FORM 5.041 (Subsections 487.051(4) and 487.055(3.11))
Order to a Person To Have Bodily Substances Taken for Forensic DNA Analysis
Canada
Province of
(territorial division)
To A.B., of ,
Whereas an order has been made under section 487.051, or an authorization has been granted under section 487.055, of the Criminal Code, to take from you the number of samples of bodily substances that is reasonably required for forensic DNA analysis;
This is therefore to order you, in Her Majesty’s name, to appear on (date) , at (hour), at ( place), for the purpose of the taking of bodily substances by means of the investigative procedures set out in subsection 487.06(1) of the Criminal Code.
You are warned that failure to appear in accordance with this order may result in a warrant being issued for your arrest under subsection 487.0551(1) of the Criminal Code. You are also warned that failure to appear, without reasonable excuse, is an offence under subsection 487.0552(1) of that Act.
Subsection 487.0551(1) of the Criminal Code states as follows:
487.0551 (1) If a person fails to appear at the place, day and time set out in an order made under subsection 487.051(4) or 487.055(3.11) or in a summons referred to in subsection 487.055(4) or 487.091(3), a justice of the peace may issue a warrant for their arrest in Form 5.062 to allow samples of bodily substances to be taken.
Subsection 487.0552(1) of the Criminal Code states as follows:
487.0552 (1) Every person who, without reasonable excuse, fails to comply with an order made under subsection 487.051(4) or 487.055(3.11) of this Act or under subsection 196.14(4) or 196.24(4) of the National Defence Act, or with a summons referred to in subsection 487.055(4) or 487.091(3) of this Act, is guilty of
(a) an indictable offence and liable to imprisonment for a term of not more than two years; or
(b) an offence punishable on summary conviction.
Dated (date) , at (place).
(Signature of judge of the court or clerk of the court)