Form 4—Notice of receipt of request for Form 4—Notice of receipt of request for provisional arrest

Form 4—Notice of receipt of request for provisional arrest

Commonwealth of Australia

International Criminal Court Act 2002

Notice under subsection 21(1) of receipt of request for provisional arrest by the International Criminal Court

To a magistrate:

I, , Attorney‑General of the Commonwealth of Australia, under subsection 21(1) of the International Criminal Court Act 2002 (the Act), state that I have:

(a) received a request for the provisional arrest of [insert name of person] from the International Criminal Court; and

(b) signed a certificate under section 22 of the Act that it is appropriate for me to issue this notice.

Division 2 of Part 3 of the Act has been complied with in respect of the request.

Dated

Attorney‑General