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Family Violence Initiative
Sample Application for Limitation on Firearms Access (s. 117.011)
(PDF Version 165 KB, PDF Help)
NOT AN OFFICIAL FORM
Included only as guidelines for assistance with Criminal Harassment cases. For further information contact the
National Weapons Enforcement Support Team (NWEST)
at1-800-731-4000 Ext 2053.
Canada,
Province of ,
(territorial division)
IN THE MATTER OF AN APPLICATION
TO A JUDGE OF THE PROVINCIAL
COURT FOR AN ORDER PURSUANT TO
SECTION 117.011 OF THE CRIMINAL
CODE.
APPLICATION
TAKE NOTICE THAT an application is hereby made pursuant to Section 117.011 of the Criminal Code, for an order for the limitation on access to any firearm, cross-bow, prohibited weapon, restricted weapon, prohibited device, ammunition, prohibited ammunition or explosive substance, or all such things.
AND FURTHER TAKE NOTICE THAT upon and in support of said application will be read the affidavit(s) of attached hereto.
DATED at , this day of , 20 .
TO: A Judge of the Provincial Court
Peace Officer/ Firearms Officer/
Chief Firearms Officer
Pursuant to this Application, I hereby fix day, the day of 20 , at a.m./p.m. at for the hearing AND I DIRECT that a notice of the hearing be given to (respondent/counsel/agent) by serving a copy hereof upon him/her (personally/by registered mail/by substituted service/by any other method specified by the justice).
DATED at , this day of , 20 .
Judge of the Provincial Court
