Form No. 1
Application for Ministerial Review - Miscarriages of Justice
SECTION A - PERSONAL INFORMATION
Name
Alias or Former Name
Address
Date of Birth
RCMP Automated Fingerprint Indentication System No. (if any)
Type of Conviction (Summary or Indictable or Finding of Dangerous Offender or Long-Term Offender
Person Making Application on Applicant's Behalf (if any)
Telephone Number
Repesentative's Address
SECTION B - SUPPORTING INFORMATION
PRE-TRIAL HEARING
Date of Preliminary Inquiry
Court and Its Address
Date of Other Pre-Trial Motions (eg. Bail Hearing, Charter Application, etc.)
Particulars Relating to Motion
TRIAL
Date of Trial
Court and Its Address
Plea:
Names and Addresses of Counsel
Mode of Trial
Date of Conviction
Date of Sentence
Particulars Relating to Motion
COURT OF APPEAL
Date of Appeal Filed
Date of Hearing
Date of Decision
Address of Court
SUPREME COURT OF CANADA
Date of Appeal Filed
Date of Hearing
Date of Decision
Grounds for Application
Add another page if needed

Description of the New Matters of Significance that Support this Application
Add another page if needed

SECTION C - REQUIRED DOCUMENTS (Mandatory)

PRE-TRIAL
(if unable to provide any of the following, please explain why)
Explanation
TRIAL
Explanation
APPEALS
Explanation
SECTION D - OTHER SUPPORTING EVIDENCE (OPTIONAL)
(Affidavits, letters, photographs, plans, drawings, technical and scientific reports, etc.)
- Date Modified: