Province of Quebec

Quebec Superior Court

(Criminal Division)

Application of (given names and surname of applicant) made pursuant to section 745.6 of the Criminal CodeAffidavit

I, the undersigned, (given names and surname of applicant), detained at (name and place of institution of detention), Province of , make oath and say as follows:

  • 1 I am the applicant.

  • 2 The facts set out in the attached application are true.

(Signature of applicant)

Sworn before me this day of the month of , 200, at , Province of

Commissioner for oaths
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