Form 7	Warrant—breach of periodic detention obligations
Crimes (Sentence Administration) Act 2005
(see s 65 (Arrest warrant—breach of periodic detention obligations))
In the *[Supreme/Magistrates] Court of the Australian Capital Territory
Criminal jurisdiction

No *[SCC/CC]			of (year)		

Authority and directions
To*[(insert name of police officer)/the police officers of the ACT]:
You are authorised and directed to arrest the person named in this warrant (the offender) and as soon as practicable bring the offender before the Sentence Administration Board, or if the board is not sitting––a Magistrate.

Details of offender
Name of offender:
Address:

Reason for arrest
I am satisfied by information on oath before me that there are reasonable grounds for suspecting that the offender has breached, or will breach, a periodic detention obligation of the offender.
The matter on which the information is based is as follows:
(state briefly the matter on which the information is based)

Date:
*[Judge/Magistrate]:

*omit if, or whichever is, inapplicable