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Criminal Code (R.S.C., 1985, c. C-46)

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Act current to 2020-10-05 and last amended on 2020-07-01. Previous Versions

FORM 12(Section 515.1)Surety Declaration

Canada,

Province of blank line,

(territorial division).

  • 1 Identification

    Surname: blank line Given name(s): blank line

    Date of Birth: blank line

    Home address: blank line

    Phone number(s): blank line (primary) blank line (other)

    Other contact information (if any): blank line

    Employment or occupation (if any): blank line

    Name and contact information for employer (if any): blank line

  • 2 Information about the Accused

    Surname: blank line Given name(s): blank line

    Date of Birth: blank line

    Court file number: blank line

  • 3 Other information required

    Relationship to the accused: blank line

    I am acting as a surety in respect of another accused.

    □ Yes □ No

    If yes, name and date of birth of any other accused: blank line

    I have a criminal record or there are outstanding criminal charges against me.

    □ Yes □ No

    If yes, description of criminal record, if any, and all outstanding criminal charges, specifying offence and year of conviction: blank line

  • 4 Charges against the Accused

    I understand that the accused has been charged with (set out briefly the offence in respect of which the accused was charged).

  • 5 Other Outstanding Charges against the Accused

    □ I understand that the accused does not have any other outstanding criminal charges.

    □ I understand that the accused has also been charged with (set out briefly the offence in respect of which the accused was charged), but this declaration does not apply to those charges.

  • 6 Criminal Record of the Accused

    □ I understand that the accused does not have a criminal record.

    □ I understand that the accused has a criminal record, which is described below or a copy of which I have attached and initialled.

    blank line

  • 7 Financial Promise or Deposit

    As a surety for the accused, I am willing to (promise or deposit) to the court the amount of blank line

  • 8 Acknowledgment

    I understand that failure on the part of the accused to follow any of the conditions in their release order or recognizance could lead to the forfeiture of the amount of money that has been promised or deposited.

    I understand that I may, at any time, ask to no longer be a surety by making an application, by bringing the accused to the court in order to be discharged from my obligation (section 767 of the Criminal Code) or by taking and giving the accused into custody (section 768 of the Criminal Code).

    I voluntarily make this declaration and it is my free choice to take on the responsibilities of a surety.

  • 9 Signature

    Signed on (date), at (place).

    blank line

    (Signature of the surety)

    Sworn before me on (date), at (place).

    blank line

    (Signature of the person who is authorized to take or receive statements made under oath, solemn declaration or solemn affirmation)

  • R.S., 1985, c. C-46, Form 12
  • R.S., 1985, c. 27 (1st Supp.), s. 184
  • 1994, c. 44, s. 84
  • 1999, c. 25, s. 25
  • 2008, c. 18, s. 45.1
  • 2018, c. 29, s. 72
  • 2019, c. 25, s. 337
 
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