Province of ,
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)
- R.S., 1985, c. C-46, Form 13
- 1999, c. 25, s. 26
- Date modified: