Criminal Code (R.S.C., 1985, c. C-46)

Canada,

Province of ,

(territorial division).

• 1 Identification

  Surname: Given name(s):

  Date of Birth:

• 2 Contact Information

  

• 3 Proceeding in which you were served a subpoena or bound by a recognizance, to attend to give evidence

  Whereas A.B. has been charged that (state offence as in the information), and it has been made to appear that you are likely to give material evidence and/or bring with you anything in your possession or under your control that relates to the said charge.

• 4 Mandatory Condition

  You must attend court as indicated below, and afterwards as required by the court:

  Date:

  Time:

  Court number:

  Court address:

• 5 Conditions determined by the court, judge, justice or provincial court judge

  You must also comply with the following conditions (reproduce the conditions determined by the court, justice or provincial court judge as set out in Form 29.1):

• 6 Conditions in effect

  The mandatory condition and the conditions determined by the court, judge, justice or provincial court judge on this undertaking remain in effect until they are cancelled or changed or until you appear and remain in attendance at the proceeding as required by the mandatory condition (section 763 of the Criminal Code).

• 7 Variation

  The conditions of this undertaking may be varied by application to the court, judge, justice or provincial court judge.

• 8 Consequence for non-compliance

  You are warned that, unless you have a lawful excuse, you commit an offence under section 145 of the Criminal Code if you fail to follow any of the conditions set out in this undertaking, including

  • (a) if you fail to attend court as required; or

  • (b) if you fail to comply with the conditions determined by the court, judge, justice or provincial court judge.

  If you commit an offence under section 145 of the Criminal Code, a warrant for your arrest may be issued (section 512 or 512.2 of the Criminal Code) and you may be liable to a fine or to imprisonment, or to both.

• 9 Signatures

  WITNESS:

  I understand the contents of this undertaking and agree to comply with the mandatory condition and the conditions determined by the court, judge, justice or provincial court judge.

  I understand that I do not have to accept the conditions and that, if I do not accept the conditions, I will be brought before a court, judge, provincial court judge or justice under sections 705 and 706 of the Criminal Code.

  Signed on (date), at (place).

  

  (Signature of witness)

  PEACE OFFICER:

  Signed on (date), at (place) .

  

  (Signature of peace officer)

  

  (Name of the peace officer)