Criminal Code

Canada,

Province of ,

(territorial division).

To the peace officers in the said (territorial division) or to the (named public officers):

Whereas it appears on the oath of A.B., of that there are reasonable grounds for believing that (describe things to be searched for and offence in respect of which search is to be made) are in at , hereinafter called the premises;

This is, therefore, to authorize and require you between the hours of (as the justice may direct) to enter into the said premises and to search for the said things and to bring them before me or some other justice.

Dated this day of A.D. , at .

A Justice of the Peace in and for