Criminal Code

Canada, Province of , (territorial division).

I, A.B., of , (occupation), understand that it is alleged that I have committed (set out substance of offence).

In order that I may be released from custody, I hereby acknowledge that I owe $ (not exceeding $500) to Her Majesty the Queen to be levied on my real and personal property if I fail to attend court as hereinafter required.

(or, for a person not ordinarily resident in the province in which the person is in custody or within two hundred kilometres of the place in which the person is in custody)

In order that I may be released from custody, I hereby acknowledge that I owe $ (not exceeding $500) to Her Majesty the Queen and deposit herewith (money or other valuable security not exceeding in amount or value $500) to be forfeited if I fail to attend court as hereinafter required.

• 1 I acknowledge that I am required to attend court on day, the day of A.D. , at o’clock in the noon, in courtroom No. , at court, in the municipality of , and to attend thereafter as required by the court, in order to be dealt with according to law.

• 2 I acknowledge that I am also required to appear on day, the day of A.D. , at o’clock in the noon, at (police station), (address), for the purposes of the Identification of Criminals Act. (Ignore if not filled in.)

I understand that failure without lawful excuse to attend court in accordance with this recognizance to appear is an offence under subsection 145(5) of the Criminal Code.

Subsections 145(5) and (6) of the Criminal Code state as follows:

• “(5) Every person who is named in an appearance notice or promise to appear, or in a recognizance entered into before an officer in charge or another peace officer, that has been confirmed by a justice under section 508 and who fails, without lawful excuse, the proof of which lies on the person, to appear at the time and place stated therein, if any, for the purposes of the Identification of Criminals Act or to attend court in accordance therewith, is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.

• (6) For the purposes of subsection (5), it is not a lawful excuse that an appearance notice, promise to appear or recognizance states defectively the substance of the alleged offence.”

Section 502 of the Criminal Code states as follows:

• “502 Where an accused who is required by an appearance notice or promise to appear or by a recognizance entered into before an officer in charge or another peace officer to appear at a time and place stated therein for the purposes of the Identification of Criminals Act does not appear at that time and place, a justice may, where the appearance notice, promise to appear or recognizance has been confirmed by a justice under section 508, issue a warrant for the arrest of the accused for the offence with which the accused is charged.”

Dated this day of A.D. , at .

(Signature of accused)