Canada,

Province of ,

(territorial division).

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

Whereas A.B., hereinafter called the accused, was committed for trial on a charge that (state offence as in the information);

And Whereas E.F., hereinafter called the witness, having appeared as a witness on the preliminary inquiry into the said charge, and being required to enter into a recognizance to appear as a witness on the trial of the accused on the said charge, has (failed or refused) to do so;

This is therefore to command you, in Her Majesty’s name, to arrest, if necessary, and take and safely convey the said witness to the (prison) at and there deliver him to the keeper thereof, together with the following precept:

I do hereby command you, the said keeper, to receive the witness into your custody in the said prison and keep him there safely until the trial of the accused on the said charge, unless before that time the witness enters into the said recognizance.

Dated this day of A.D. , at .

A Justice of the Peace in and for