Sch 2Forms

Schedule 2—Forms Sch. 2 Form 1 amended by S.R. No. 46/2019 reg. 8. Form 1 Regulation 23(2) Order to bring a prisoner before a court or coroner To [*insert title of person in charge of prison*] at [*insert name of prison*] AND to all police officers in Victoria. Under the provisions of regulation 23 of the Corrections Regulations 2019 I order that [*insert name of prisoner, date of birth and JAID (if known)*] a prisoner detained at [*insert name of prison*] be brought before the [*insert name of court*] to be held at [*insert place where court to be held*] on [*insert date*] for the purpose of [*insert purpose for which the prisoner is required to attend. If the purpose is to answer a charge include the nature of the offences with which the prisoner is charged* (*specify the most serious offence first)*] and the prisoner is to remain in the custody of those officers and police officers acting under this order until the prisoner is returned to the prison from which the prisoner was removed or is released by order of the court. | Prisoner's legal representative (if applicable)<br>*[Insert name]*<br>*[Insert phone number]*<br>*[Insert address]*<br>*[Insert email]*<br>*[Insert fax]* | | Dated the day of , 20 Judge Registrar of Criminal Appeals Judicial Registrar of the Supreme Court Magistrate Coroner Sch. 2 Form 2 amended by S.R. No. 46/2019 reg. 9. Form 2 Regulation 23(3) NOTICE TO THE OFFICERS AND POLICE OFFICERS BRINGING A PRISONER BEFORE A COURT OR CORONER The prisoner [*insert name and date of birth of prisoner*] is detained for other matters and must be returned to the place of detention* is not detained for other matters and may be released if so ordered by the court.* is granted bail and may be released if so ordered by the court.* | Name and signature of the person in charge of the prison from which the prisoner is removed to attend before a court or coroner | <br><br> | | | --- | --- | --- | Form 3 Regulation 98(1)(a) Certificate of sample I, [*name of analyst, prison officer or escort officer*] of [*name of employer*] CERTIFY that— 1. On [*insert date*] I received a sealed container labelled 2. The sealed container contained [*insert description of contents including description by weight*] 3. I analysed a sample of the contents of the sealed container and found the sample to constitute [*insert analysis of sample*] [*Signature*] [*Qualification*] Date: Form 4 Regulation 103(1)(a) WARRANT TO ARREST AND RETURN AN UNLAWFULLY RELEASED PRISONER TO PRISON ISSUED BY THE SECRETARY UNDER SECTION 108A(2) OF THE CORRECTIONS ACT 1986 Prisoner name: Prisoner JAID/MNI: Prisoner CRN: Prisoner date of birth: Case number/s: **To the Chief Commissioner of Police and to all police officers in the State of Victoria:** The Secretary to the Department of Justice and Community Safety, under section 108A(2)(a) of the **Corrections Act 1986**, authorises any police officer to break, enter and search any place where the prisoner named on this warrant is reasonably believed to be and to arrest the prisoner and return the prisoner to prison. You must take and safely convey the prisoner named on this warrant to a prison and deliver the prisoner to the person in charge of that prison. **To all prison officers and escort officers:** The Secretary to the Department of Justice and Community Safety, under section 108A(2)(b) of the **Corrections Act 1986**, authorises any prison officer or escort officer to arrest the prisoner and return the prisoner to prison. You must take and safely convey the prisoner named on this warrant to a prison and deliver the prisoner to the person in charge of that prison. **To the person in charge of a prison into whose custody the prisoner named in this warrant is received:** You are directed and authorised to receive the prisoner named in this warrant into custody and detain that prisoner for the period specified in the original court warrant identified by the case number above, or until that person is otherwise released from custody according to law. Dated: Signature of the Secretary to the Department of Justice and Community Safety: Form 5 Regulation 103(1)(b) WARRANT TO ARREST AND RETURN AN UNLAWFULLY RELEASED PRISONER TO PRISON BY A MAGISTRATE UNDER SECTION 108A(3) OF THE CORRECTIONS ACT 1986 Prisoner name: Prisoner JAID/MNI: Prisoner CRN: Prisoner date of birth: Case number/s: **To the Chief Commissioner of Police and to all police officers in the State of Victoria:** The Secretary to the Department of Justice and Community Safety, under section 108A(3) of the **Corrections Act 1986**, has authorised the making of an application to a magistrate for a warrant authorising any police officer to break, enter and search any place where the prisoner named on this warrant is reasonably believed to be and to arrest the prisoner and return the prisoner to prison. This warrant authorises you to take and safely convey the prisoner named on this warrant to a prison and deliver the prisoner to the person in charge of that prison. **To all prison officers and escort officers:** The Secretary to the Department of Justice and Community Safety, under section 108A(3) of the **Corrections Act 1986**, has authorised the making of an application to a magistrate for a warrant authorising any prison officer or escort officer to arrest the prisoner and return the prisoner to prison. This warrant authorises you to take and safely convey the prisoner named on this warrant to a prison and deliver the prisoner to the person in charge of that prison. **To the person in charge of a prison into whose custody the prisoner named in this warrant is received:** This warrant directs and authorises you to receive the prisoner named in this warrant into custody and detain that prisoner for the period specified in the original court warrant identified by the case number above, or until that person is otherwise released from custody according to law. Dated: Magistrate Form 6 Regulation 105 NOTICE TO ATTEND A MEETING OF THE ADULT PAROLE BOARD TO: [*insert name of person to whom notice is directed*] OF: [*insert address*] The Adult Parole Board may, under section 71A of the **Corrections Act 1986**, serve written notice on a person for the purposes of obtaining evidence and informing itself in the performance of its functions. This is a written notice for the purposes of section 71A of the **Corrections Act 1986**. **What you must do** You must— □ attend a meeting of the Adult Parole Board to produce the document/s or other thing/s specified below; or □ attend a meeting of the Adult Parole Board to give evidence from day to day until excused; or □ attend a meeting of the Adult Parole Board to give evidence from day to day until excused and produce the document/s or other thing/s specified below. □ *Tick one of these options* **Where and when you must *attend and/or *produce documents and/or things** [*Insert details of where and when (including date and time) a person must attend, and/or insert details of where, when and how a person must produce the document/s and/or thing/s*] **Delete if inapplicable.* **What you must produce to the Adult Parole Board (if applicable)** [*Insert description of document/s or thing/s to be produced*] Note: You must bring this notice with you when you attend at the Adult Parole Board at the time and place specified in this notice. **Objecting to this notice** You may object to this notice under section 71B of the **Corrections** **Act 1986** if you have (or will have) a reasonable excuse for failing to comply with this notice. For example, it is a reasonable excuse to fail to provide a document or thing if the document or thing—  might tend to incriminate you or make you liable to a penalty; or  is the subject of parliamentary privilege; or  is the subject of legal professional privilege; or  is the subject of public interest immunity; or  is prohibited from disclosure by a court order; or  is prohibited from disclosure by a provision of another Act that specifically applies to the giving of information or the production of documents or other things to the Adult Parole Board. *You may also object to the notice by claiming that the document/s or thing/s specified in the notice are not relevant to the subject matter of the meeting of the Adult Parole Board. **Delete if not applicable* If you wish to object to this notice, you must do so in writing to [*insert name and contact details*] by [*insert date*]. Your written objection must outline your reasons for objecting and attach any relevant evidence or documents in support of your claim. If the Adult Parole Board is satisfied that your excuse for failure to comply is reasonable, the Adult Parole Board may vary or revoke this notice under section 71B of the **Corrections Act 1986**. **Failure or refusal to comply with this notice without reasonable excuse may constitute a criminal offence. The maximum penalty for this offence is 30 penalty units or imprisonment for 3 months. This penalty is set out in section 71H of the Corrections Act 1986.** Name: [*insert name of person issuing this notice*] Title: [*insert title of person issuing notice*] Date: [*insert date*] Form 7 Regulation 106 NOTICE TO PRODUCE DOCUMENTS AND/OR THINGS TO THE ADULT PAROLE BOARD TO: [*insert name of person to whom notice is directed*] OF: [*insert address*] The Adult Parole Board may, under section 71A of the **Corrections Act 1986**, serve written notice on a person for the purposes of obtaining evidence and informing itself in the performance of its functions. This is a written notice for the purposes of section 71A of the **Corrections Act 1986**. **What you must do** You must produce to the Adult Parole Board the document/s or other thing/s specified below. **Where and when you must produce documents and/or things** [*Insert details of where, when and how a person must produce the document/s and/or thing/s*] **What you must produce to the Adult Parole Board** [*Insert description of document/s and/or thing/s to be produced*] **Objecting to this notice** You may object to this notice under section 71B of the **Corrections** **Act 1986** if you have (or will have) a reasonable excuse for failing to comply with this notice. For example, it is a reasonable excuse to fail to produce a document or thing if the document or thing—  might tend to incriminate you or make you liable to a penalty; or  is the subject of parliamentary privilege; or  is the subject of legal professional privilege; or  is the subject of public interest immunity; or  is prohibited from disclosure by a court order; or  is prohibited from disclosure by a provision of another Act that specifically applies to the giving of information or the production of documents or other things to the Adult Parole Board. If you wish to object to this notice, you must do so in writing to [*insert name and contact details*] by [*insert date*]. Your written objection must outline your reasons for objecting and attach any relevant evidence or documents in support of your claim. If the Adult Parole Board is satisfied that your excuse for failure to comply is reasonable, the Adult Parole Board may vary or revoke this notice under section 71B of the **Corrections Act 1986**. **Failure or refusal to comply with this notice without reasonable excuse may constitute a criminal offence. The maximum penalty for this offence is 30 penalty units or imprisonment for 3 months. This penalty is set out in section 71H of the Corrections Act 1986.** Name: [*insert name of person issuing this notice*] Title: [*insert title of person issuing notice*] Date: [*insert date*] Form 8 Regulation 107 NOTICE TO ATTEND A MEETING OF THE ADULT PAROLE BOARD ISSUED TO PERSON IN CUSTODY TO: [*insert name and title of person in charge of the place where person is held in custody, e.g. the Governor of the prison or the officer in charge of the police gaol*] AT: [*insert name and address of place where person is held in custody*] In accordance with section 71F of the **Corrections Act 1986**, I direct that [*name of person held in custody*] who is detained at [*insert name of place where person is held in custody*]— □ be brought to a place equipped with facilities to enable the person to appear before the Adult Parole Board by audio visual link; or □ be brought before the Adult Parole Board. □ *Tick one of these options* LOCATION: [*insert specified place to which person held in custody is to be brought*] DATE: [*insert date on which person held in custody is to be brought to the specified place*] and from day to day until excused from further attendance. TIME: [*insert time when person held in custody is to be brought to the specified place*] for the purpose of [*insert purpose e.g. to produce documents or to give evidence in relation to a matter before the Adult Parole Board*] and the person is to be returned to the place from which they were removed or to a police gaol each day by the direction of the Adult Parole Board. Name: [*insert name of person giving direction*] Title: [*insert position of person giving direction*] Date: [*insert date the direction is made*] Form 9 Regulation 110(a) Parole Order TO *[Given names and surname]* [*Surname in BLOCK letters*] Now the Adult Parole Board orders that you be released on parole on □ a sexual offence/sexual offences. □ a serious violent offence/serious violent offences. □ *Tick whichever applies. *Delete if inapplicable* Within 2 clear working days you are required to report to the following Community Corrections Centre: **Terms and conditions of Parole Order** The terms and conditions of this Order apply to you for the period of your parole, except for any terms and conditions that must be completed in an intensive parole period. You are released on parole on the following mandatory terms and conditions of this Order: 2. You must report to the community corrections centre specified in this Order within 2 clear working days after this Order comes into force. 3. You must notify a community corrections officer of any change of address at least 2 clear working days before the change of address. 4. You must notify a community corrections officer of any change of employment within at least 2 clear working days of the change of employment. 6. You must report to, and receive visits from, a community corrections officer as and when directed by the community corrections officer. 7. You must be available for interview by a community corrections officer, the Regional Manager or the Adult Parole Board at the time and place as directed by the community corrections officer or the Regional Manager or the Adult Parole Board. 8. You must attend in person at a community corrections centre as directed in writing by a community corrections officer. 9. You must not leave Victoria without the written permission of the Regional Manager. 10. You must comply with any direction given by a community corrections officer or the Regional Manager or the Adult Parole Board that is necessary for a community corrections officer or the Regional Manager or the Adult Parole Board to give to ensure that you comply with this Order. (If applicable, insert term and condition) *****The following other terms and conditions also apply to you under this Order: 11. *You must not consume any alcohol. 12. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you are suitable for treatment for abuse of or dependency on alcohol or any drug of dependence or prohibited poison, or medical, psychological or psychiatric treatment, AND, if you are assessed as suitable, undergo or submit to that treatment. 13. *You must submit to testing for alcohol consumption or use of a drug of dependence or prohibited poison as directed by the Secretary to the Department of Justice and Community Safety. 14. *You must report to your supervising community corrections officer [*specify reporting frequency*] until [*specify end of reporting period*]. 15. *You must not enter, or be within [*specify vicinity*] of [*specify area*] unless otherwise approved in writing by the *Regional Manager*/ **Adult Parole Board. 16. *You must remain in [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 17. *You must remain at [*specify place*] between [**a.m.*] and [**p.m.*] each day unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 18. *You must not use or access the Internet. 19. *You must not contact, directly or indirectly, [*specify person or class of person or both*]. 20. *You must not enter in or be within [*specify vicinity*] of [*specify place*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 21. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you can satisfactorily participate in [*specify any suitable program or training that addresses factors specific or related to the prisoner's offending behaviour or any other suitable program or training for any purpose including for employment, educational, cultural or personal development purposes*] AND, if you are assessed as suitable, participate in that program or training. 22. *You must undertake unpaid community work as directed by a community corrections officer or the Regional Manager, unless you are employed or participating in [*program or training specified under term and condition 21*]. 23. *You must not reside any night at [*specify place of excluded residence*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 24. *You must reside each night at [*specify place of required residence*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 25. *You must not contact, directly or indirectly, [*specify person or class of person or both*] without being under the supervision of a person or persons approved in writing by the *Regional Manager/*Adult Parole Board. 26. 27. You must be electronically monitored in relation to [*specify term and condition*]. 28. You must complete [*specify term(s) and condition(s)*] within [*specify period*]. The Adult Parole Board may change the terms and conditions of this Order at any time. It is a condition of this Order that if the Adult Parole Board does change this Order and the changes are explained to you, you must sign (when asked to do so) a declaration acknowledging that the changes have been explained to you. You are still under a sentence of imprisonment. The Adult Parole Board may cancel the Parole Order at any time before the end of the parole period. If you are sentenced to imprisonment in respect of one or more offences committed during the parole period (whether or not in Victoria), the Adult Parole Board may cancel the Parole Order even though your parole period may have ended. You must not break any law. If you are charged with or convicted of an offence punishable by imprisonment, the Parole Order may be cancelled. If the Parole Order is cancelled, you will be returned to prison. Your period on parole may not count as time served and you may serve the remainder of the full sentence as originally imposed, unless the Adult Parole Board orders otherwise. You must comply with the terms and conditions of this Order. It is a criminal offence to breach a term and condition of a parole order that is prescribed by the Regulations and the offence is punishable by up to 3 months imprisonment or a fine of up to 30 penalty units or both. You may be arrested by police and detained in custody if you are suspected of committing this offence. Unless the Court orders otherwise, the sentence of imprisonment must be served cumulatively on the remainder of your sentence (if your parole is cancelled) or any prison sentence imposed for the offence for breaching a term and condition of your parole. Otherwise, if you comply with the terms and conditions of the Parole Order, your parole will expire on: You Must Comply With This Order. Sch. 2 Form 10 amended by S.R. No. 26/2023 reg. 5. Form 10 Regulation 110(b) PAROLE ORDER TO [*Given names*] [*Surname in BLOCK letters*] of [*Address*] Now the Adult Parole Board orders that you be released on parole on  a sexual offence/sexual offences.  a serious violent offence/serious violent offences.  *Tick whichever applies. *Delete if inapplicable* Within 2 clear working days you are required to report to the following community corrections centre: **Terms and conditions of parole order** The terms and conditions of this order apply to you for the period of your parole, except for any terms and conditions that must be completed in an intensive parole period. You are released on parole on the following mandatory terms and conditions of this order: 2. You must report to the community corrections centre specified in this order within 2 clear working days after this order comes into force. 3. You must notify a community corrections officer of any change of address at least 2 clear working days before the change of address. 4. You must notify a community corrections officer of any change of employment within at least 2 clear working days of the change of employment. 6. You must report to, and receive visits from, a community corrections officer as and when directed by the community corrections officer. 7. You must be available for interview by a community corrections officer, the Regional Manager or the Adult Parole Board at the time and place as directed by the community corrections officer, the Regional Manager or the Adult Parole Board. 8. You must attend in person at a community corrections centre as directed in writing by a community corrections officer. 9. You must not leave Victoria except with the written permission, granted either generally or in a particular case, of the *Regional Manager/*Adult Parole Board. 10. You must comply with any direction given by a community corrections officer, the Regional Manager or the Adult Parole Board that is necessary for a community corrections officer, the Regional Manager or the Adult Parole Board (as the case requires) to give to ensure that you comply with this order. *****The following other terms and conditions also apply to you under this order: 11. *You must not consume any alcohol, unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 12. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you are suitable for treatment for abuse of or dependency on alcohol or any drug of dependence or prohibited poison, or medical, psychological or psychiatric treatment, AND, if you are assessed as suitable, undergo or submit to that treatment. 13. *You must submit to testing for alcohol consumption or use of a drug of dependence or prohibited poison as directed by the Secretary to the Department of Justice and Community Safety. 14. *You must report to your supervising community corrections officer [*specify reporting frequency*] until [*specify end of reporting period*]. 15. *You must not enter, or be within [*specify vicinity*] of, [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 16. *You must remain in [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 17. *You must remain at [*specify place*] between [**a.m.*] and [**p.m.*] each day unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 18. *You must not use or access the Internet unless your use or access is for the purposes of [*specify purposes*] approved in writing by the *Regional Manager/*Adult Parole Board. 19. *You must not contact, directly or indirectly, [*specify person or class of person or both*], unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 20. *You must not enter, or be within [*specify vicinity*] of [*specify place*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 21. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you can satisfactorily participate in [*specify any suitable program or training that addresses factors specific or related to the prisoner's offending behaviour or any other suitable program or training for any purpose including for employment, educational, cultural or personal development purposes*] AND, if you are assessed as suitable, participate in that program or training. 22. *You must undertake unpaid community work as directed by a community corrections officer or the Regional Manager, unless you are employed or participating in [*program or training specified under term and condition 21*]. 23. *You must not reside at [*specify place of excluded residence and time of a day*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 24. *You must reside at [*specify place of required residence*], and must not temporarily reside at another address, unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 25. *You must not contact, directly or indirectly, [*specify person or class of person or both*] without being under the supervision of a person or persons approved in writing by the *Regional Manager/*Adult Parole Board. 26. *You must provide to the Adult Parole Board information pertaining to your financial affairs, if directed by the Adult Parole Board. 27. *You must submit to the auditing of data held in computers and any other devices in your possession or under your control, if directed by the Adult Parole Board. 28. 29. You must be electronically monitored in relation to [*specify term and condition*]. 30. You must complete [*specify term(s) and condition(s)*] within [*specify period*]. The Adult Parole Board may change the terms and conditions of this parole order at any time. It is a condition of this parole order that if the Adult Parole Board does change this parole order and the changes are explained to you, you must sign (when asked to do so) a declaration acknowledging that the changes have been explained to you. You are still under a sentence of imprisonment. The Adult Parole Board may cancel this parole order at any time before the end of the parole period. If you are sentenced to imprisonment in respect of one or more offences committed during the parole period (whether or not in Victoria), the Adult Parole Board may cancel this parole order even though your parole period may have ended. You must not break any law. If you are charged with or convicted of an offence punishable by imprisonment, this parole order may be cancelled. If this parole order is cancelled, you will be returned to prison. Your period on parole may not count as time served and you may serve the remainder of the full sentence as originally imposed, unless the Adult Parole Board orders otherwise. You must comply with the terms and conditions of this parole order. It is a criminal offence to breach a term or condition of a parole order that is prescribed by the Regulations without reasonable excuse and the offence is punishable by up to 3 months imprisonment or a fine of up to 30 penalty units or both. You may be arrested by police and detained in custody if you are suspected of committing this offence. Unless the Court orders otherwise, the sentence of imprisonment must be served cumulatively on the remainder of your sentence (if your parole is cancelled) or any prison sentence imposed for the offence for breaching a term and condition of your parole. Otherwise, if you comply with the terms and conditions of this parole order, your parole will expire on: You must comply with this order. Form 11 Regulation 117(2) DECLARATION BY PRISONER RELEASED UNDER A PAROLE ORDER I, [*name, in BLOCK letters, of prisoner released under a parole order*] declare that I have been given an explanation of the terms and conditions of my parole and I acknowledge that I must comply with this order. Signed Dated Form 12 Regulation 119(1)(a) Varied Parole Order TO *[Given names and surname]* [*Surname in BLOCK letters*] The Adult Parole Board ordered that you be released on parole on the day of 20 subject to terms and conditions. □ a sexual offence/ sexual offences. □ a serious violent offence/ serious violent offences. □ *Tick whichever applies. *Delete if inapplicable* Now the Adult Parole Board, on the day of 20 , varies the terms and conditions of the Order with effect from [*date*]. On and from that date the terms and conditions of your parole are as set out in this Order. **Terms and conditions of Parole Order** The terms and conditions of this Order apply to you on and from the [*insert date of variation by the Board*] for the period of your parole, except for any terms and conditions that must be completed in an intensive parole period. You are released on parole on the following mandatory terms and conditions of this Order: 2. You must report to the community corrections centre specified in this Order within 2 clear working days after this Order comes into force. 3. You must notify a community corrections officer of any change of address at least 2 clear working days before the change of address. 4. You must notify a community corrections officer of any change of employment within at least 2 clear working days of the change of employment. 6. You must report to, and receive visits from, a community corrections officer as and when directed by the community corrections officer. 7. You must be available for interview by a community corrections officer, the Regional Manager or the Adult Parole Board at the time and place as directed by the community corrections officer or the Regional Manager or the Adult Parole Board. 8. You must attend in person at a community corrections centre as directed in writing by a community corrections officer. 9. You must not leave Victoria without the written permission of the Regional Manager. 10. You must comply with any direction given by a community corrections officer or the Regional Manager or the Adult Parole Board that is necessary for a community corrections officer or the Regional Manager or the Adult Parole Board to give to ensure that you comply with this Order. (*If applicable, insert term and condition*) *****The following other terms and conditions also apply to you under this Order: 11. *You must not consume any alcohol. 12. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you are suitable for treatment for abuse of or dependency on alcohol or any drug of dependence or prohibited poison, or medical, psychological or psychiatric treatment, AND, if you are assessed as suitable, undergo or submit to that treatment. 13. *You must submit to testing for alcohol consumption or use of a drug of dependence or prohibited poison as directed by the Secretary to the Department of Justice and Community Safety. 14. *You must report to your supervising community corrections officer [*specify reporting frequency*] until [*specify end of reporting period*]. 15. *You must not enter in or be within [*specify vicinity*] of [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 16. *You must remain in [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 17. *You must remain at [*specify place*] between [**a.m.*] and [**p.m.*] each day unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 18. *You must not use or access the Internet. 19. *You must not contact, directly or indirectly, [*specify person or class of person or both*]. 20. *You must not enter in or be within [*specify vicinity*] of [*specify place*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 21. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you can satisfactorily participate in [*specify any suitable program or training that addresses factors specific or related to the prisoner's offending behaviour or any other suitable program or training for any purpose including for employment, educational, cultural or personal development purposes*] AND, if you are assessed as suitable, participate in that program or training. 22. *You must undertake unpaid community work as directed by a community corrections officer or the Regional Manager, unless you are employed or participating in [*program or training specified under term and condition 21*]. 23. *You must not reside any night at [*specify place of excluded residence*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 24. *You must reside each night at [*specify place of required residence*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 25. *You must not contact, directly or indirectly, [*specify person or class of person or both*] without being under the supervision of a person or persons approved in writing by the *Regional Manager/*Adult Parole Board. 26. 27. You must be electronically monitored in relation to [*specify term and condition*]. 28. You must complete [*specify term(s) and condition(s)*] within [*specify period*]. **Delete if inapplicable.* The Adult Parole Board may change the terms and conditions of this Order at any time. It is a condition of this Order that if the Adult Parole Board does change this Order and the changes are explained to you, you must sign (when asked to do so) a declaration acknowledging that the changes have been explained to you. You are still under a sentence of imprisonment. The Adult Parole Board may cancel the Parole Order at any time before the end of the parole period. If you are sentenced to imprisonment in respect of one or more offences committed during the parole period (whether or not in Victoria), the Adult Parole Board may cancel the Parole Order even though your parole period may have ended. You must not break any law. If you are charged with or convicted of an offence punishable by imprisonment, the Parole Order may be cancelled. If the Parole Order is cancelled, you will be returned to prison. Your period on parole may not count as time served and you may serve the remainder of the full sentence as originally imposed, unless the Adult Parole Board orders otherwise. You must comply with the terms and conditions of this Order. It is a criminal offence to breach a term and condition of a Parole Order that is prescribed by the Regulations and the offence is punishable by up to 3 months imprisonment or a fine of up to 30 penalty units or both. You may be arrested by police and detained in custody if you are suspected of committing this offence. Unless the Court orders otherwise, the sentence of imprisonment must be served cumulatively on the remainder of your sentence (if your parole is cancelled) or any prison sentence imposed for the offence for breaching a term and condition of your parole. Otherwise, if you comply with the terms and conditions of the Parole Order, your parole will expire on: You Must Comply With This Order. Sch. 2 Form 13 amended by S.R. No. 26/2023 reg. 6. Form 13 Regulation 119(1)(b) VARIED PAROLE ORDER TO *[Given names]* [*Surname in BLOCK letters*] The Adult Parole Board ordered that you be released on parole on  a sexual offence/sexual offences.  a serious violent offence/serious violent offences.  *Tick whichever applies. *Delete if inapplicable* Now the Adult Parole Board, on the day of 20 , varies the terms and conditions of the order with effect from [date]. On and from that date the terms and conditions of your parole are set out in this order. **Terms and conditions of parole order** The terms and conditions of this order apply to you from the [*insert date of variation by the Board*] for the period of your parole, except for any terms and conditions that must be completed in an intensive parole period. You are released on parole on the following mandatory terms and conditions of this order: 2. You must report to the community corrections centre specified in this order within 2 clear working days after this order comes into force. 3. You must notify a community corrections officer of any change of address at least 2 clear working days before the change of address. 4. You must notify a community corrections officer of any change of employment within at least 2 clear working days of the change of employment. 6. You must report to, and receive visits from, a community corrections officer as and when directed by the community corrections officer. 7. You must be available for interview by a community corrections officer, the Regional Manager or the Adult Parole Board at the time and place as directed by the community corrections officer, the Regional Manager or the Adult Parole Board. 8. You must attend in person at a community corrections centre as directed in writing by a community corrections officer. 9. You must not leave Victoria except with the written permission, granted either generally or in a particular case, of the *Regional Manager/*Adult Parole Board. 10. You must comply with any direction given by a community corrections officer, the Regional Manager or the Adult Parole Board that is necessary for a community corrections officer, the Regional Manager or the Adult Parole Board (as the case requires) to give to ensure that you comply with this order. *****The following other terms and conditions also apply to you under this order: 11. *You must not consume any alcohol, unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 12. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you are suitable for treatment for abuse of or dependency on alcohol or any drug of dependence or prohibited poison, or medical, psychological or psychiatric treatment, AND, if you are assessed as suitable, undergo or submit to that treatment. 13. *You must submit to testing for alcohol consumption or use of a drug of dependence or prohibited poison as directed by the Secretary to the Department of Justice and Community Safety. 14. *You must report to your supervising community corrections officer [*specify reporting frequency*] until [*specify end of reporting period*]. 15. *You must not enter, or be within [*specify vicinity*] of, [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 16. *You must remain in [*specify area*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 17. *You must remain at [specify place] between [**a.m.*] and [**p.m.*] each day unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 18. *You must not use or access the Internet unless your use or access is for the purposes of [*specify purposes*] approved in writing by the *Regional Manager/*Adult Parole Board. 19. *You must not contact, directly or indirectly, [*specify person or class of person or both*], unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 20. *You must not enter, or be within [*specify vicinity*] of [*specify place*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 21. *You must undergo assessment, as directed by a community corrections officer or the Regional Manager, to determine whether you can satisfactorily participate in [*specify any suitable program or training that addresses factors specific or related to the prisoner's offending behaviour or any other suitable program or training for any purpose including for employment, educational, cultural or personal development purposes*] AND, if you are assessed as suitable, participate in that program or training. 22. *You must undertake unpaid community work as directed by a community corrections officer or the Regional Manager, unless you are employed or participating in [*program or training specified under term and condition 21*]. 23. *You must not reside at [*specify place of excluded residence and time of a day*] unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 24. *You must reside at [*specify place of required residence*], and must not temporarily reside at another address, unless otherwise approved in writing by the *Regional Manager/*Adult Parole Board. 25. *You must not contact, directly or indirectly, [*specify person or class of person or both*] without being under the supervision of a person or persons approved in writing by the *Regional Manager/*Adult Parole Board. 26. *You must provide to the Adult Parole Board information pertaining to your financial affairs, if directed by the Adult Parole Board. 27. *You must submit to the auditing of data held in computers and any other devices in your possession or under your control, if directed by the Adult Parole Board. 28. 29. You must be electronically monitored in relation to [*specify term and condition*]. 30. You must complete [*specify term(s) and condition(s)*] within [*specify period*]. The Adult Parole Board may change the terms and conditions of this parole order at any time. It is a condition of this parole order that if the Adult Parole Board does change this parole order and the changes are explained to you, you must sign (when asked to do so) a declaration acknowledging that the changes have been explained to you. You are still under a sentence of imprisonment. The Adult Parole Board may cancel this parole order at any time before the end of the parole period. If you are sentenced to imprisonment in respect of one or more offences committed during the parole period (whether or not in Victoria), the Adult Parole Board may cancel this parole order even though your parole period may have ended. You must not break any law. If you are charged with or convicted of an offence punishable by imprisonment, this parole order may be cancelled. If this parole order is cancelled, you will be returned to prison. Your period on parole may not count as time served and you may serve the remainder of the full sentence as originally imposed, unless the Adult Parole Board orders otherwise. You must comply with the terms and conditions of this parole order. It is a criminal offence to breach a term or condition of a parole order that is prescribed by the Regulations without reasonable excuse and the offence is punishable by up to 3 months imprisonment or a fine of up to 30 penalty units or both. You may be arrested by police and detained in custody if you are suspected of committing this offence. Unless the Court orders otherwise, the sentence of imprisonment must be served cumulatively on the remainder of your sentence (if your parole is cancelled) or any prison sentence imposed for the offence for breaching a term and condition of your parole. Otherwise, if you comply with the terms and conditions of this parole order, your parole will expire on: You must comply with this order. Form 14 Regulation 119(2)(a) NOTICE OF VARIATION OF PAROLE ORDER TO On [*Date of Order*] you were granted release on a parole order by the Adult Parole Board subject to certain terms and conditions. On [*Date of varied Order*] the Adult Parole Board varied the terms and conditions of the order, with effect from [*date*]. A copy of the varied order is attached to this notice. TAKE NOTICE that the order has been varied as above. Form 15 Regulation 119(4)(c) and (5)(b) DECLARATION OF RECEIVING A VARIED PAROLE ORDER I, [*name, in BLOCK letters, of prisoner whose parole order is varied*] declare that I have been given a copy of the varied parole order, and an explanation of the variation to the terms and conditions of my parole order and I acknowledge that I must comply with the order. Signed Dated Form 16 Regulation 120 REVOCATION OF A PAROLE ORDER was convicted and sentenced to a term of imprisonment with a non-parole period for [*insert offence(s), name of Court, and date of sentence*] and by the order of the Adult Parole Board dated [*insert date*] was to be released on parole on [*insert date*]. Now the Adult Parole Board, by further order, revokes the parole order pursuant to section 74(2) of the **Corrections Act 1986**. [*Insert reasons for decision.*]* Form 17 Regulation 121(1) CANCELLATION OF A PAROLE ORDER was convicted and sentenced to a term of imprisonment with a non-parole period for [*insert offence(s), name of Court, and date of sentence*] and by the order of the Adult Parole Board dated [*insert date*] was released on a parole order. Now the Adult Parole Board cancels the parole order, pursuant to section 77 of the **Corrections Act 1986**.* [*Insert reasons for decision.*]* Now the parole order is taken to have been cancelled, pursuant to section 77(6) of the **Corrections Act 1986**.* By a warrant separately issued under the **Corrections Act 1986**, you will be returned to prison. Your period on parole may not count as time served and you may serve the remainder of the full sentence as originally imposed, unless the Adult Parole Board orders otherwise. Sch. 2 Form 18 substituted by S.R. No. 118/2025 reg. 8. FORM 18 Regulation 122 REVOCATION OF CANCELLATION OF A PAROLE ORDER was convicted and sentenced to a term of imprisonment with a non-parole period for [*insert offence(s), name of Court and date of sentence*]. • By the order of the Adult Parole Board dated [*insert date*] your parole order was cancelled on [*insert date*].*  Your parole was taken to have been cancelled under section 77(6) of the **Corrections Act 1986** on [*insert date*] because you were convicted of relevant offences under that section.*  Your parole was taken to have been cancelled under section 77(7A) of the **Corrections Act 1986** on [*insert date*] because you were sentenced to another term of imprisonment.* Now the Adult Parole Board, by order, revokes the cancellation of the parole order, pursuant to section 77A of the **Corrections Act 1986**. Your parole order is revived by this order. You remain on parole. [*Insert reasons for the decision to revoke the cancellation of the parole order*] [*If the parole order was taken to be cancelled under section 77(6) of the* ***Corrections Act 1986*** *but the Adult Parole Board revokes that cancellation under section 77A(2) of that Act, insert a statement noting that the Board is satisfied that exceptional circumstances exist*] Form 19 Regulation 123(1) Warrant to arrest and return to prison To the Chief Commissioner of Police and to all police officers 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. was convicted of and by the order of the Adult Parole Board dated was released on parole on [*insert date*]. The Adult Parole Board cancelled that parole order on [*insert date*]. This warrant authorises any police officer to break, enter and search any place where the person whose parole was cancelled is reasonably believed to be and arrest the person 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. Form 20 Regulation 127(1)(a) ORDER TO DETAIN PERSON UNDER SECTION 78C(1)(a) OF THE CORRECTIONS ACT 1986 TO the Chief Commissioner of Police and to all police officers 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. The Adult Parole Board under section 78C(1)(a) of the **Corrections Act 1986** orders that [*insert name of prisoner*] **be detained** in a prison or a police gaol pending consideration by the Adult Parole Board of the breach of the term or condition of the prisoner's parole order. This order authorises any police officers to detain the person named in this order until released according to law. TAKE NOTICE that the order has been made as above. Form 21 Regulation 127(1)(b) ORDER UNDER SECTION 78C(1)(b) OF THE CORRECTIONS ACT 1986 TO CEASE DETENTION TO the Chief Commissioner of Police and to all police officers 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. The Adult Parole Board, under section 78C(1)(b) of the **Corrections Act 1986**, orders that [*insert name of prisoner*] **cease to be detained** in custody. TAKE NOTICE that the order has been made as above. Dated this day of 20 Form 22 Regulation 127(3) NOTICE OF DECISION NOT TO CANCEL PAROLE To the Chief Commissioner of Police and to all police officers 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. On [*date*] the Adult Parole Board under section 78C(1)(a) of the **Corrections Act 1986** ordered that [*insert name of prisoner*] be detained in a prison or a police gaol pending consideration by the Adult Parole Board of the breach of the term or condition of the prisoner's parole order. On [*date*] the Adult Parole Board considered the breach of the term or condition in respect of the prisoner in accordance with Division 5 of Part 8 of the **Corrections Act 1986** and the Adult Parole Board has decided not to cancel the prisoner's parole. The prisoner's detention in a prison or a police gaol under section 78C(1)(a) of the **Corrections Act 1986** has ended. TAKE NOTICE that the decision has been made as above. Dated this day of 20 Sch. 2 Form 22A inserted by S.R. No. 46/2019 reg. 10. Form 22A Regulation 133G Undertaking of Confidentiality I, [*name of nominee*] of [*address*] have been nominated by [*insert name of applicant*], subsequently referred to as "**the applicant**", to be given, on behalf of the applicant, information under section 30A of the **Corrections Act 1986** relating to [*insert name of prisoner or name of offender who is or was subject to a supervision order, a detention order or an emergency detention order or is or was subject to an application for such an order*]. I consent to the nomination and undertake that— (a) I will not disclose the information disclosed to me under section 30A of the **Corrections Act 1986** other than in accordance with the **Corrections Act 1986**; and (b) I will treat the information disclosed to me under section 30A of the **Corrections Act 1986** in an appropriate manner that respects the confidential nature of the information. In giving this undertaking I acknowledge that— (a) if the applicant is included on the victims register, my obligations of confidentiality under the **Corrections Act 1986** and this undertaking remain even if my nomination ceases or the applicant is removed from the victims register; and (b) I *have read/*have had explained to me the content of sections 30H and 30I of the **Corrections Act 1986**. [*Signature of nominee*] [*Signature of witness*] of [*name and address*] Form 23 Regulation 135 Notification to the Secretary of legal proceedings against a prisoner in respect of a criminal act by the prisoner Ref. No. **DETAILS OF PERSON COMMENCING THE LEGAL PROCEEDINGS** Surname: Given names: Address: Postcode: **DETAILS OF THE LEGAL PROCEEDINGS** Name of prisoner against whom proceedings have been commenced: Parties to the proceedings: Court in which proceedings commenced: Date proceedings commenced: Court Reference Number: Form 24 Regulation 136 Notification to the Secretary of the final determination of legal proceedings against a prisoner in respect of a criminal act by the prisoner Ref. No. **DETAILS OF PERSON WHO COMMENCED THE LEGAL PROCEEDINGS** Surname: Given names: Address: Postcode: **DETAILS OF THE FINAL DETERMINATION OF THE LEGAL PROCEEDINGS** Name of prisoner against whom proceedings have been commenced: Parties to the proceedings: Court in which proceedings commenced: Court Reference Number: Date proceedings finalised: Final determination of proceedings: Amount awarded to the victim in those proceedings: ═════════════ Endnotes 1 General information See [www.legislation.vic.gov.au](http://www.legislation.vic.gov.au) for Victorian Bills, Acts and current Versions of legislation and up-to-date legislative information. The Corrections Regulations 2019, S.R. No. 27/2019 were made on 16 April 2019 by the Lieutenant-Governor as the Governor's deputy, with the advice of the Executive Council, under sections 112 and 112A of the **Corrections Act 1986**, No. 117/1986 and came into operation on 28 April 2019: regulation 3. The Corrections Regulations 2019 will sunset 10 years after the day of making on 16 April 2029 (see section 5 of the **Subordinate Legislation Act 1994**). INTERPRETATION OF LEGISLATION ACT 1984 (ILA) Style changes Section 54A of the ILA authorises the making of the style changes set out in Schedule 1 to that Act. References to ILA s. 39B Sidenotes which cite ILA s. 39B refer to section 39B of the ILA which provides that where an undivided regulation, rule or clause of a Schedule is amended by the insertion of one or more subregulations, subrules or subclauses the original regulation, rule or clause becomes subregulation, subrule or subclause (1) and is amended by the insertion of the expression "(1)" at the beginning of the original regulation, rule or clause. Interpretation As from 1 January 2001, amendments to section 36 of the ILA have the following effects: • Headings All headings included in a Statutory Rule which is made on or after 1 January 2001 form part of that Statutory Rule. Any heading inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, forms part of that Statutory Rule. This includes headings to Parts, Divisions or Subdivisions in a Schedule; Orders; Parts into which an Order is divided; clauses; regulations; rules; items; tables; columns; examples; diagrams; notes or forms. See section 36(1A)(2A)(2B). • Examples, diagrams or notes All examples, diagrams or notes included in a Statutory Rule which is made on or after 1 January 2001 form part of that Statutory Rule. Any examples, diagrams or notes inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, form part of that Statutory Rule. See section 36(3A). • Punctuation All punctuation included in a Statutory Rule which is made on or after 1 January 2001 forms part of that Statutory Rule. Any punctuation inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, forms part of that Statutory Rule. See section 36(3B). • Provision numbers All provision numbers included in a Statutory Rule form part of that Statutory Rule, whether inserted in the Statutory Rule before, on or after 1 January 2001. Provision numbers include regulation numbers, rule numbers, subregulation numbers, subrule numbers, paragraphs and subparagraphs. See section 36(3C). • Location of "legislative items" A "legislative item" is a penalty, an example or a note. As from 13 October 2004, a legislative item relating to a provision of a Statutory Rule is taken to be at the foot of that provision even if it is preceded or followed by another legislative item that relates to that provision. For example, if a penalty at the foot of a provision is followed by a note, both of these legislative items will be regarded as being at the foot of that provision. See section 36B. • Other material Any explanatory memorandum, table of provisions, endnotes, index and other material printed after the Endnotes does not form part of a Statutory Rule. See section 36(3)(3D)(3E). 2 Table of Amendments This publication incorporates amendments made to the Corrections Regulations 2019 by statutory rules, subordinate instruments and Acts. Corrections Amendment Regulations 2019, S.R. No. 46/2019 | *Date of Making:* | 12.6.19 | | *Date of Commencement:* | 12.6.19 | Corrections Amendment (Parole) Regulations 2023, S.R. No. 26/2023 | *Date of Making:* | 26.4.23 | | *Date of Commencement:* | 1.7.23: reg. 3 | Corrections Amendment Regulations 2025, S.R. No. 118/2025 | *Date of Making:* | 18.11.25 | | *Date of Commencement:* | 18.11.25: reg. 3 | 3 Explanatory details 1. Reg. 108: S.R. No. 170/2018. —— **Penalty Units** These Regulations provide for penalties by reference to penalty units within the meaning of section 110 of the **Sentencing Act 1991**. The amount of the penalty is to be calculated, in accordance with section 7 of the **Monetary Units Act 2004**, by multiplying the number of penalty units applicable by the value of a penalty unit. The value of a penalty unit for the financial year commencing 1 July 2025 is $203.51. The amount of the calculated penalty may be rounded to the nearest dollar. The value of a penalty unit for future financial years is to be fixed by the Treasurer under section 5 of the **Monetary Units Act 2004**. The value of a penalty unit for a financial year must be published in the Government Gazette and a Victorian newspaper before 1 June in the preceding financial year. [↑](#endnote-ref-1)