CANADA

PROVINCE OF NOVA SCOTIA [CR # ]

HALIFAX REGIONAL MUNICIPALITY

IN THE SUPREME COURT OF NOVA SCOTIA

HER MAJESTY THE QUEEN

vs.

ORDER TO RETURN CASH BAIL FROM SUPREME COURT

BEFORE THE HONOURABLE JUSTICE

WHEREAS ____________________________ of __________________________________

was charged that he/she did:

Cite offence Section date place

AND WHEREAS, a sum of $ ___________ was deposited in cash, paid for his/her

release on a Recognizance with conditions dated _____________ at _______________ Court.

AND WHEREAS, on _______________ before Honourable Justice_____________________

of the Supreme Court he/she was: ________________________________________________

NOW UPON MOTION:

IT IS ORDERED that the Supreme Court return the sum of $ _____________ deposited as

bail to _________________________________________________________________.

                  CONSENTED TO AS FORM ___________________________

                                                                         Crown

                                                                          ___________________________

                                                                          Defence

__________________________ _____________________________________

__________________________ ________________________

Date Issued Deputy Prothonotary

Supporting affidavit required for the return of bail monies to anyone other than the defendant