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 ................. .

R.S., 1985, c. C-46, Part XXVIII; R.S., 1985, c. 27 (1st Supp.), ss. 101(E), 184, 203, c. 1 (4th Supp.), ss. 17, 18(F), c. 42 (4th Supp.), ss. 6 to 8; 1991, c. 43, s. 8; 1992, c. 1, s. 58; 1993, c. 45, ss. 12 to 14; 1994, c. 44, s. 84; 1995, c. 22, ss. 9, 10, 18; 1997, c. 18, s. 115, c. 30, s. 3, c. 39, s. 3; 1998, c. 37, s. 24; 1999, c. 3, s. 58, c. 5, ss. 45 to 47, c. 25, ss. 24 to 27(Preamble); 2000, c. 10, s. 24; 2002, c. 1, ss. 185, 186, c. 13, ss. 85, 86(F); 2004, c. 10, s. 21, c. 12, s. 17; 2005, c. 10, s. 34, c. 22, ss. 40, 41.