FORM 5.05
(Subsection 487.055(1))

APPLICATION FOR AN AUTHORIZATION TO TAKE BODILY SUBSTANCES FOR FORENSIC DNA ANALYSIS

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

I, (name of peace officer), (occupation), of .......... in the said (territorial division), apply for an authorization to take bodily substances for forensic DNA analysis. A certificate referred to in paragraph 667(1)(a) of the Criminal Code is filed with this application.

Whereas (name of offender), before June 30, 2000

(a) had been declared a dangerous offender under Part XXIV of the Criminal Code,

(b) had been declared a dangerous offender or a dangerous sexual offender under Part XXI of the Criminal Code, being chapter C-34 of the Revised Statutes of Canada, 1970, as it read from time to time before January 1, 1988,

(c) had been convicted of murder

(c.1) had been convicted of attempted murder or conspiracy to commit murder or to cause another person to be murdered and is currently serving a sentence of imprisonment for that offence,

(d) had been convicted of a sexual offence within the meaning of subsection 487.055(3) of the Criminal Code and is currently serving a sentence of imprisonment for that offence, or

(e) had been convicted of manslaughter and is currently serving a sentence of imprisonment for that offence.

Therefore, I request that an authorization be granted under subsection 487.055(1) of the Criminal Code to take from (name of offender) the number of samples of bodily substances that is 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.

Dated this ... day of ........,
A.D. ......, at ............... .
.........................................
(Signature of applicant)