District No.

............... Prosecutor

............... Accused

YOU ARE HEREBY REQUIRED to attend at the sitting of the District Court to be held at ........... on the ... day of .... 19..., at .... .m. and on any day to which the hearing of these proceedings shall be adjourned, to give evidence on behalf of ..................... on the hearing of a complaint that the above-named accused did

*AND YOU ARE REQUIRED TO BRING WITH YOU the following accounts, papers, documents (or things)

Dated this .... day of ......... 19 .... .

Signed ...............................

Judge of the District Court

(or)

Clerk of the District Court

(or)

Peace Commissioner

To

Of

NOTE

If, without lawful excuse, you do not obey this summons, a warrant for your arrest may be issued.

*Delete where inapplicable