Criminal Code (R.S.C., 1985, c. C-46)

Canada,

Province of ,

(territorial division).

Whereas this warrant is issued under subsection 705(1) or (2) of the Criminal Code in respect of a witness who has been served with a subpoena to give evidence in a proceeding or who has been bound by a recognizance to attend and give evidence in a proceeding, I authorize the release of that person under subsections 705(4) and (5) of that Act.

This endorsement is subject to the following conditions: (specify conditions).

Dated (date), at (place)

(Signature of judge, justice or provincial court judge)