The Bharatiya Nagarik Suraksha Sanhita, 2023

The Second Schedule

11,487 words over 61 pages, as the Government publishes it.

The schedule as printed. This is the text of the document India Code publishes for this schedule, in the order that document sets it out. A schedule is often a two-column table and these files carry no ruled lines to recover the columns from, so nothing here is restated as data: read it against the document itself where the alignment matters.

Pages 1 to 25 of 61, as the document is paginated.

THE SECOND SCHEDULE
(See section 522)
FORM No.1
NOTICE FOR APPEARANCE BY THE POLICE
[See section 35(3)]
Serial No……. Police Station………
To,
.................................
[Name of the Accused/Noticee]
.................................
[Last known Address]
.................................
[Phone No./ Email ID (if any)]
In pursuance of sub-section (3) of section 35 of the Bharatiya Nagarik Suraksha Sanhita, 2023, I
hereby inform you that during the investigation of FIR/Case No …………………..dated…………… u/s
………………………………… registered at Police Station ……………………………………………...,
it is revealed that there are reasonable grounds to question you to ascertain facts and circumstances from
you, in relation to the present investigation. Hence you are directed to appear before me at
………..........…… AM/PM on……………………... at

Police Station.
Name and Designation of the Officer In charge
(Seal)

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IndiaCode

FORM No. 2
SUMMONS TO AN ACCUSED PERSON
(See section 63)
To..............................................(name of accused) of ..............................................(address)
WHEREAS your attendance is necessary to answer to a charge of..........................................
.............................................(state shortly the offence charged), you are hereby required to appear in person
(or
by
an
advocate,
before
the
(Magistrate)
of..............................................,
on
the..............................................day............................................... Herein fail not.

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 3
WARRANT OF ARREST
(See section 72)
To .............................................. (name and designation of the person or persons who is or are to execute
the warrant).
WHEREAS
(name
of
accused)
of
(address)
stands
charged
with
the
offence
of
...................................................... (state the offence), you are hereby directed to arrest the said
......................................................, and to produce him before me. Herein fail not.
Dated, this.............................................. day of.............................................. , 20 ............... .

(Seal of the Court) (Signature)

(See section 73)
This warrant may be endorsed as follows:—

If the said.............................................................. shall give bail himself in the sum of
rupees.............................................. with one surety in the sum of rupees.............................................. (or
two sureties each in the sum of rupees..............................................) to attend before me on
the.............................................. day of.............................................. and to continue so to attend until
otherwise directed by me, he may be released.

Dated, this.............................................. day of.............................................. , 20 ............... .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 4
BOND AND BAIL-BOND AFTER ARREST UNDER A WARRANT
(See section 83)
I, ............................................................(name), of..........................................................., being brought
before the District Magistrate of...........................................................(or as the case may be) under a
warrant issued to compel my appearance to answer to the charge of...........................................................,
do hereby bind myself to attend in the Court of.................................................................on
the..................................day of ...........................................................next, to answer to the said charge, and
to continue so to attend until otherwise directed by the Court; and, in case of my making default herein, I
bind myself to forfeit, to Government, the sum of rupees................................................. .

Dated, this.............................................. day of.............................................. , 20 ............... .

(Signature)

I
do
hereby
declare
myself
surety
for
the
above-named..............................................
of..........................................................
that
he
shall
attend
before
in
the
Court
of
on
the.............................................. day of.............................................. next, to answer to the charge on which
he has been arrested, and shall continue so to attend until otherwise directed by the Court; and, in case of
his
making
default
therein,
I
bind
myself
to
forfeit,
to
Government,
the
sum
of
rupees............................................................. .

Dated, this.............................................. day of.............................................. , 20 ............. .

(Signature)

————

IndiaCode

FORM No. 5
PROCLAMATION REQUIRING THE APPEARANCE OF A PERSON ACCUSED

(See section 84)
WHEREAS a complaint has been made before me that................................................... (name,
description and address) has committed (or is suspected to have committed) the offence of
.............................................. , punishable under section.............................................. of the Bharatiya
Nyaya Sanhita, 2023, and it has been returned to a warrant of arrest thereupon issued that the
said.............................................. (name) cannot be found, and whereas it has been shown to my satisfaction
that the said.............................................. (name) has absconded (or is concealing himself to avoid the
service of the said warranty);
Proclamation is hereby made that the said.............................................. of..............................................
is required to appear at.............................................. (place) before this Court (or before me) to answer the
said complaint on the.............................................. day of..............................................
Dated, this.............................................. day of.............................................. , 20 ............... .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 6
PROCLAMATION REQUIRING THE ATTENDANCE OF A WITNESS
(See sections 84, 90 and 93)

WHEREAS complaint has been made before me that..............................................(name, description and
address)
has
committed
(or
is
suspected
to
have
committed)
the
offence
of
..............................................(mention the offence concisely) and a warrant has been issued to compel the
attendance of..............................................(name, description and address of the witness) before this Court
to be examined touching the matter of the said complaint; and whereas it has been returned to the said
warrant that the said..............................................(name of witness) cannot be served, and it has been shown
to my satisfaction that he has absconded (or is concealing himself to avoid the service of the said warrant);

Proclamation is hereby made that the said..............................................(name) is required to appear
at..............................................(place)
before
the
Court..............................................on
the........................................day of.........................................next at..............................................o'clock to
be examined touching..............................................the offence complained of.

Dated, this.............................................. day of.............................................. , 20 ............... .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 7
ORDER OF ATTACHMENT TO COMPEL THE ATTENDANCE OF A WITNESS
(See section 85)
To the officer in charge of the police station at..............................................
WHEREAS
a
warrant
has
been
duly
issued
to
compel
the
attendance
of.........................................................(name, description and address) to testify concerning a complaint
pending before this Court, and it has been returned to the said warrant that it cannot be served; and whereas
it has been shown to my satisfaction that he has absconded (or is concealing himself to avoid the service of
the said warrant); and thereupon a Proclamation has been or is being duly issued and published requiring
the said..............................................to appear and give evidence at the time and place mentioned therein;
This is to authorise and require you to attach by seizure the movable property belonging to the
said..............................................to the value of rupees..............................................which you may find
within the District..............................................of..............................................and to hold the said property
under attachment pending the further order of this Court, and to return this warrant with an endorsement
certifying the manner of its execution.
Dated, this.............................................. day of.............................................. , 20 ............... .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 8
ORDER OF ATTACHMENT TO COMPEL THE APPEARANCE OF A PERSON ACCUSED
(See section 85)
To .............................................. (name and designation of the person or persons who is or are to execute
the warrant).
Whereas complaint has been made before me that .............................................. (name, description and
address) has committed (or is suspected to have committed) the offence of ..............................................
punishable under section .............................................. of the Bharatiya Nyaya Sanhita, 2023 and it has been
returned to a warrant of arrest thereupon issued that the said .............................................. (name) cannot be
found; and whereas it has been shown to my satisfaction that the said .............................................. (name)
has absconded (or is concealing himself to avoid the service of the said warrant) and thereupon a
Proclamation has been or is being duly issued and published requiring the said ..............................................
to appear to answer the said charge within .............................................. days; and whereas the said
.............................................. is possessed of the following property, other than land paying revenue to
Government, in the village (or town), of .............................................., in the District of
.............................................., viz., .............................................., and an order has been made for the
attachment thereof;
You are hereby required to attach the said property in the manner specified in clause (a), or clause (c),
or both*, of sub-section (3) of section 85, and to hold the same under attachment pending further order of
this Court, and to return this warrant with an endorsement certifying the manner of its execution.
Dated, this .............................................. day of .............................................., 20 ............... .

(Seal of the Court)
(Signature)

* Strike out the one which is not applicable, depending on the nature of the property to be attached.

IndiaCode

FORM No. 9
ORDER AUTHORISING AN ATTACHMENT BY THE DISTRICT MAGISTRATE OR COLLECTOR
(See section 85)

To the District Magistrate/Collector of the District of ..............................................
WHEREAS complaint has been made before me that .............................................. (name, description
and
address)
has
committed
(or
is
suspected
to
have
committed)
the
offence
of
.............................................., punishable under section .............................................. of the Bharatiya
Nyaya Sanhita, 2023 and it has been returned to a warrant of arrest thereupon issued that the said
.............................................. (name) cannot be found; and whereas it has been shown to my satisfaction
that the said .............................................. (name) has absconded (or is concealing himself to avoid the
service of the said warrant) and thereupon a Proclamation has been or is being duly issued and published
requiring the said ....................................... (name) to appear to answer the said charge within
......................................... days; and whereas the said .............................................. is possessed of certain
land paying revenue to Government in the village (or town) of .............................................., in the District
of ..............................................;
You are hereby authorised and requested to cause the said land to be attached, in the manner specified
in clause (a), or clause (c), or both*, of sub-section (4) of section 85, and to be held under attachment
pending the further order of this Court, and to certify without delay what you may have done in pursuance
of this order.
Dated, this .............................................. day of .............................................., 20 ............... .

(Seal of the Court) (Signature)

* Strike out the one which is not desired.
IndiaCode

FORM No. 10
WARRANT IN THE FIRST INSTANCE TO BRING UP A WITNESS
(See section 90)
To .............................................. (name and designation of the police officer or other person or persons
who is or are to execute the warrant).

WHEREAS complaint has been made before me that .............................................. (name and description
of accused) of .............................................. (address) has (or is suspected to have) committed the offence
of .............................................. (mention the offence concisely), and it appears likely that
.............................................. (name and description of witness) can give evidence concerning the said
complaint, and whereas I have good and sufficient reason to believe that he will not attend as a witness on
the hearing of the said complaint unless compelled to do so;

This is to authorise and require you to arrest the said .............................................. (name of witness),
and on the .............................................. day of .............................................. to bring him before this Court
.............................................., to be examined touching the offence complained of.

Dated, this .............................................. day of .............................................., 20 ............... .

(Seal of the Court) (Signature)

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IndiaCode

FORM No. 11
WARRANT TO SEARCH AFTER INFORMATION OF A PARTICULAR OFFENCE
(See section 96)
To .............................................. (name and designation of the police officer or other person or persons
who is or are to execute the warrant).
WHEREAS information has been laid .............................................. (or complaint has been made) before
me of the commission .............................................. (or suspected commission) of the offence of
.............................................. (mention the offence concisely), and it has been made to appear to me that the
production of .............................................. (specify the thing clearly) is essential to the inquiry now being
made (or about to be made) into the said offence (or suspected offence);

This is to authorise and require you to search for the said .............................................. (the thing
specified) in the .............................................. (describe the house or place or part thereof to which the
search is to be confined), and, if found, to produce the same forthwith before this Court, returning this
warrant, with an endorsement certifying what you have done under it, immediately upon its execution.

Dated, this .............................................. day of .............................................., 20 ............... .

(Seal of the Court) (Signature)

______

IndiaCode

FORM No. 12
WARRANT TO SEARCH SUSPECTED PLACE OF DEPOSIT
(See section 97)
To ..............................................
(name and designation of the police officer above the rank of a constable).
WHEREAS information has been laid before me, and on due inquiry thereupon had, I have been led to
believe that the .............................................. (describe the house or other place) is used as a place for the
deposit (or sale) of stolen property (or if for either of the other purposes expressed in the section, state the
purpose in the words of the section);
This is to authorise and require you to enter the said house (or other place) with such assistance as shall
be required, and to use, if necessary, reasonable force for that purpose, and to search every part of the said
house (or other place, or if the search is to be confined to a part, specify the part clearly), and to seize and
take possession of any property (or documents, or stamps, or seals, or coins, or obscene objects, as the case
may be) (add, when the case requires it) and also of any instruments and materials which you may
reasonably believe to be kept for the manufacture of forged documents, or counterfeit stamps, or false seals,
or counterfeit coins or counterfeit currency notes (as the case may be), and forthwith to bring before this
Court such of the said things as may be taken possession of, returning this warrant, with an endorsement
certifying what you have done under it, immediately upon its execution.

Dated, this .............................................. day of .............................................., 20 ............ .

(Seal of the Court) (Signature)

______

IndiaCode

FORM No. 13
BOND TO KEEP THE PEACE
(See sections 125 and 126)
WHEREAS I,.............................................................. (name), inhabitant of ..............................................
(place), have been called upon to enter into a bond to keep the peace for the term of
.............................................
or
until
the
completion
of
the
inquiry
in
the
matter
of
.............................................. now pending in the Court of .............................................., I hereby bind
myself not to commit a breach of the peace, or do any act that may probably occasion a breach of the peace,
during the said term or until the completion of the said inquiry and, in case of my making default therein, I
hereby bind myself to forfeit, to Government, the sum of rupees ..............................................
Dated, this .............................................. day of .............................................., 20 ............ .

(Signature)

______

IndiaCode

FORM No. 14
BOND FOR GOOD BEHAVIOUR
(See sections 127, 128 and 129)
Whereas I, ............................................................... (name), inhabitant of ..............................................
(place), have been called upon to enter into a bond to be of good behaviour to Government and all the
citizens of India for the term of .............................................. (state the period) or until the completion of
the inquiry in the matter of .............................................. now pending in the Court of
.............................................., I hereby bind myself to be of good behaviour to Government and all the
citizens of India during the said term or until the completion of the said inquiry; and, in case of my making
default therein, I hereby bind myself to forfeit to Government the sum of rupees ...................

Dated, this .............................................. day of .............................................., 20 ............... .

(Seal of the Court) (Signature)

(Where a bond with sureties is to be executed, add)
We do hereby declare ourselves sureties for the above-named ........................................ that he will be
of good behaviour to Government and all the citizens of India during the said term or until the completion
of the said inquiry; and, in case of his making default therein, we bind ourselves, jointly and severally, to
forfeit to Government the sum of rupees .................................
Dated, this .............................................. day of .............................................., 20 ............ .

(Seal of the Court) (Signature)

______

IndiaCode

FORM No. 15
SUMMONS ON INFORMATION OF A PROBABLE BREACH OF THE PEACE
(See section 132)
To .............................................. of ..............................................
WHEREAS it has been made to appear to me by credible information that ................................ (state the
substance of the information), and that you are likely to commit a breach of the peace (or by which act a
breach of the peace will probably be occasioned), you are hereby required to attend in person (or by a duly
authorised agent) at the office of the Magistrate of .............................................. on the
.............................................. day of .............................................. 20 ..........., at ten o'clock in the forenoon,
to show cause why you should not be required to enter into a bond for rupees ..............................................
[when sureties are required, add, and also to give security by the bond of one (or two, as the case may be)
surety (or sureties) in the sum of rupees .............................................. (each if more than one)], that you
will keep the peace for the term of ..............................................
Dated, this .............................................. day of .............................................., 20 ........... .

(Seal of the Court) (Signature)

______

IndiaCode

FORM No. 16
WARRANT OF COMMITMENT ON FAILURE TO FIND SECURITY TO KEEP THE PEACE
(See section 141)
To the Officer in charge of the Jail at ..............................................
WHEREAS .............................................. (name and address) appeared before me in person (or by his
authorised agent) on the .............................................. day of .............................................. in obedience to
a summons calling upon him to show cause why he should not enter into a bond for rupees
.............................................. with one surety (or a bond with two sureties each in rupees
..............................................), that he, the said .............................................. (name) would keep the peace
for the period of months; and whereas an order was then made requiring the said
.............................................. (name) to enter into and find such security ......................................... (state
the security ordered when it differs from that mentioned in the summons), and he has failed to comply with
the said order;
This is to authorise and require you to receive the said .............................................. (name) into your
custody, together with this warrant, and him safely to keep in the said Jail for the said period of
.............................................. (term of imprisonment) unless he shall in the meantime be lawfully ordered
to be released, and to return this warrant with an endorsement certifying the manner of its execution.
Dated, this .............................................. day of .............................................., 20 ........... .

(Seal of the Court) (Signature)
______

IndiaCode

FORM No. 17
WARRANT OF COMMITMENT ON FAILURE TO FIND SECURITY FOR GOOD BEHAVIOUR
(See section 141)
To the Officer in charge of the Jail at..............................................
WHEREAS it has been made to appear to me that .............................................. (name and description)
has been concealing his presence within the district of .............................................. and that there is reason
to believe that he is doing so with a view to committing a cognizable offence;
or
WHEREAS evidence of the general character of..............................................(name and description) has
been adduced before me and recorded, from which it appears that he is an habitual robber (or house-breaker,
etc., as the case may be);

AND WHEREAS an order has been recorded stating the same and requiring the said (name) to furnish
security for his good behaviour for the term of (state the period) by entering into a bond with one surety
(or two or more sureties, as the case may be), himself for rupees.............................................. and the said
surety
(or
each
of
the
said
sureties)
rupees
..............................................and
the
said..............................................(name) has failed to comply with the said order and for such default has
been adjudged imprisonment for (state the term) unless the said security be sooner furnished;

This is to authorise and require you receive the said..............................................( name) into your
custody, together with this warrant and him safely to keep in the Jail, or if he is already in prison, be detained
therein, for the said period of (term of imprisonment) unless he shall in the meantime be lawfully ordered
to be released, and to return this warrant with an endorsement certifying the manner of its execution.

Dated, this.............................................. day of.............................................. , 20 ........... .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 18
WARRANT TO DISCHARGE A PERSON IMPRISONED ON FAILURE TO GIVE SECURITY
(See sections 141 and 142)
To the Officer in charge of the Jail at..............................................(or other officer in whose custody the
person is).
WHEREAS..............................................(name and description of prisoner) was committed to your
custody
under
warrant
of
the
Court,
dated
the..............................................
day
of
..............................................20..............................................; and has since duly given security under
section .............................................. of the Bharatiya Nagarik Suraksha Sanhita, 2023.
or
WHEREAS..............................................(name and description of prisoner) was committed to your
custody
under
warrant
of
the
Court,
dated
the.........................................................
day
of
..............................................20.................; and there have appeared to me sufficient grounds for the opinion
that he can be released without hazard to the community;
This is to authorise and require you forthwith to discharge the said .............................................. (name)
from your custody unless he is liable to be detained for some other cause.
Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 19
WARRANT OF IMPRISONMENT ON FAILURE TO PAY MAINTENANCE
(See section 144)
To the Officer in charge of the Jail at..............................................
WHEREAS..............................................(name, description and address) has been proved before me to
be possessed of sufficient means to maintain his wife ..............................................(name) [or his
child..............................................(name) or his father or mother..............................................(name), who
is by reason of (state the reason) unable to maintain herself (or himself)] and to have neglected (or refused)
to do so, and an order has been duly made requiring the said......................................................( name) to
allow to his said ..............................................wife (or child or father or mother) for maintenance the
monthly sum of rupees..............................................; and whereas it has been further proved that the
said..............................................(name) in wilful disregard of the said order has failed to pay
rupees.............................................., being the amount of the allowance for the month (or months)
of..............................................;
And thereupon an order was made adjudging him to undergo imprisonment in the said Jail for the period
of..............................................;
This is to authorise and require you receive the said..............................................(name) into your
custody in the said Jail, together with this warrant, and there carry the said order into execution according
to law, returning this warrant with an endorsement certifying the manner of its execution.
Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 20
WARRANT TO ENFORCE THE PAYMENT OF MAINTENANCE BY ATTACHMENT AND SALE
(See section 144)
To............................................................................................................................................. ..........
(name and designation of the police officer or other person to execute the warrant).

WHEREAS an order has been duly made requiring..............................................(name) to allow to his
said
wife
(or
child
or
father
or
mother)
for
maintenance
the
monthly
sum
of
rupees.............................................., and whereas the said..............................................(name) in wilful
disregard of the said order has failed to pay rupees.............................................., being the amount of the
allowance for the month (or months) of..............................................

This is to authorise and require you to attach any movable property belonging to the
said..............................................(name)
which
may
be
found
within
the
district
of.............................................., and if within..............................................(state the number of days or
hours allowed) next after such attachment the said sum shall not be paid (or forthwith), to sell the movable
property attached, or so much thereof as shall be sufficient to satisfy the said sum, returning this warrant,
with an endorsement certifying what you have done under it, immediately upon its execution.

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 21
ORDER FOR THE REMOVAL OF NUISANCES
(See section 152)
To..............................................(name, description and address).
WHEREAS it has been made to appear to me that you have caused an obstruction (or nuisance) to persons
using the public roadway (or other public place) which, etc., (describe the road or public place)
........................................................... by, etc., ..............................................(state what it is that causes the
obstruction or nuisance), and that such obstruction (or nuisance) still exists;
or
WHEREAS it has been made to appear to me that you are carrying on, as owner, or manager, the trade
or occupation of ..............................................(state the particular trade or occupation and the place where
it is carried on), and that the same is injurious to the public health (or comfort) by
reason..............................................(state briefly in what manner the injurious effects are caused), and
should be suppressed or removed to different place;
or
WHEREAS it has been made to appear to me that you are the owner (or are in possession of or have the
control
over)
a
certain
tank
(or
well
or
excavation)
adjacent
to
the
public
way
..............................................(describe the thoroughfare), and that the safety of the public is endangered by
reason of the said tank (or well or excavation) being without a fence (or insecurely fenced);
or
WHEREAS , etc., etc., (as the case may be);
I do hereby direct and require you within..............................................(state the time allowed) (state
what is required to be done to abate the nuisance) ............................................. or to appear
at..............................................in the ............................................. Court of..............................................on
the ..............................................day of..............................................next, and to show cause why this order
should not be enforced;
or
I do hereby direct and require you within..............................................(state the time allowed) to cease
carrying on the said trade or occupation at the said place, and not again to carry on the same, or to remove
the said trade from the place where it is now carried on, or to appear, etc.;
or
I do hereby direct and require you within..............................................(state the time allowed) to put up
a sufficient fence (state the kind of fence and the part to be fenced); or to appear, etc.;
or
I do hereby direct and require you, etc., etc. (as the case may be).

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)
————
IndiaCode

FORM No. 22
MAGISTRATE'S NOTICE AND PEREMPTORY ORDER
(See section 160)
To..............................................(name, description and address).
I
HEREBY give you notice that it has been found that the order issued on the
...............................................................day of..................................................................................requiring
you ..............................................(state substantially the requisition in the order) is reasonable and proper.
Such order has been made absolute, and I hereby direct and require you to obey the said order within (state
the time allowed), on peril of the penalty provided by the Bharatiya Nyaya Sanhita, 2023 for disobedience
thereto.

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 23
INJUNCTION TO PROVIDE AGAINST IMMINENT DANGER PENDING INQUIRY
(See section 161)

To..............................................(name, description and address).
WHEREAS the inquiry into the conditional order issued by me on the..............................................day
of .............................................., 20.............................................., is pending, and it has been made to appear
to me that the nuisance mentioned in the said order is attended with such imminent danger or injury of a
serious kind to the public as to render necessary immediate measures to prevent such danger or injury, I do
hereby, under the provisions of section 161 of the Bharatiya Nagarik Suraksha Sanhita, 2023, direct and
enjoin you forthwith to .............................................. (state plainly what is required to be done as a
temporary safeguard), pending the result of the inquiry.
Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)
————

IndiaCode

FORM No. 24
MAGISTRATE’S ORDER PROHIBITING THE REPETITION, ETC., OF A NUISANCE
(See section 162)
To..............................................(name, description and address).
WHEREAS it has been made to appear to me that, etc. ..............................................(state the proper
recital, guided by Form No. 21 or Form No. 25, as the case may be);
I do hereby strictly order and enjoin you not to repeat or continue, the said nuisance.

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

————

IndiaCode

FORM No. 25
MAGISTRATE’S ORDER TO PREVENT OBSTRUCTION, RIOT, ETC.
(See section 163)
To..............................................(name, description and address).
WHEREAS it has been made to appear to me that you are in possession (or have the management) of
..............................................(describe clearly the property), and that, in digging a drain on the said land,
you are about to throw or place a portion of the earth and stones dug-up upon the adjoining public road, so
as to occasion risk of obstruction to persons using the road;
or
WHEREAS it has been made to appear to me that you and a number of other persons (mention the class
of persons) are about to meet and proceed in a procession along the public street, etc., (as the case may be)
and that such procession is likely to lead to a riot or an affray;
or
WHEREAS, etc., etc., (as the case may be);
I do hereby order you not to place or permit to be placed any of the earth or stones dug from land on
any part of the said road;
or
I do hereby prohibit the procession passing along the said street, and strictly warn and enjoin you not
to take any part in such procession (or as the case recited may require).

Dated, this.............................................. day of.............................................. , 20 ............ .

(Seal of the Court) (Signature)

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