Form 4	Application for arrest and removal order
Crimes (Forensic Procedures) Act 2000
(see s 40A (Magistrate may order arrest etc of suspect not in custody for carrying out forensic procedure))

In the *[Magistrates/Childrens] Court of the Australian Capital Territory 
Criminal jurisdiction 

No *[KP/CP]	 		of (year) 

(name)
Authorised Applicant

(name)
Respondent

The applicant requests that the Court make the following orders (an arrest and removal order):
1. The person named in this application (the suspect) be arrested for the purpose of carrying out a forensic procedure under the Crimes (Forensic Procedures) Act 2000, part 2.5 (Forensic procedures on suspect by order of magistrate).
2. The suspect be taken to (insert place where forensic procedure is to be carried out) for the forensic procedure to be carried out on the suspect.

Details of suspect
Name:
Address:
Date of birth (if known):

Grounds of application
The suspect is not in custody.
*[This application accompanies an application for an order that/On (date) the court ordered that] a forensic procedure be carried out on the suspect.
The arrest is necessary *[to ensure that the forensic procedure will be carried out/because the suspect might destroy evidence that might be obtained by carrying out the forensic procedure/for the following reasons: (briefly state reasons for justification)]

Supporting affidavit
This application is supported by the affidavit of (name) *[sworn/affirmed] on (date).
(the affidavit must be filed with the application and a sealed copy of the affidavit served on the suspect with the application (see r 4809).) 

Date:
(signature of person making application)
(name and capacity of person making application) 

*omit if, or whichever is, inapplicable