FORM 5.04
(Paragraph 487.051(1)(b) and subsection 487.052(1))

ORDER AUTHORIZING THE TAKING OF BODILY SUBSTANCES FOR FORENSIC DNA ANALYSIS

Canada,
Province of .................
(territorial division)

To the peace officers in (territorial division):

Whereas (name of offender), in this order called the "offender", has been convicted, discharged under section 730 of the Criminal Code or, in the case of a young person, found guilty under the Young Offenders Act of (offence), an offence that is

(a) a secondary designated offence within the meaning of section 487.04 of the Criminal Code, or

(b) a designated offence within the meaning of section 487.04 of the Criminal Code committed before subsection 5(1) of the DNA Identification Act came into force;

Whereas I have considered the offender's criminal record, the nature of the offence and the circumstances surrounding its commission and the impact that this order would have on the offender's privacy and security of the person;

And whereas I am satisfied that it is in the best interests of the administration of justice to make this order;

Therefore, you are authorized to take from (name of offender) or cause to be taken by a person acting under your direction, the number of samples of bodily substances that are reasonably required for forensic DNA analysis, provided that the person taking the samples is able by virtue of training or experience to take them by means of the investigative procedures described in subsection 487.06(1) of the Criminal Code and provided that, if the person taking the samples is not a peace officer, he or she take the samples under the direction of a peace officer.

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This order is subject to the following terms and conditions that I consider advisable to ensure that the taking of the samples is reasonable in the circumstances:
Dated this ................ day of ................
A.D. ........, at ................ .
........................................
(Signature of judge of the court)