Extradition Regulations 1988

(subsection 12(1) regulation 3)

Commonwealth of Australia

Extradition Act 1988

To a magistrate or eligible Judge within the meaning of the Extradition Act 1988 (the Act).

I, , of , apply under subsection 12(1) of the Act on behalf of (insert name of country), an extradition country, for the issue of a warrant under that subsection for the arrest of (insert name of person).

The affidavit attached to this application and marked ...……………….... sets out information that (insert name of person) is an extraditable person for the purposes of the Act in relation to that extradition country.

Dated (Signature and designation of applicant)