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IN THE HIGH COURT OF JUSTICIARY [or IN THE SHERIFF...
AT (place)
NOTICE
by
[A.B.] (address [or Prisoner in the Prison of (place)]
under
Section 16A(4) of the Criminal Law (Consolidation) (Scotland) Act 1995...
To: (name of prosecutor, or co-accused)
I HEREBY GIVE NOTICE that under section 16A(4) of the...
(here set out reasons for regarding condition as unsatisfied)
I HEREBY REQUIRE (insert name and designation of prosecutor) to...
(Signed)
[A.B.]
[or Solicitor for [A.B.]]
(Address and telephone number of Solicitor)
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