Victorian Numbered Regulations

CORRECTIONS REGULATIONS 2009 (SR NO 40 OF 2009) - SCHEDULE 6

SCHEDULE 6

Sch. 6

Regulation 86

REVOCATION OR CANCELLATION OF A PAROLE ORDER

(Christian Names or Given Names) (Surname in BLOCK Letters )

was convicted of

and by the order of the Adult Parole Board dated

was released, or was to be released on parole on

Now the Adult Parole Board revokes/cancels* the parole order, the Adult Parole Board being advised that

Dated this day of 20

For and on behalf of the Adult Parole Board

Member/Secretary of the Adult Parole Board

* Strike out whichever is inapplicable

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