Criminal Code (R.S.C., 1985, c. C-46)

Canada,

Province of ,

(territorial division).

To the peace officers in the (territorial division) and to the keeper of the (prison) at (place):

Because E.F. of , in this warrant called the defaulter, was on (date) , at (place), convicted before for contempt because the defaulter did not attend before to give evidence on the trial of a charge that (state offence as in the information) against A.B. of , although (duly subpoenaed or bound by recognizance to appear and give evidence in that regard, as the case may be) and did not show any sufficient excuse for the default;

And because, following the conviction it was ordered that the defaulter (set out the punishment imposed);

And because the defaulter has not paid the amounts ordered to be paid; (delete if not applicable)

Therefore, you are ordered, in Her Majesty’s name, to arrest, if necessary, and take the defaulter and convey them safely to the prison at and there deliver them to its keeper, together with the following order:

You, the keeper, are ordered to receive the defaulter into your custody in this prison and keep them safely thereFootnote ^* and for so doing this is a sufficient warrant.

• Return to footnote ^*Insert whichever of the following is applicable:

• (a) for the term of ;

• (b) for the term of , unless the sums and the costs and charges of the committal and of conveying the defaulter to the prison are sooner paid;

• (c) for the term of and for the term of (if consecutive so state) unless the sums and the costs and charges of the committal and of conveying the defaulter to the prison are sooner paid.

Dated (date), at (place).

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

(Seal, if required)