Extradition Regulations 1988

(insert name of person) is on remand under section 15 of the Extradition Act 1988;

I am satisfied that † has voluntarily informed a magistrate or eligible Judge under subsection 15A(3) of that Act that *he/*she/ wishes to waive extradition in relation to the following extradition *offence/*offences/:

I have informed † of the following in accordance with paragraph 15A(5)(b) of that Act:

once the order below is made, *he/*she/ cannot apply for the order to be revoked;

the consequences of the fact that the extradition country concerned may not have given, and if the order is made will not be required to give, a speciality assurance;

certain requirements in that Act that would otherwise apply in respect of the person will not apply if the order is made (including, but not limited to, requirements relating to extradition objections);

after the order is made, *he/*she/ will be surrendered to the extradition country if the Attorney‑General determines under subsection 15B(2) of that Act that *he/*she/ is to be surrendered;

I am satisfied in accordance with paragraph 15A(5)(c) of that Act that † has confirmed that *he/*she/ wishes to waive extradition;

I am satisfied that *he/*she/ is legally represented or was given adequate opportunity to be legally represented;