FORM 79.03A

C A N A D A,

PROVINCE OF PRINCE EDWARD ISLAND,

SUPREME COURT OF PRINCE EDWARD ISLAND — TRIAL DIVISION

(given names and surname of the applicant)

Application for a reduction in the number of years of imprisonment without eligibility for parole pursuant to section 745 of the Criminal Code

To the Honourable Chief Justice of the Supreme Court of Prince Edward Island — Trial Division:

  • 1 I, (given names and surname of the applicant), born on (applicant’s date of birth) and currently detained at (name and place of the institution), hereby request, pursuant to section 745 of the Criminal Code, that the number of years of imprisonment during which I will not be eligible for parole with respect to the sentence imposed on me on (give date of sentencing) at (give place of trial) be reduced to (give number of years).

  • 2 Since my arrest for the offence referred to in paragraph 3, I have been detained in the following institutions: (Give a COMPLETE list of the names and places of the institutions in which the applicant has been detained and specify the date of entry into each of the institutions).

  • 3 The sentence referred to in paragraph 1 was imposed on me for the following offence: (Indicate the offence for which the applicant was convicted and give the date of conviction).

  • 4 The sentence imposed on me was (give a description of the sentence) and the number of years of imprisonment without eligibility for parole was set at (give number of years). (Indicate whether the sentence has been commuted and, if so, give the date of commutation).

  • 5 My criminal record is as follows: (Give a complete list of convictions and sentences and indicate the date of each).

  • 6 In support of my application I am relying on the following grounds: (Specify ALL grounds PRECISELY and CONCISELY).

  • 7 My address for service is: (Give complete address).

Filed with the registrar of the Supreme Court of Prince Edward Island at Charlottetown on (give date).

(Signature of applicant)

 
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