Provincial Court of Saskatchewan Judicial Centre of Saskatoon Standardized Endorsement/Court Order Forms

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1 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Standardized Endorsement/Court Order Forms # S1 Adult Endorsement # S2 Adult Undertaking / Recognizance Basic (& DVC) # S3 - Adult Undertaking (Bail supervision & Intensive Bail Supervision) #S4 - Adult - Bail Supervision - Electronic Monitoring #S5 - Adult - Undertaking / Recognizance (Drugs) #S6 Adult Probation / Conditional Discharge (& BECAP & Impaired driver treatment) #S7 - Adult - Conditional Sentence Basic (& BECAP) #S8 - Adult - Conditional Sentence with Electronic Monitoring #S9 - ADULT - Conditional Sentence (DRUGS) #S10 - Adult - Amendment to / Undertaking / Recognizance / Probation / Conditional Sentence / Conditions #S11 - Adult - Intermittent Sentence #S12 Adult Mental Health Remand #S13 - Adult Muirhead Order #S14 - Adult Notice of Re-election pursuant to s. 561 Criminal Code #S15 - Adult Peace Bond s. 810 Criminal Code or Common Law Jurisdiction #S16 Adult Allegation of Breach of Conditional Sentence Order spw Jan 19 09

2 Provincial Court of Saskatchewan Accused Form # S 1 Judicial Centre of Saskatoon Information #s Prov/Fed Crown Agent/Courtworker Defence Counsel Accused Charge/Allegation Read Reading waived Witness Appears on Warrant Crown Election Summary Indictment Absolute Deferred Accused Election Waive Reading PCJ J alone J&J Consent Re-Election Plea Guilty cts NG cts G to LIO/s.606(4) ct # C S O Breach Allegations Admitted Denied APPEARANCE / COUNSEL Accused Present Not present In custody Witness Not present Bench Warrant To Go Held to adj date No Process Order personal attendance on next date Attendance waived today next date Designation of Counsel filed Video / audio conference today adj date MENTAL HEALTH ORDER Exam & Report a) Not Fit? b) Not Crim Resp? Dr. Menzies?N. Battleford BAIL Crown Opposes Consents BVSR Ordered Hearing Held Denied Released Undertaking Recog $ Cash Own Recog Sureties Optional Conditions att Statutory only ADJOURNED / REMANDED By Consent. Request of Crown Accused TO CC Pen CC& N. Battleford Hospital CC & RPC RCMP & hold RCMP & Pinegrove to / or the Undertaking/Recognizance is sooner entered into. to date AT 9:30 10:00 10:30 2:00 ctrm # at Saskatoon or FOR: SCH Election / Plea Mediation Case Management Early Case Resolution Prelim Trial Sentence To be spoken to Conditional Sentence Breach Hearing Review For trial at the next sittings of Queen s Bench Court Other REPORTS & OTHER ORDERS DVC?Assessment PSR Rest n Psychiatric Neuro/psych Impaired Driver treatment Sex Offender treatment AMENDMENT release sentence conditions PRELIMINARY INQUIRY Committal for trial by Consent by Court Order WARRANT ENDORSEMENTS Rec d serve all or part of sentence at Imp Dr Treatment 515(12) no communication / Preliminary Hearing Requested Yes No Crown Defense Request filed CM/ECR Required Day or more Charter Expert Disclosure Court required Disclosure ordered arranged Accused self represented yes no Accused Seeks Counsel Has Legal Aid Appt. Legal Aid denied appealed Court appointed counsel Application Court appoints Publication Ban Bail s.517 PH s.539 compl/witness ID s Witnesses excluded but for test after test SENTENCE / DISPOSITIONS Mediation complete Charge/Allegation withdrawn SOP Dismissed Absolute Disch Conditional Disch?Concurrent?Consecutive / Information & count #s to sentence this date / to sentence now serving. INCARCERATION / time served / time served & / Total sentence Intermittent for days - conditions attached Impaired Driver Treatment recommended days SUSP SENT PROBATION for Optional Conditions attached Statutory only FINE $ in default Pay by Surcharge $ Waived No Mention DRIVING PROH yrs Interlock ordered After mos Notice Traffic Safety 141(1). Lic surr prev in Court Licence to be surrendered by CONDITIONAL SENTENCE for Optional Conditions attached Statutory only CONDITIONAL SENTENCE REVIEW (9) a) no action b) change conditions att c) suspend & serve & resume CS d) terminate PEACE BOND 810 s. $ / without deposit / Term Conditions att Statutory only 738 REST N $ for (see att) WEAPONS 109/110 CC for yrs, life begins this date begins after release Surrender by DNA (1)Primary Mandatory (2)Primary Presumptive Secondary / to SPS / to by (date) SOIRA for yrs ORDER to stay & sign / return & sign by Clerk (Approved by Administrative S.P.Whelan -----)

3 Provincial Court of Saskatchewan Saskatoon Adult - Undertaking / Recognizance (Basic & DVC) Form # S2 Accused Information #s TO THE ACCUSED: You are released on Undertaking / Recognizance / in the sum of $ cash / without deposit / with surety / on conditions that you shall: 1 appear in court when required. 2 keep the peace & be of good behaviour. Residence & Curfew 3 reside at / / a residence approved by your Probation Officer / & not change that address without prior written permission of / your Probation Officer or / the Court. 4 comply with a curfew of pm to am daily & not leave your approved residence during this curfew unless you receive prior / written / permission from your / Probation Officer / or except 5 personally present yourself on demand at the door of your approved residence to any Peace or Probation Officer who may be checking the residence & curfew conditions of this order. Domestic Violence Assessment & Programming 6 report / immediately / within days / by to Probation Services at (address) & thereafter as required to the Probation Officer, or designate, & follow all lawful directions regarding assessment for & attendance at Domestic Violence & other programming. Contact - Persons & Location 7 have no contact directly or indirectly with subject to further Court order & the following exception (s): through / a member of the Law Society of Saskatchewan /. 8 not be at /or within a one block radius / of / the residence, school or work place of person(s) listed in #7, / as may be known to known to you / / except: / to obtain your personal possessions, on one on occasion, provided you are in the company of a peace officer /, subject to further Court Order. 9 not loiter in the area bounded by Ave. B. to Ave. W. & 22 nd St. to 17 th St. between p.m. & a.m., except 10 not be in Saskatoon except for attendance: as required by the Court, at pre-arranged appointments with legal counsel, for medical emergencies, and. Alcohol & Drugs 11 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 12 submit to alcohol/drug testing on demand of your Probation or a Peace Officer. C 13 report to Addictions Services by & thereafter as directed by Probation Services / or Addictions Services/ & actively participate in alcohol & drug, detoxification, assessment, education, counselling, out-patient / & in-patient / treatment / & / AA meetings /, & not give cause for dismissal from any such program. C Weapons 14 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) Police Contact & Search 15 report to the Saskatoon Police Service / or once per week, between 9 am & 5 pm, in person, or by phone, as required by the said Service, commencing & each thereafter. 16 submit to a demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess, subject to further order of the Court. C In s discretion, Accused asked & consented to clauses: (Approved by Administrative S. P. Whelan )

4 Form S3 may be combined Provincial Court of Saskatchewan Saskatoon with Drugs form S5 & Form # S 3 Adult Undertaking (Bail supervision & Intensive Bail Supervision) amended as needed. Accused Information #s TO THE ACCUSED: You are released on Undertaking/Recognizance in the sum of $ cash / without deposit / with surety / on conditions that you shall: 1 appear in court when required. 2 keep the peace & be of good behaviour. Bail Supervision & Police Contact & Search 3 be released to or designate. (phone # to be provided to security) 4 report / immediately upon release / within days / by /, in person & once a week thereafter to (address), as directed, to the Probation Officer, or designate, & follow all lawful directions. 5 immediately advise the Probation Officer of a change in employment /education status. 6 carry a copy of this order with you when outside your residence & show it to any peace officer that approaches you & immediately advise the Probation Officer of any contact with police. 7 not travel outside the City of Saskatoon, without prior written permission of the Probation Officer or the Court. 8 submit to any demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess. C Residence & Curfew 9 reside at / / a residence approved by the Probation Officer and not change that address without prior written permission of the Probation Officer or the Court. 10 comply with a curfew of pm to am daily & not leave your approved residence during this curfew unless you receive prior / written / permission from the Probation Officer, / except 11 personally present yourself on demand at the door of your approved residence to any Probation / Peace / Officer checking the residence & curfew conditions of this order. Contact - Persons & Location 12 have no contact directly or indirectly with subject to further Court order & the following exception(s): / through / a member of the Law Society of Saskatchewan / 13 not be at / or within / a one block radius / of / the residence, school or work place / / of the person(s) listed in #11, or as may be known to you / except / subject to further Court Order. 14 not loiter in the area bounded by Ave. B. to Ave. W. & 22 nd St. to 17 th St. between p.m. & a.m., except Alcohol & Drugs 15 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 16 submit to alcohol/drug testing on demand of the Probation / Peace / Officer. C 17 actively participate in alcohol / & drug / detoxification, assessment, education, counselling, out-patient / & in-patient / treatment, / & AA meetings / as directed by your Probation Officer & not give cause for dismissal from any such program. C Weapons 18 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) In s discretion, Accused asked & consented to clauses: (Approved by Administrative S. P. Whelan )

5 Provincial Court of Saskatchewan Saskatoon ADULT - Bail Supervision - Electronic Monitoring Form S4 may be combined with Drugs form S5 & amended as needed. Form # S4 Accused Information # TO THE ACCUSED: You are released on Undertaking/Recognizance in the sum of $ cash deposit / without deposit / with surety /on conditions that you shall: 1 appear in court when required. 2 keep the peace & be of good behaviour. Bail Supervision with Electronic Monitoring & Police Contact & Search 3 report / immediately upon release / within days / by /, in person & once a week thereafter, or as directed, at (address), to the Probation Officer or designate, & follow all lawful directions. 4 comply with the rules of the Electronic Monitoring Program, including: immediately arrange for & maintain residential telephone services from SASKTEL to accommodate the electronic monitoring equipment, immediately upon connection provide the Probation Officer with the telephone number & not change that number without prior permission of the Probation Officer, & maintain the electronic monitoring equipment in proper operating condition. 5 immediately upon release & until the electronic monitoring equipment can be installed, return to the approved residence & remain there unless prior written permission to leave is obtained from the Probation Officer. 6 once the electronic monitoring equipment has been installed, not leave the approved residence without prior written permission of the Probation Officer or designate & you must strictly comply with the terms of permission. 7 in the event of a medical emergency involving you or a member of your immediate family, be permitted to leave your approved residence without prior permission, but you must provide the Probation Officer with a note from the attending physician, verifying the emergency. 8 personally present your self on demand at the door of your approved residence to the Probation or Peace Officer, checking for compliance with the conditions of this order & permit such persons entry into the residence at any time to verify equipment operation. 9 immediately advise the Probation Officer of a change in employment/education status. 10 carry a copy of this order when you are outside the approved residence & show it to any peace officer that approaches you & immediately advise the Probation Officer of any contact with police. 11 not travel outside a 40 km radius of the approved residence, without prior written permission of the Probation Officer, or the Court. 12 submit to any demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possesses, subject to further order of the Court. C Residence 13 reside at, or a residence approved by the Probation Officer & not change that address without prior written permission of the Probation Officer, or the Court. Contact - Persons & Location 14 have no contact directly or indirectly with subject to further order of the Court & the following exception(s): / through / a member of the Law Society of Saskatchewan / 15 not be at / or within / a one block radius / of the residence, school or work place / of the person(s) listed in #14, or as may be known to you / except / subject to further Court Order. 16 not loiter in the area bounded by Ave. B. to Ave. W. & 22 nd St. to 17 th St. between 8 p.m. & 4 a.m. Alcohol & Drugs 17 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 18 submit to alcohol/drug testing on demand of the Probation or Police Officer. C 19 actively participate in alcohol / drug detoxification, assessment, education, counselling, out-patient / & in-patient / treatment, / & AA meetings / as directed by your Probation Officer & not give cause for dismissal from any such program. C Weapons 20 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) In s discretion Accused specifically asked & consented to clauses: (Approved by Administrative S. P. Whelan )

6 Provincial Court of Saskatchewan Saskatoon Adult - Undertaking / Recognizance (Drugs) Form S5 may be combined with bail supervision forms S3 & S4 & amended, as needed. Form # S5 Accused Information #s TO THE ACCUSED: You are released on Undertaking/Recognizance / in the sum of $ cash / without deposit / with surety / on conditions that you shall: 1 appear in court when required. 2 keep the peace & be of good behaviour. Residence, Curfew, Occupation, Name & Travel 3 reside at & not change that address without prior written permission of the Court. 4 comply with a curfew of pm to am daily & not leave your approved residence during this curfew, except 5 personally present yourself on demand at the door of your residence to any Peace or Probation Officer who may be checking for compliance with the conditions of this order. 6 not change your name, or employment, without prior permission of the Court & not use any name, other than the name that appears on this order, on any other document for any purpose. 7 not travel beyond a 100 km radius of your approved residence, except to attend Court or appointments with your lawyer, & shall carry & produce written proof of such an appointment to any officer that approaches you, provided: Contact Persons, Location & Gangs 8 have no contact directly or indirectly with, subject to further order of the Court & the following exception (s): through / a member of the Law Society of Saskatchewan / 9 not be at /or within a one block radius / of / the residence, school or work place / of person(s) listed in #8, / as may be known to known to you / to further order of the Court & the following exception(s): / through / a member of the Law Society of Saskatchewan / 10 not be in Saskatoon except for attendance: as required by the Court, at pre-arranged appointments with legal counsel or for medical emergencies. 11 except through a member of the Law Society, have no contact, directly or indirectly with anyone who wears or displays colors, paraphernalia, tattoos or symbols of gang or anyone you know to be a member of or associated with the said gang nor anyone you know or believe has a criminal drug record or is in any way connected with the production, possession or sale of illegal drugs. 12 when outside your residence, not wear any colors, paraphernalia or symbols & not display any tattoos associated with gang. Alcohol & Drugs 13 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 14 submit to alcohol/drug testing on demand of your Probation or a Police Officer. C 15 report to Addictions Services by & thereafter as directed by / Addictions / Probation / Services & actively participate in alcohol / & drug /, detoxification, assessment, education, counselling, out-patient / & in-patient treatment, / & AA meetings/, & not give cause for dismissal from any program. C Cell Phones, Pagers, Passport, Cash, Vehicles 16 not possess or use any cell phone, pager, or blackberry or other mobile electronic communications Device, & not register any of same in your name or anyone else s name. 17 prior to release from custody, deposit your passport & any international travel document(s) with the Court or written confirmation from the Passport Office that these documents have expired & you are prohibited from applying for a passport or international travel document. 18 not possess more than $ in cash. 19 not be in any rental vehicle unless it is rented in your name as it appears on this order & within one hour of signing the rental agreement fax it to Weapons 20 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence /, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) Police Contact & Search 21 report to the Saskatoon Police Service, once a week, between 9:00 am & 5:00 pm, in person or by phone, as required by the Police, commencing & each thereafter. 22 submit to any demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess. C 23 carry a copy of this document with you when outside your residence & show it to any peace officer that approaches you & immediately advise the Bail Supervision/Probation/Officer of any contact with police. In s discretion, Accused asked & consented to clauses: (Approved by Administrative S. P. Whelan )

7 Provincial Court of Saskatchewan Saskatoon Form # S6 ADULT- Probation, Conditional Discharge (including BECAP & Impaired driver treatment) Accused Information #s TO THE ACCUSED: The Court sentences you to a Cond Discharge Susp Sentence & Probation for days/mos/yrs, on the mandatory conditions & further conditions (732.1 Code) that you shall: Residence &Curfew 1 report / immediately upon release from / treatment / jail / within days / by to Saskatoon Probation Services at (address) & thereafter, as directed, to a Probation Officer or designate & follow all lawful directions. 2 immediately advise the Probation Officer of your current address & any change in your address. 3 reside at or a residence approved by your Probation Officer & not change that address without the prior written permission of your Probation Officer or the Court. 4 comply with a curfew of pm to am daily & not leave your residence during this curfew except / with prior written permission from your Probation Officer / 5 personally present yourself on demand at the door of your approved residence to any Peace / Probation / Officer, checking the residence & curfew conditions of this order. Contact - Persons & Location 6 have no contact directly or indirectly with, subject to further Court order & the following exception(s): / through / a member of the Law Society of Saskatchewan / 7 not be at / or within / a one block radius / of the residence, school or work place / of the person(s) listed in #6, / or as may be known to the accused / except / subject to further Court Order. 8 not loiter in the area bounded by Ave. B. to Ave. W. & 22 nd St. to 17 th St. between 8 p.m. & 4 a.m. Alcohol & Drugs 9 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 10 submit to alcohol/drug testing on demand of your Probation or Police Officer. C 11 actively participate in alcohol/drug detoxification, assessment, education, counselling, out-patient / & inpatient / treatment, & AA meetings, as directed by your Probation Officer & not give cause for dismissal from such program. C Community Service & Restitution 12 report as directed & complete hours of CSW by to the satisfaction of the Community Service Order Coordinator, or designate. 13 make restitution by paying to the Provincial Court, at Saskatoon, SK, $ in trust for the victim(s) listed in the attachment, [on or before.] [which sum shall be paid in equal monthly installments of, the first payment to be made on or before the day of 20 & in equal payments, on the same day of each month thereafter, until paid in full.] Assessment, Programming, Education & Employment 14 participate in the completion of any assessments of a psychological or psychiatric nature & follow the assessment recommendations, as directed by the Probation Officer as to education, counselling & treatment, including with respect to: domestic violence anger management sex offenders programming. C 15 attend upon a /medical doctor/psychiatrist/psychologist/ as directed & follow his/her directions as to appointments, counselling, treatment, & prescribed medication & direct the release of information to your Probation Officer concerning appointments & prescribed medication. C 16 participate in Attendance Centre programming, as directed by the Probation Officer. 17 actively seek &/or maintain employment or attendance in an educational program, as directed by the Probation Officer. Weapons, Instruments & Search 18 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) 19 submit to any demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess. C 20 not possess any instruments suitable for break & enter into buildings or vehicles. In s discretion Accused was asked & consented to clauses: (Approved by Administrative, S. P. Whelan, ----)

8 Provincial Court of Saskatchewan Saskatoon Form # S7 ADULT - Conditional Sentence Basic (including BECAP) Accused Information # TO THE ACCUSED: The Court sentences you to in a Provincial Correctional Center, to be served in the community, subject to mandatory conditions & additional conditions (742.3) that you shall: Reporting & lawful instructions 1 report / immediately / within working days / by / to the Probation Officer or designate & thereafter as directed & follow all lawful directions. 2 when outside your residence, carry a copy of this order & any approval for your absence & show them to any Peace Officer that approaches you & advise the Probation Officer of contact with police. Residence & curfew 3 reside at or a residence approved by the Probation Officer & not change that address without prior written approval of the Probation Officer or the Court. 4 for a term of from today, remain in your approved residence & not leave it without prior written approval from the Probation Officer for purposes approved by the Probation Officer, which may include: 5 from to comply with a curfew of pm to am daily & not be out of your approved residence during the curfew without prior written approval of the Probation Officer. 6 personally present yourself on demand at the door of your approved residence to any Peace Officer, Probation Officer or designate who may be monitoring compliance with this order. Alcohol & Drugs 7 not use, possess or consume alcohol or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 8 submit to alcohol/drug testing on demand of the Probation or Peace Officer. C 9 actively participate in alcohol/drug/ detoxification, assessment, education, counselling, out-patient / & inpatient / treatment, / & AA meetings/, as directed by the Probation Officer & not give cause for dismissal from such program. C Contact - Persons & Location 10 have no contact directly or indirectly with subject to further Court Order & the following exceptions: 11 not be at / or within / a one block radius / of / the residence, school or work place / of the person(s) listed in #10, / or as may be known to the accused / except / subject to further Court Order. 12 not loiter in the area bounded by Ave. B. to Ave. W. & 22 nd St. to 17 th St. between 8 p.m. & 4 a.m. Community Service & Restitution 13 report as directed and complete hours of CSW by to the satisfaction of the Probation Officer, or designate. 14 make restitution by paying to the Provincial Court at Saskatoon, SK, $ in trust for the victim(s) listed in the attachment, [on or before.] [which sum shall be paid in equal monthly installments; of, the first payment to be made on or before the day of 20 & in equal payments on the same day of each month thereafter until paid in full.] Assessment & Programming 15 participate in completion of any assessments, including of a psychological or psychiatric nature, & follow the assessment recommendations, as directed by the Probation Officer as to: education, counselling & treatment, with respect to: domestic violence anger management sex offenders programming. C 16 attend upon a /medical doctor/psychiatrist/psychologist/ as directed & follow his/her directions as to appointments, counselling, treatment, & prescribed medication & direct the release of information to your Probation Officer concerning appointments & prescribed medication. C 17 participate in Attendance Centre programming, as directed by the Probation Officer. C 18 actively seek and/or maintain employment or attendance in an educational program or participate in Attendance Centre programming, as directed by the Probation Officer. Weapons & Search 19 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender / dispose of / or deal with such items as follows: s 515(4.1) 20 submit to any demand by a peace officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess. C Education or Employment 21 actively / seek & / maintain / employment / educational programming, as directed by the Probation Officer. 22 actively participate in Attendance Centre programming as directed by the Probation Officer. Probation to Follow 23 report within days of completing this order to Probation Services& follow the attached probation order. In the s discretion Accused was asked & consented to clauses: (Approved by Administrative S. P. Whelan )

9 Provincial Court of Saskatchewan Saskatoon Form # S8 ADULT - Conditional Sentence with Electronic Monitoring Accused Information # TO THE ACCUSED: The Court sentences you to in a Provincial Correctional Center, to be served in the community, subject to mandatory conditions & on the following conditions (742.3) that you shall: Reporting, Lawful Instructions & Electronic Monitoring Equipment Operation 1 report / immediately / within days / by / to the Probation Officer or designate at (address) & thereafter as directed & follow all lawful directions. 2 comply with the Electronic Monitoring Program Rules for months, beginning today /. 3 when outside your residence, carry a copy of this order & any approval for your absence & show them to any Peace Officer that approaches you & immediately advise the Probation Officer of contact with police. Residence & Curfew 4 reside at or a residence approved by your supervisor & not change that address without the prior written approval of your Probation Officer or the Court. 5 if the electronic monitor is not installed immediately, go to your residence & not leave it except with prior written approval from your supervisor, unless required to leave for a medical emergency. 6 while required to comply with the Electronic Monitoring Program, be confined to your approved residence continuously & not leave the residence except in accordance with prior written approval from your Probation Officer, which may include 7 after the electronic monitoring portion of this sentence is complete, comply with a curfew for a further of pm to am daily & not be out of your residence during the curfew unless you have prior written approval from your Probation Officer. 8 personally present yourself at the door of your approved residence to any Peace or Probation Officer or designate who may be monitoring compliance with this order & permit such persons entry into your residence to verify equipment operation. Alcohol & Drugs 9 not use, possess or consume alcohol / or non-prescription illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 10 submit to alcohol/drug testing on demand of your Probation or Peace Officer. C 11 actively participate in alcohol / drug detoxification, assessment, education, counseling, & in-patient / or outpatient / treatment & attend AA meetings, as directed by your Probation Officer & not give cause for dismissal from such program. C Contact - Persons & Location 12 have no contact directly or indirectly with subject to further order of the court & the following exceptions: 13 not be at / or within / a one block radius / of / the residence, school or work place / of the person(s) listed in #12, / or as may be known to you / except / subject to further Court Order. 14 not loiter in the area bounded by Ave. B. to Ave. W. & 22nd St. to 17th St. between 8 p.m. & 4 a.m. Community Service & Restitution 15 report as directed & complete hours of community service work by to the satisfaction of the Probation Officer, or designate. 16 make restitution by paying to the Provincial Court at Saskatoon, SK, $ in trust for the victim(s) listed in the attachment, [on or before.] [which sum shall be paid in equal monthly installments; of, the first payment to be made on or before the day of 20 & in equal payments on the same day of each month thereafter until paid in full.] Assessment & Programming 17 participate in the completion of any assessments, including those of a psychological or psychiatric nature & follow the assessment recommendations, as directed by the Supervisor as to education, counselling & treatment, including with respect to: domestic violence anger management sex offenders programming. C 18 attend upon a /medical doctor/psychiatrist/psychologist/ as directed & follow his/her directions as to appointments, counselling, treatment, & prescribed medication & direct the release of information to your Probation Officer concerning appointments & prescribed medication. C Weapons & Search 19 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender / dispose of / or deal with such items as follows: s 515(4.1) 20 submit to any demand by a Peace Officer, without warrant or reasonable & probable grounds, to search your person & any residence or vehicle you own, operate, control or possess. C Education or Employment 21 actively / seek & / maintain / employment / educational programming, as directed by the Probation Officer. Probation to Follow 22 report within days of completing this order to Probation Services & follow the attached probation order. In s discretion Accused was asked & consented to clauses: (Approved by Administrative S. P. Whelan----)

10 Provincial Court of Saskatchewan Saskatoon Form # S9 ADULT - Conditional Sentence of Imprisonment (DRUGS) Accused Information # TO THE ACCUSED: The Court sentences you to in a Provincial Correctional Center, to be served in the community, subject to mandatory conditions & on additional conditions (742.3) that you shall: Reporting & lawful instructions 1 report / immediately / within days / by / to the Probation Officer or designate & thereafter as directed & follow all lawful directions. 2 when outside your residence, carry a copy of this order & any approval for your absence and show them to any Peace Officer that approaches you & immediately advise the Probation Officer of contact with police. Residence, Curfew, Occupation, Name & Travel 3 reside at & not change that address without prior permission of the Court. 4 comply with a curfew of pm to am daily & not leave your approved residence during this curfew except 5 personally present yourself on demand at the door of your residence to any Peace Officer or Probation Officer who may be checking for compliance with the conditions of this order. 6 not change your name, or employment, without the prior permission of the Court & not use any name, other than the name that appears on this order, on any other document for any purpose. 7 not travel beyond a 100 Km radius of your residence except: to attend Court for appointments with your Lawyer & you shall carry written proof of an appointment with your lawyer which you shall show to any peace officer that approaches you, provided: Contact Persons, Location & Gangs 8 have no contact directly or indirectly with subject to the following exception (s): through / a member of the Law Society of Saskatchewan & further Court Order. 9 not be at /or within a one block radius / of / the residence, school or work place / of person(s) listed in #8, / as may be known to known to you / except subject to further Court Order. 10 not be in Saskatoon except for attendance: as required by the Court, at pre-arranged appointments with legal counsel, or for medical emergencies. 11 except through a member of the Law Society, have no contact, directly or indirectly with anyone who wears or displays colors, paraphernalia, tattoos or symbols of gang or anyone you know to be a member of or associated with the said gang nor anyone you know or believe has a criminal drug record or is in any way connected with the production, possession or sale of illegal drugs. 12 when outside your residence, not wear any colors, paraphernalia or symbols and not display any tattoos associated with gang. Alcohol & Drugs 13 not use, possess or consume alcohol / or non-prescription illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 14 submit to alcohol/drug testing on demand of your Probation or Police Officer. C 15 report to Addictions Services by & thereafter as directed by Probation / Addictions / Services & actively participate in alcohol / & drug / detoxification, assessment, education, counselling, outpatient / & in-patient / treatment, & AA meetings/, & not give cause for dismissal from such program. C Cell Phones, Pagers, Passport, Cash, Vehicles 16 not possess or use any cell phone, pager, or blackberry or any other mobile electronic communications device & not register any of same in your name nor any one else s name. 17 immediately deposit your passport & any international travel document(s) with the Court or written confirmation from the Passport Office that these documents have expired & you are prohibited from applying for a passport or international travel document. 18 not possess more than $ in cash. 19 not be in any rental vehicle and not rent a vehicle except under conditions specified by your Supervisor. Weapons 20 not possess a firearm cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, / or any weapons defined by the Criminal Code / or knives outside your residence, & if in possession of any of the foregoing, you must surrender or deal with such items as follows: s 515(4.1) Police Contact & Search 21 submit to any demand by a Peace Officer, without warrant or reasonable and probable grounds, to search your person and any residence or vehicle you own, operate, control or possess, up to 5 times per month. C Probation to Follow 22 report within days of completing this order to Probation Services & follow the attached probation order. In s discretion Accused asked & consented to clauses: (Approved by Administrative S. P. Whelan )

11 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Form # S10 Adult - Amendment to / Undertaking / Recognizance / Probation / Conditional Sentence / Conditions Accused Information #s TO THE ACCUSED: The Court Orders amendment / deletion / addition / of conditions of the Undertaking / Recognizance / Probation Order / Conditional Sentence / dated as follows: AMENDMENT Residence & Curfew Clause # Reside at and not change that address without prior permission your Probation Officer or the Court. Clause # Comply with a curfew of pm to am daily & not leave your approved residence during this curfew except Contact - Persons & Location Clause # Have no contact directly or indirectly with, except / through / a member of the Law Society of Saskatchewan / subject to further order of the Court & the following exception(s): Clause # Not be at /or within / a one block radius / of / the residence, school or work place / / of person(s) listed in clause, / as may be known to known to you / except: / to obtain your personal possessions, on one on occasion, provided you are in the company of a peace officer /, and except:, subject to further Court Order. DELETION Clause # is deleted. Clause # is deleted. New Conditions or other Amendments (indicate clause # to be amended) (Approved by Administrative S. P. Whelan )

12 Provincial Court of Saskatchewan Saskatoon Form # S11 Adult - Intermittent Sentence Accused Information # TO THE ACCUSED: The Court ordered a sentence of 90 / days to be served INTERMITTENTLY in a Provincial Correctional Centre in Saskatchewan & for that purpose you shall present yourself to the keeper of the Saskatoon / Correctional Centre of Saskatchewan, not later than 7:00 p.m., on Friday, the day of 20 & remain for release at 7:00 am on the Sunday / Monday immediately following & you shall continue to present yourself, each Friday thereafter for release, each week as on that first occasion, until the sentence is satisfied. When not confined, you shall be subject to a probation order for a period of months. You shall comply with the mandatory & following optional conditions of probation: 1 report / immediately upon release from / treatment / jail / within days / by to at (address) Saskatoon Probation Services / Addiction Services/ & thereafter as directed & follow all lawful directions of the Probation / Addictions / Officer, or designate. 2 immediately advise the Probation / Addictions Officer of your current address & any change in your address. 3 Refrain from consuming alcohol for a period 12 hours prior to presenting yourself for week-end incarceration. 4 not use, possess or consume alcohol / or non-prescribed illicit drugs / & not enter any licensed premises in which the primary purpose is the sale or consumption of alcohol. 5 actively participate in alcohol/drug detoxification, assessment, education, counselling, out-patient / & inpatient / treatment, & AA meetings, as directed by your Probation / Addictions / Officer & not give cause for dismissal from such program. C 6 have no contact directly or indirectly with, subject to further order of the Court, & the following exception(s): / through / a member of the Law Society of Saskatchewan / 7 not be at / or within / a one block radius / of the residence, school or work place of the person(s) listed in #6, / or as may be known to the accused / except / subject to further Court Order. 8 make restitution by paying to the Provincial Court, at Saskatoon, SK, $ in trust for the victim(s) listed in the attachment, [on or before.] [which sum shall be paid in equal monthly installments of, the first payment to be made on or before the day of 20 & in equal payments, on the same day of each month thereafter, until paid in full.] In s discretion, Accused was asked & consented to clauses: 5 (Approved by Administrative, S. P. Whelan, ----)

13 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Adult Mental Health Remand Form # S12 Accused Information #(s) Pursuant to s , this Court has reasonable grounds to believe that evidence of the mental condition of the Accused, may be necessary to determine: a) fitness to stand trial b) criminal responsibility This Court orders an assessment & report into the mental health condition of the Accused, concerning the foregoing & for this purpose the Accused shall be: 1) Remanded to the Saskatoon Provincial Correctional Centre pending escort to the Saskatchewan Hospital Forensic Unit, North Battleford, Saskatchewan, for assessment and report. 2) He/she is to be held there for such period as may be necessary for assessment, provided that it does not exceed the date of the next court appearance. 3) The Director of the Forensic Unit at the Saskatchewan Hospital, North Battleford, & the Director of the Saskatoon Provincial Correction Centre are authorized to transfer the Accused to the Regional Psychiatric Centre. 4) The Director of the Regional Psychiatric Centre is authorized to accept the Accused where he/she requires a level of security, safety, or psychiatric care, which cannot be provided by the North Battleford Forensic Unit or the Provincial Correctional Centre. 5) In the event that the detention of the Accused is no longer required for the purpose of assessment, prior to the date of the next court appearance, a peace officer may take custody of the Accused and return him/her to the Court as soon as practicable. (Approved by Administrative S.P.Whelan -----)

14 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Adult Muirhead Order Form # S13 Accused Information #s THE Accused, having indicated that he/she intends to represent him/herself, & is prepared to abide by the conditions herein; it is hereby ordered that the Accused shall: 1 maintain all disclosure material provided by the Crown in his/her sole possession and not release or show any of the said material to any member of the public or the press. 2 use the said material, solely for the purpose of preparing for his/her trial. 3 not reproduce or store the said material in a retrieval system or transmit it in any form. 4 immediately return the said material upon completion of the trial of this matter. d this day of, 20, at Saskatoon, Saskatchewan Provincial Court I,, agree to comply with the conditions of this order. Accused s signature Accused s Address Phone Fax (Approved by Administrative S.P.Whelan -----)

15 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Form # S14 Adult Notice of Re-election pursuant to s. 561 Criminal Code Accused Information #s Charge(s) The Accused having elected trial by now desires to re-elect to be tried by a Provincial Court pursuant to s. 561 of the Criminal Code of Canada. Accused or his/her Counsel to sign On behalf of the Attorney General of Saskatchewan, I consent to this re-election. Crown Counsel to sign (Approved by Administrative S.P.Whelan -----)

16 Provincial Court of Saskatchewan Judicial Centre of Saskatoon Form # S15 Adult Peace Bond s. 810 Criminal Code or Common Law Jurisdiction Accused Peace Bond Allegation # TO THE ACCUSED: You Shall: 1 keep the peace and be of good behaviour. 2 report to the Court when required to do so. 3 have no contact, directly or indirectly with, subject to further order of the Court & the following exception(s): / through / a member of the Law Society of Saskatchewan / 4 not be at / or within / a one block radius / of / the residence, school or work place / of the person(s) listed in #3, / or as may be known to the accused / except, subject to further Court Order. (Approved by Administrative S.P.Whelan -----)

17 ALLEGATION OF BREACH OF CONDITIONAL SENTENCE ORDER Form # S16 (To be typed) In the matter of a Conditional Sentence dated for pertaining to Information #(s): (day/mo/year) (length) Canada Province of Saskatchewan I of, Saskatchewan, (occupation) have reasonable grounds to believe and do believe that (accused) born the day of A.D. of (address) on / between and, at, did, while bound by a conditional sentence order, made by, breach, without reasonable excuse, the following conditions of that order: (1) (2) (3) The foregoing conditions were breached in the following manner: (numbers of condition & manner to correspond) (1) (2) (3) This allegation of breach has been supported by a written report produced to me by the Supervisor of this conditional sentence, which breach is contrary to section of the Criminal Code of Canada (signature Conditional Sentence Order Supervisor/Police Officer) (print name) (day/mo/year) (Approved by Administrative S. P. Whelan, ----)

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