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Paragraph 2(3).

SCHEDULE

Form 20.12A-A

RESTRICTION OF LIBERTY ORDER

under section 245A(1) of the Criminal Procedure (Scotland) Act 1995

COURT:

DATE:

OFFENDER'S NAME, ADDRESS AND DATE OF BIRTH:

OFFENCE FOR WHICH CONVICTED:

THE COURT, having convicted (name of offender) of (specify offence) and being satisfied that the most appropriate method of disposal is to make an order under subsection (1) of section 245A of the Criminal Procedure (Scotland) Act 1995;

AND having complied with any requirement imposed on it by subsection (6) of, and provided the offender with the explanation required by subsection (4) of, that section and obtained from him his agreement that he will comply with the requirements of the proposed order;

ORDERS that for (specify, as respects a day [or week], a period in that day [or week]) the offender shall be in (specify a place) [or that at (specify a time) [or during (specify a period)] the offender shall not be in (specify a place)].

(Signed)

Clerk of Court.

Date:

Note: (Name and address of monitor) has been designated by the court, under section 245B(2) of the Criminal Procedure (Scotland) Act 1995, as the person responsible for monitoring the offender’s compliance with this order.

I confirm that I understand the requirements of this order and will comply with them.

Form 20.12A-BForm of application under section 245E(1) of the Criminal Procedure (Scotland) Act 1995

UNTO THE RIGHT HONOURABLE THE LORD JUSTICE GENERAL, LORD JUSTICE-CLERK AND LORDS COMMISSIONERS OF JUSTICIARY

[or Unto The Honourable The Sheriff of (name of sheriffdom)

At (place)]

[or Unto The Justices In The District Court Of (name of district) At (place)]

Application

by

(name of offender) (address) [or Prisoner

in the Prison of (place)]

[or name and address of applicant with responsibility for monitoring offender’s compliance with restriction of liberty order]

APPLICANT

HUMBLY SHEWETH

1.  That a restriction of liberty order, a copy of which is annexed to this application, was made in respect of (name of offender) on (date) in the High Court of Justiciary sitting [ or in the sheriff court or in the district court] at (place).

2.  That the applicant applies to the court in terms of subsection (1) of section 245E of the Criminal Procedure (Scotland) Act 1995 to revoke [or vary] the order for the following reason–

Form 20.12A-CForm of citation of offender under section 245E(3) of the Criminal Procedure (Scotland) Act 1995

IN THE HIGH COURT OF JUSTICIARY

[or IN THE SHERIFF [or DISTRICT] COURT]

AT (place)

CITATION

To: (name and address of offender)

Date of citation: (date of citation or, if citation by post, the day after the date of posting)

YOU ARE HEREBY CITED to appear on (date) at (time) in the High Court of Justiciary [or Sheriff [or District] Court] at (address) because it appears to the court to be in the interests of justice that the restriction of liberty order made in respect of you on (date) should be varied or revoked.

IF YOU FAIL TO ATTEND COURT WITHOUT A LAWFUL EXCUSE THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST.

Form 20.12A-DForm of citation of offender under section 245F(1) of the Criminal Procedure (Scotland) Act 1995

IN THE HIGH COURT OF JUSTICIARY

[or IN THE SHERIFF [or DISTRICT] COURT]

AT (place)

CITATION

To: (name and address of offender)

Date of citation: (date of citation or, if citation by post, the day after the date of posting)

YOU ARE HEREBY CITED to appear on (date) at (time) in the High Court of Justiciary [or Sheriff [or District] Court] at (address) because it has been reported to the court that you have failed to comply with a requirement of your restriction of liberty order by (specify the failure alleged).

IF YOU FAIL TO ATTEND COURT WITHOUT A LAWFUL EXCUSE THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST.