Court File No.___________

PROVINCIAL COURT
(SPECIFY COURT LOCATION) 
(Criminal Division)

BETWEEN.

HER MAJESTY THE QUEEN
(Applicant, Appellant or Respondent)

-and-

(SPECIFY NAME OF ACCUSED)
(Applicant, Appellant or Respondent)


NOTICE OF ABANDONMENT


	TAKE NOTICE that the (specify whether Applicant or Appellant) hereby wholly abandons his (or her) application for (indicate the nature of the order and relief sought).


DATED at ________________________________ this __________ day of __________________ 20____.





____________________________________
(Signature of applicant or appellant or counsel acting on behalf of that person) (name and address)