Criminal Code

Canada,

Province of ,

(territorial division).

To the peace officers in the (territorial division):

You are hereby commanded forthwith to arrest, if necessary, and convey to the (prison) at the persons named in the following schedule each of whom has been remanded to the time mentioned in the schedule:

Person charged Offence Remanded to

And I hereby command you, the keeper of the said prison, to receive each of the said persons into your custody in the prison and keep him safely until the day when his remand expires and then to have him before me or any other justice at at o’clock in the noon of the said day, there to answer to the charge and to be dealt with according to law, unless you are otherwise ordered before that time.

Dated this day of A.D. , at .

A Justice of the Peace in and for