Annex K: Form and Sample of Direction on Release from Custody

I direct that [service number, rank (if applicable) and name of person arrested]
D11 222 333 Cpl A.B. Robert be released:

[Delete (a) or (b) as applicable]

1. without conditions (deleted), or
2. on the condition that the person comply with all of the following conditions:
   1. remain under military authority;
   2. report at [specified times] 0700, 1800 and 2200 hours to [specified military authority] the Base Duty Officer;
   3. remain within the confines of [specified defence establishment or location within a geographical area] CFB Edmonton;
   4. abstain from communicating with [witness or specified person] Miss Lucy Gendron;
   5. refrain from going to [specified place] any mess or other facility serving alcohol; and
   6. [other reasonable conditions as are specified] abstain from the consumption of alcohol.

Date: 17 June 06

[Rank, name, appointment and unit of custody review officer]
Maj B. McDonald, D/CO, 460 Sqn

I, [service number, rank (if applicable) and name of arrested person] D11 222 333 Cpl A.B. Robert acknowledge and agree to comply with the above conditions as a condition of my release from arrest.

Date: 17 June 06

[signature of arrested person] A.B. Robert

[name of witness to signature of arrested person] CWO T. Blais

AL 2-99