FORM 51 (Paragraphs 732.1(3)(c.2), 742.3(2)(a.2), 810(3.02)(c), 810.01(4.1)(g), 810.011(6)(f), 810.1(3.02)(i) and 810.2(4.1)(g))
Notice of Obligation To Provide Samples of Bodily Substance
To A.B., of , (occupation), (address in Canada), (date of birth), (gender):
Because, on (date), you were ordered, under (applicable provision) of the Criminal Code, to provide samples of a bodily substance prescribed by regulation at regular intervals for the purpose of analysis;
You are provided with this notice to inform you of your obligations with respect to providing samples.
1 On (specify a day not earlier than 24 hours after the day on which the notice is served), you must report, at any time from (time) to (time), at (address of place at which sample to be taken, as designated by the Attorney General of the province or Minister of Justice of the territory), to provide a sample of your (specify type of bodily substance prescribed by regulation).
2 Every (specify a number not less than seven) days after you first report to provide a sample, you must report, at any time from (time) to (time), at (address of place at which sample to be taken, as designated by the Attorney General of the province or Minister of Justice of the territory), to provide a sample of your (specify type of bodily substance prescribed by regulation).
3 You have the right to apply to a court to terminate the obligation to provide samples, and the right to appeal any decision of that court.
4 If you are found to have not complied with your obligation to provide samples as set out in this notice, you may be subject to a fine or imprisonment, or to both (or, in the case of a conditional sentence, you may be subject to proceedings under section 742.6 of the Criminal Code, the consequences of which may include imprisonment).
5 The results of the analysis of the bodily substances may be used or disclosed in accordance with the Criminal Code, including in proceedings against you, the result of which may be that you are subject to a fine or imprisonment, or to both (or, in the case of a conditional sentence, including in proceedings under section 742.6 of the Criminal Code, the consequences of which may include imprisonment).
Served on (date), at (place the notice is served).
(Signature of probation officer, supervisor or person designated by the Attorney General or Minister of Justice, as the case may be)