Criminal Code

Canada,

Province of ,

(territorial division).

I, A.B., of , (occupation), understand that I have been charged that (set out briefly the offence in respect of which accused is charged).

In order that I may be released from custody, I undertake to attend court on day, the day of A.D. , and to attend after that as required by the court in order to be dealt with according to law (or, where date and place of appearance before court are not known at the time undertaking is given, to attend at the time and place fixed by the court and after that as required by the court in order to be dealt with according to law).

(and, where applicable)

I also undertake to (insert any conditions that are directed)

• (a) report at (state times) to (name of peace officer or other person designated);

• (b) remain within (designated territorial jurisdiction);

• (c) notify (name of peace officer or other person designated) of any change in my address, employment or occupation;

• (d) abstain from communicating, directly or indirectly, with (identification of victim, witness or other person) except in accordance with the following conditions: (as the justice or judge specifies);

• (e) deposit my passport (as the justice or judge directs); and

• (f) (any other reasonable conditions).

I understand that failure without lawful excuse to attend court in accordance with this undertaking is an offence under subsection 145(2) of the Criminal Code.

Subsections 145(2) and (3) of the Criminal Code state as follows:

• “(2) Every one who,

  • (a) being at large on his undertaking or recognizance given to or entered into before a justice or judge, fails, without lawful excuse, the proof of which lies on him, to attend court in accordance with the undertaking or recognizance, or

  • (b) having appeared before a court, justice or judge, fails, without lawful excuse, the proof of which lies on him, to attend court as thereafter required by the court, justice or judge,

  or to surrender himself in accordance with an order of the court, justice or judge, as the case may be, is guilty of an indictable offence and liable to imprisonment for a term not exceeding two years or is guilty of an offence punishable on summary conviction.

• (3) Every person who is at large on an undertaking or recognizance given to or entered into before a justice or judge and is bound to comply with a condition of that undertaking or recognizance, and every person who is bound to comply with a direction under subsection 515(12) or 522(2.1) or an order under subsection 516(2), and who fails, without lawful excuse, the proof of which lies on them, to comply with the condition, direction or order is guilty of

  • (a) an indictable offence and liable to imprisonment for a term not exceeding two years; or

  • (b) an offence punishable on summary conviction.”

Dated this day of A.D. , at .

(Signature of accused)