Criminal Code (R.S.C., 1985, c. C-46)

Canada,

Province of ,

(territorial division).

To the peace officers in the (territorial division):

This warrant is issued for the arrest of (name of person), of , born on (date of birth), referred to in this warrant as the accused.

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

And because (check those that are applicable):

• □ (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 the accused [512(2)];

• □ (c) (an appearance notice or undertaking) was confirmed and the accused failed to attend court in accordance with it [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 (summons or appearance notice or undertaking or release order) on which the accused was released [512.3];

• □ (g) there are reasonable grounds to believe that the accused has committed an indictable offence since their release from custody on (summons or appearance notice or undertaking or release order) [512.3];

• □ (h) the accused was required by (appearance notice or undertaking or summons) to attend at a time and place stated in it for the purposes of the Identification of Criminals Act and did not appear at that time and place [512.1, 512.2];

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

• □ (j) (if none of the above applies, reproduce the provisions of the statute that authorize this warrant).

Therefore, you are ordered, in Her Majesty’s name, to immediately arrest the accused and to bring them before (state court, judge or justice), to be dealt with according to law.

• □ (Check if applicable) Because there are reasonable grounds to believe that the accused is or will be present in (specify dwelling-house), this warrant is also issued to authorize you to enter the dwelling-house for the purpose of arresting 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 is present in the dwelling-house.

Signed on (date), at (place).

(Signature of judge, provincial court judge, justice or clerk of the court)

(Name of the judge, provincial court judge or justice who has issued this warrant)