Form 6—Application for provisional arresForm 6—Application for provisional arrest warrant

Form 6—Application for provisional arrest warrant

Commonwealth of Australia

International Criminal Court Act 2002

Application under subsection 21(2) for provisional arrest warrant

To a magistrate:

I, [insert name of applicant and the capacity in which application is made], apply under subsection 21(2) of the International Criminal Court Act 2002 (the Act) on behalf of the International Criminal Court for issue of a warrant, according to a notice under subsection 21(1) of the Act, for the provisional arrest of [insert name of person].

Dated

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[Signature of the applicant and the capacity in which application is made]