Sch. 7
WARRANT FOR APPREHENSION AND RETURN TO PRISON
To the Chief Commissioner of Police and to all members of the Police Force in the State of Victoria, and to the Governor of Her Majesty's Melbourne Assessment Prison or any other prison in the State which is more accessible or convenient.
(Christian Names or Given Names) (Surname in BLOCK Letters )
was convicted of
and by the order of the Adult Parole Board dated
was released on parole on
The Adult Parole Board cancelled that parole order on
This warrant authorises any member of the police force to apprehend the person whose parole was cancelled and return him or her to a prison, and this warrant requires the Governor of the Prison to receive that person into custody and detain him or her until released according to law.
Dated this day of 20
For and on behalf of the Adult Parole Board
Member/Secretary of the Adult Parole Board