Bail Release Form

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See s. 515(4) of the Criminal Code




CASE #s:___________________

Publication Ban
  • Order for ban on publication pursuant to s. 487.4 of the Criminal Code

Type of Release
  • Undertaking
  • Recognizance $ ____________
  • Own $ ___________ Surety $ _________________ $ Sureties (2) $ ________________

The Applicant shall

  • keep the peace and be of good behaviour.
  • attend court as and when directed.
  • report within twenty-four (24) hours of his release from custody, in person, to the ___________________, and thereafter he shall report as and when directed by ______________ and in any event not less than once per week in person.
  • reside at___, and shall not change his address without first obtaining the consent of the Court.
  • when first reporting to the Bail Supervisor, provide his phone number to the Bail Supervisor and he shall not change that phone number without first advising the Bail Supervisor.
  • obey all rules and regulations of his residence.
  • remain within the Province of _____________.
  • remain within the property upon which his residence is located at all times, except he may leave his residence between the hours of 6:00 a.m. and 8:00 p.m. as follows:
    • while in the company of his mother, _______________;
    • while in the company of his counsel; or
    • while in the company of another adult person approved in writing by the Bail Supervisor.
  • The present himself at the door of his residence when any Peace Officer or Bail Supervisor attends there for the purpose of determining his compliance with this Order.
  • respond personally and immediately to the phone when any Peace Officer or Bail Supervisor makes a phone call to his residence for the purpose of determining his compliance with this Order.
  • not leave ______, except with the permission of the Court or the written permission of the Bail Supervisor.
  • abstain from communicating, directly or indirectly, and shall have no contact, with [named persons], except as follows:
    • through legal counsel, or
    • while in attendance at court and within the courtroom.
  • not attend at or be within fifty (50) meters of any place which he knows to be the residence, school or workplace of any of those persons mentioned in condition 11, except while on a highway in a moving motor vehicle.
  • not possess or consume any alcohol or any controlled substance as defined in Section 2 of the Controlled Drugs and Substances Act, except as prescribed for him by a Physician.
  • not enter any liquor store, beer and wine store, bar, pub, lounge or other business premise where the primary commodity sold is liquor.
  • not possess any pipe, syringe or other drug paraphernalia.
  • register the number of any cell phone, pager or portable telecommunication device with the Bail Supervisor.
  • not possess any weapon as defined in Section 2 of the Criminal Code, and he shall not reside in a home where any other person keeps or stores any such weapon.
  • forthwith surrender for safekeeping to the ____ RCMP Detachment any firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance in his possession, together with any authorization or registration certificate for any such item. Except for purposes of making the delivery to the ____ RCMP in accordance with this condition, he shall not possess any of the listed items and he shall not reside in a home where any other person keeps or stores any such item.
  • not possess any knife except for the purpose of preparing or eating food.
House Arrest/Curfew

The Applicant shall: