Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698844526787.pdf (New Zealand)
Version as at 16 August 2022 Sentencing Regulations 2002 (SR 2002/178) Silvia Cartwright, Governor-General Order in Council At Wellington this 13th day of June 2002 Present: The Right Hon Helen Clark presiding in Council Pursuant to section 147 of the Sentencing Act 2002, Her Excellency the Governor- General, acting on the advice and with the consent of the Executive Council, makes the following regulations.
Contents Title Commencement Interpretation Changes to ownership of confiscated motor vehicles [Revoked] Registrar of court to check personal property securities register Information relating to making of protection order under section 123B of Act to be sent to Family Court Prescribed forms Page 2 2 2 2 2 3 3 1 2 3 4 4A 4B 5 Note The Parliamentary Counsel Office has made editorial and format changes to this version using the powers under subpart 2 of Part 3 of the Legislation Act 2019.
Note 4 at the end of this version provides a list of the amendments included in it.

These regulations are administered by the Ministry of Justice and the Department of Corrections.

1 r 1 Sentencing Regulations 2002 Schedule Forms Regulations Version as at 16 August 2022 5 1 2 3 Title These regulations are the Sentencing Regulations 2002.

Commencement These regulations come into force on 30 June 2002.
Interpretation In these regulations, unless the context otherwise requires, Act means the Sen‐ tencing Act 2002.

Regulation 3: replaced, on 1 August 2012, by regulation 4 of the Sentencing Amendment Regulations 2012 (SR 2012/132).

4 Changes to ownership of confiscated motor vehicles [Revoked] Regulation 4: revoked, on 1 August 2012, by regulation 5 of the Sentencing Amendment Regulations 2012 (SR 2012/132).
4A Registrar of court to check personal property securities register (1) This regulation applies if a motor vehicle is confiscated under section 128, 129, or 129A of the Act and— (a) (b) surrendered in accordance with section 132 of the Act; or seized under a warrant issued under section 132 of the Act.
The Registrar of the court must, on the day after the vehicle is surrendered or seized, take all lawful and reasonable steps to check whether a financing state‐ ment has been registered in respect of the vehicle on the personal property securities register kept under the Personal Property Securities Act 1999.
If a financing statement is found to be registered, the Registrar must immedi‐ ately notify the person entered in the register as the secured party (including any lessor) of the following matters: (a) that the Registrar may— (i) (ii) sell the motor vehicle under section 137 of the Act; or dispose of the motor vehicle under section 138 of the Act: (b) (c) if the vehicle is confiscated under section 128 or 129 of the Act, the effect of sections 137 and 139 to 142 of the Act: if the vehicle is confiscated under section 129A of the Act, the effect of sections 137, 137A, 139, and 142 of the Act.
(2) (3) 2 Version as at 16 August 2022 Sentencing Regulations 2002 r 5 Regulation 4A: inserted, on 1 December 2009, by regulation 5 of the Sentencing Amendment Regu‐ lations 2009 (SR 2009/360).

Regulation 4A heading: replaced, on 1 August 2012, by regulation 6(1) of the Sentencing Amend‐ ment Regulations 2012 (SR 2012/132).

Regulation 4A(2): replaced, on 1 August 2012, by regulation 6(2) of the Sentencing Amendment Regulations 2012 (SR 2012/132).
Regulation 4A(3): amended, on 1 August 2012, by regulation 6(3)(a) of the Sentencing Amendment Regulations 2012 (SR 2012/132).

Regulation 4A(3): amended, on 1 August 2012, by regulation 6(3)(b) of the Sentencing Amendment Regulations 2012 (SR 2012/132).

4B (1) Information relating to making of protection order under section 123B of Act to be sent to Family Court This regulation applies if a protection order is made under section 123B(2) of the Act.
(2) As soon as possible after complying with section 123F(1) of the Act, the court must send to the Registrar of the Family Court,— (a) (b) (c) if the offender has been served with a copy of the order, proof of service; and if the court has made a direction under section 188 of the Family Vio‐ lence Act 2018, a copy of that direction; and if requested by the Registrar of the Family Court, copies of any other specified information relating to the making of the protection order.
Regulation 4B: inserted, on 1 July 2010, by regulation 5 of the Sentencing Amendment Regulations 2010 (SR 2010/123).

Regulation 4B(2)(b): replaced, on 1 July 2019, by regulation 4 of the Sentencing (Family Violence) Amendment Regulations 2019 (LI 2019/98).

5 Prescribed forms (1) A reference in these regulations to a numbered form is a reference to that form as set out in the Schedule.
(2) (3) Forms 1 to 9, 11, 11AA, 11A, 11B, 12, and 12F, or forms to the same effect, may be used in respect of the matters under the Act to which those forms relate.

Forms 10, 12A, 12AB, and 13 to 27, or forms to the same effect, must be used in respect of the matters under the Act to which those forms relate.
(4) A form specified in subclause (2) or (3) is used in accordance with that sub‐ clause even if the form is used with either or both of the following, so long as the form is not misleading: (a) additional information included because it is required for identification or other official purposes: (b) any variations that the circumstances may require.
3 r 5 Sentencing Regulations 2002 Version as at 16 August 2022 Regulation 5: substituted, on 1 December 2009, by regulation 4 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

Regulation 5(2): substituted, on 1 July 2010, by regulation 4 of the Sentencing Amendment Regula‐ tions 2010 (SR 2010/123).

Regulation 5(2): amended, on 16 August 2022, by section 33 of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
Regulation 5(2): amended, on 26 August 2010, by regulation 4 of the Sentencing Amendment Regu‐ lations (No 2) 2010 (SR 2010/207).

Regulation 5(3): substituted, on 1 July 2010, by regulation 4 of the Sentencing Amendment Regula‐ tions 2010 (SR 2010/123).

Regulation 5(3): amended, on 1 August 2012, by regulation 7 of the Sentencing Amendment Regula‐ tions 2012 (SR 2012/132).
4 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Schedule Forms Schedule: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).
r 5 Order for sentence of supervision Order for sentence of intensive supervision Order for sentence of community work Order for sentence of community detention Warrant to arrest offender Order for sentence of home detention Order for minimum period of imprisonment within determinate sentence or sentence of imprisonment for life Order for minimum period of imprisonment within sentence of preventive detention Warrant of commitment for sentence of imprisonment Summons to offender subject to an order to come up for sentence if called on Warrant to arrest offender subject to an order to come up for sentence if called on 11AA Protection order 11A 11B 12 12A Warning notice to party to security agreement or lease Written caution Warrant for confiscation of motor vehicle Warrant for recovery of motor vehicle 12AB Warrant for recovery of motor vehicle from secured party 12B 12C 12D 12E 12F 13 14 Notice of consequences of first warning [Revoked] Notice of consequences of final warning [Revoked] Notice of cancellation of warning [Revoked] Notice of substituted warning [Revoked] Order that offender serve full term of imprisonment General heading for proceedings that relate to instrument forfeiture orders Prosecutor’s notice that court should consider making instrument forfeiture order Page 7 10 13 16 19 20 25 27 28 30 31 32 37 39 42 44 46 47 48 49 50 51 52 53 5 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Notice of court’s decision and directions in response to prosecutor’s
 notice Notice to interested persons that court to consider making instrument forfeiture order Order to enter on register notice of possible instrument forfeiture order Order to cancel entry on register noting possible instrument forfeiture order Direction to provide further information to court Order requiring offender or other person to complete declaration of ownership Declaration of ownership Instrument forfeiture order Warrant authorising officer of court to search for and seize document(s) to effect transfer of property Application for relief from instrument forfeiture order List of persons served with notice of application for relief from instrument forfeiture order Order for relief from instrument forfeiture order Notice of application for leave to apply out of time for relief from instrument forfeiture order 54 56 57 58 59 60 61 63 65 67 70 71 74 26 27 6 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 1 Order for sentence of supervision Section 45, Sentencing Act 2002 Case No: To [full name] of [address], [occupation] At a sitting of the [court and place] this [date] you were sentenced to supervision for a period of [specify period] for [offence].
*The start date of the sentence is the date of this order.

*The start date of the sentence is the date you finish serving your current sentence of [sentence type] (including any post-detention conditions), because your sentence of supervision has been deferred under section 20A(2)(b) of the Sentencing Act 2002.

*Delete whichever is inapplicable.


You must report to a probation officer in the probation area in which you reside as soon as practicable, and not later than 72 hours, after the start date of your sentence of supervision.

The standard conditions for supervision are set out in section 49 of the Sentencing Act 2002 (a list of which is attached to this form).
*In addition to the standard conditions for supervision, the court imposed the follow‐ ing special conditions under sections 50 and 52 of the Sentencing Act 2002: [specify special conditions].

*Delete if inapplicable.

Consequences of non-compliance Failure to comply with the terms of this sentence, without reasonable excuse, may result in you being charged under section 70 of the Sentencing Act 2002 with an offence punishable by a maximum of 3 months’ imprisonment or a fine not exceeding $1,000.
Variation or cancellation of sentence You, or your probation officer, may apply under section 54 of the Sentencing Act 2002 for variation or cancellation of this sentence if you are unable to comply with its terms, or if one of the other grounds for variation or cancellation in that section applies.

Dated at the [specify] Court at [place] on [date].
................................................. (Deputy) Registrar 7 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Standard conditions of sentence of supervision Section 49 of the Sentencing Act 2002 provides that the following conditions apply to every sentence of supervision: (a) (b) (c) (d) (e) (f) (fa) (g) (h) (i) the offender must report in person to a probation officer in the probation area in which the offender resides as soon as practicable, and not later than 72 hours, after the start date of the sentence: the offender must report to the probation officer as and when required to do so by the probation officer, and must notify the officer of his or her residential address and the nature and place of his or her employment when requested to do so: the offender must not move to a new residential address in another probation area without the prior written consent of a probation officer: if consent is given under paragraph (c), the offender must report in person to a probation officer in the new probation area in which the offender is to reside as soon as practicable, and not later than 72 hours, after the offender’s arrival in the new area: if the offender intends to change his or her residential address within a proba‐ tion area, the offender must give a probation officer reasonable notice before moving from his or her residential address (unless notification is impossible in the circumstances) and must advise the probation officer of the new address: the offender must not reside at
 any address at which a probation officer has directed the offender not to reside: the offender must, if a probation officer directs, allow the collection of biomet‐ ric information: the offender must not engage, or continue to engage, in any employment or occupation in which a probation officer has directed the offender not to engage or continue to engage: the offender must not associate with any specified person, or with persons of any specified class, with whom a probation officer has, in writing, directed the offender not to associate: the offender must take part in a rehabilitative and reintegrative needs assess‐ ment if and when directed to do so by a probation officer.
The conditions in paragraphs (c) to (f) do not apply to the extent that they are incon‐ sistent with— any special condition imposed by the court; or in the case of an offender who is also subject to a sentence of community detention, any condition of that sentence.

Schedule form 1: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).
Schedule form 1: amended, on 22 August 2017, by section 66 of the Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42).

• • 8 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Schedule form 1: amended, on 22 January 2014, by regulation 4 of the Sentencing Amendment Regulations 2013 (SR 2013/491).
9 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 2 Order for sentence of intensive supervision Section 54B, Sentencing Act 2002 Case No: To [full name] of [address], [occupation] At a sitting of the [court and place] this [date] you were sentenced to intensive super‐ vision for a period of [specify period] for [offence].

*The start date of the sentence is the date of this order.
*The start date of the sentence is the date you finish serving your current sentence of [sentence type] (including any post-detention conditions), because your sentence of intensive supervision has been deferred under section 20A(2)(b) of the Sentencing Act 2002.

*Delete whichever is inapplicable.

You must report to a probation officer in the probation area in which you reside as soon as practicable, and not later than 72 hours, after the start date of your sentence of intensive supervision.
The standard conditions for intensive supervision are set out under section 54F of the Sentencing Act 2002 (a list of which is attached to this form).

*In addition to the standard conditions for intensive supervision, the Court imposed the following special conditions under sections 54G and 54I of the Sentencing Act 2002: [specify special conditions].

*Delete if inapplicable.


Consequences of non-compliance Failure to comply with the terms of this sentence, without reasonable excuse, may result in you being charged under section 70A of the Sentencing Act 2002 with an offence punishable by a maximum of 6 months’ imprisonment or a fine not exceeding $1,500.
Variation or cancellation of sentence You, or your probation officer, may apply under section 54K of the Sentencing Act 2002 for variation or cancellation of this sentence if you are unable to comply with its terms, or if one of the other grounds for variation or cancellation in that section applies.

10 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Dated at the [specify] Court at [place] on [date].
................................................. (Deputy) Registrar Standard conditions of sentence of intensive supervision Section 54F of the Sentencing Act 2002 provides that the following conditions apply to every sentence of intensive supervision: (a) (b) (c) (d) (e) (f) (g) (ga) (gb) (h) (i) the offender must report in person to a probation officer in the probation area in which the offender resides as soon as practicable, and not later than 72 hours, after the start date of the sentence: the offender must report to a probation officer at least once in each week during the first 3 months of the sentence, at least once in each month during the remainder of the sentence, and otherwise as and when required to do so by a probation officer: the offender must notify a probation officer of his or her residential address and the nature and place of his or her employment when asked to do so: the offender must not move to a new residential address in another probation area without the prior written consent of a probation officer: if consent is given under paragraph (d), the offender must report in person to a probation officer in the new probation area in which the offender is to reside as soon as practicable, and not later than 72 hours, after the offender’s arrival in the new area: if an offender intends to change his or her residential address within a proba‐ tion area, the offender must give a probation officer reasonable notice before moving from his or her residential address (unless notification is
 impossible in the circumstances) and must advise the probation officer of the new address: the offender must not reside at any address at which a probation officer has directed the offender not to reside: the offender must not leave or attempt to leave New Zealand without the prior written consent of a probation officer: the offender must, if a probation officer directs, allow the collection of biomet‐ ric information: the offender must not engage, or continue to engage, in any employment or occupation in which a probation officer has directed the offender not to engage or continue to engage: the offender must not associate with any specified person, or with persons of any specified class, with whom a probation officer has, in writing, directed the offender not to associate: 11 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 (j) the offender must take part in a rehabilitative and reintegrative needs assess‐ ment if and when directed to do so by a probation officer.
The conditions in paragraphs (d) to (g) do not apply if, and to the extent that, they are inconsistent with— • • any special condition imposed by the court; or in the case of an offender who is also subject to a sentence of community detention, any condition of that sentence.

Schedule form 2: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).
Schedule form 2: amended, on 22 August 2017, by section 66 of the Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42).

Schedule form 2: amended, on 22 January 2014, by regulation 5 of the Sentencing Amendment Regulations 2013 (SR 2013/491).
12 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 3 Order for sentence of community work Section 55, Sentencing Act 2002 Case No: To [full name] of [address], [occupation] At a sitting of the [court and place] this [date] you were sentenced to [number] hours of community work for [offence].

*This sentence is cumulative on [specify cumulative sentences].

*Delete if inapplicable.


*The start date of the sentence is the date of this order or the expiry of any sentence this order is cumulative upon (if applicable).

*The start date of your sentence was deferred under section 20A(2)(b) or 57A of the Sentencing Act 2002.

The start date of your sentence is [deferred start date].

*Delete whichever is inapplicable.


You must report to a probation officer in the probation area in which you reside as soon as practicable, and not later than 72 hours, after the start date of your sentence of community work.

During the course of your sentence, you must comply with the terms of the sentence, including that you must report to a probation officer at any time you are directed to do so.

You must work as directed by your probation officer until the completion of your sen‐ tence.
Consequences of non-compliance Failure to comply with the terms of this sentence, without reasonable excuse, may result in you being charged under section 71 of the Sentencing Act 2002 with an offence punishable by a maximum of 3 months’ imprisonment or a fine not exceeding $1,000.
Variation or cancellation of sentence You, or your probation officer, may apply under section 68 of the Sentencing Act 2002 for variation or cancellation of this sentence if you are unable to comply with its terms, or if one of the other grounds for variation or cancellation in that section applies.

13 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Dated at the [specify] Court at [place] on [date].
Notes: • in accordance with section 58(1) and (2) of the Sentencing Act 2002,— ................................................. (Deputy) Registrar • • if your sentence requires you to perform community work of 100 hours or less, that sentence must be served within 6 months of the date that it commences: if your sentence requires you to perform community work of more than 100 hours you must serve at least 100 hours in every 6-month period until the number of hours imposed under the sentence has been served: in accordance with section 59A of the Sentencing Act 2002, you are required to allow the collection of biometric information if so directed by a probation offi‐ cer: in accordance with section 60 of the Sentencing Act 2002, if you move to a new residential address, you must, within 72 hours, notify a probation officer of your new residential address: in accordance with section 64(3) of the Sentencing Act 2002, you are not required to work for more than 10 hours in succession, nor more than 40 hours in a week: in accordance with section 66A of the Sentencing Act 2002, a probation officer may direct that up to 20% of your community work hours be converted to basic work and living skills training.
If you fail, without reasonable excuse, to com‐ plete the number of hours training in basic work and living skills directed, no hours spent in training are to be treated as hours of community work, and you will have to complete all of the hours of community work ordered: in accordance with section 66D of the Sentencing Act 2002, if you do not carry out your work to the satisfaction of a probation officer, the probation officer may refuse to count those hours of work as work undertaken under the sen‐ tence, up to a maximum of 10% of the total number of hours of community work ordered by the court: in accordance with section 67 of the Sentencing Act 2002, if a probation officer is satisfied that you have a good record of compliance with your sentence, the probation officer may remit up to 10% of the number of hours of community work imposed by the court.
Schedule form 3: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).

Schedule form 3: amended, on 22 August 2017, by section 66 of the Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42).

• • • • • • 14 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Schedule form 3: amended, on 22 January 2014, by regulation 6 of the Sentencing Amendment Regulations 2013 (SR 2013/491).
15 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 4 Order for sentence of community detention Section 69B, Sentencing Act 2002 Case No: To [full name] of [address], [occupation] At a sitting of the [court and place] this [date] you were sentenced to community detention for a period of [specify period] for [offence].

*This sentence is cumulative on [specify cumulative sentences].

*Delete if inapplicable.

*The start date of the sentence is the date of this order.
*The start date of the sentence is the date of the expiry of the sentence on which this order is cumulative.

*The start date of the sentence is the date you finish serving your current sentence of [sentence type] (including any post-detention conditions), because your sentence of community detention has been deferred under section 20A(2)(b) of the Sentencing Act 2002.

*Delete whichever are inapplicable.


You must report to a probation officer in the probation area in which you reside as soon as practicable, and not later than 24 hours, after the start date of your sentence of community detention.

If the 24-hour period ends on a weekend or public holiday, you must report to a probation officer in the probation area in which you reside on the next working day.
The sentence includes a curfew period or periods starting from [curfew start date], to be spent at the curfew address, as specified: [specify curfew details].

The standard conditions of community detention are set out in section 69E of the Sen‐ tencing Act 2002 (a list of which is attached to this form).
Consequences of non-compliance Failure to comply with the terms of this sentence, without reasonable excuse, may result in you being charged under section 69G of the Sentencing Act 2002 with an offence punishable by a maximum of 6 months’ imprisonment or a fine not exceeding $1,500.
Any person who refuses or fails, without reasonable excuse, to allow a probation offi‐ cer to enter the curfew address at a time when you are required to be at the address, may be charged under section 69H of the Sentencing Act 2002 with an offence pun‐ ishable by a maximum of 3 months’ imprisonment or a fine not exceeding $5,000.
Any person who refuses or fails, without reasonable excuse, to allow an authorised person to enter the curfew address at any time for the purpose of servicing or inspect‐ ing the electronic monitoring equipment, may be charged under section 69H with an 16 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule offence punishable by a maximum of 3 months’ imprisonment or a fine not exceeding $5,000.
Variation or cancellation of sentence You, or your probation officer, may apply under section 69I of the Sentencing Act 2002 for variation or cancellation of this sentence if you are unable to comply with its terms, or if one of the other grounds for variation or cancellation in that section applies.

If the curfew address becomes unsuitable, the Chief Executive of the Department of Corrections may approve an alternative curfew address under section 69JA of the Sentencing Act 2002.
Dated at the [specify] Court at [place] on [date].
................................................. (Deputy) Registrar Standard conditions of sentence of community detention Under section 69E of the Sentencing Act 2002, the following conditions apply to every sentence of community detention for the duration of the sentence: (a) during the curfew period the offender must not, at any time, leave the curfew address except in the following circumstances: • • • to seek urgent medical or dental treatment; or to avoid or minimise a serious risk of death or injury to the offender or any other person; or with the approval of a probation officer (if the offender is also serving a sentence of supervision or intensive supervision)— • • • • • to seek or engage in employment; or to attend training or other rehabilitative or reintegrative activities or programmes; or to attend a restorative justice conference or other process relating to the offender’s offending; or to carry out any undertaking arising from any restorative justice process; or with the approval of a probation officer and subject to any condi‐ tions imposed by the probation officer, on humanitarian grounds: 17 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 during the curfew period the offender is under the supervision of a probation officer and must co-operate with the probation officer and comply with any lawful direction given by that probation officer: the offender must report in person to a probation officer in the probation area in which the offender resides as soon as practicable, and not later than 24 hours, after the start date of the sentence, unless the 24 hours elapses on a weekend or public holiday, in which case the offender must report on the next working day: the offender must report to a probation officer as and when required to do so by the probation officer, and must notify the probation officer of his or her resi‐ dential address, any change to that address, and the nature and place of his or her employment when asked to do so: the offender must not leave or attempt to leave
 New Zealand without the prior written consent of a probation officer: the offender must, if a probation officer directs, allow the collection of biomet‐ ric information: the offender must keep in his or her possession this curfew order and, if reques‐ ted to do so by a constable or a probation officer, must produce the order for inspection: the offender must, if required to submit to the electronic monitoring of his or her sentence, remain during the curfew period within the area defined by the probation officer: the offender must, when required to do so by a probation officer, submit to the electronic monitoring of compliance with the conditions of his or her sentence, which may require the offender to be connected to electronic monitoring equip‐ ment throughout the sentence term and not just throughout the curfew period.
Schedule form 4: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).

Schedule form 4: amended, on 22 August 2017, by section 66 of the Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42).

Schedule form 4: amended, on 22 January 2014, by regulation 7 of the Sentencing Amendment Regulations 2013 (SR 2013/491).
Schedule form 4: amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).
(b) (c) (d) (da) (db) (e) (ea) (f) 18 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 5 Warrant to arrest offender Section 72(3), Sentencing Act 2002 Case No: To every constable On the [date], [full name] of [address], [occupation] (the offender) was convicted of [specify offence] by the [court and place] and was sentenced to [supervision, or com‐ munity work, or intensive supervision, or community detention, or home detention].
An application has been made under [section 54 or section 68 or section 54K or sec‐ tion 69I or section 80F] of the Sentencing Act 2002 for the [variation or cancella‐ tion] of the sentence.

I direct you to arrest the offender and bring the offender before the [court and place] as soon as possible to enable the application to be dealt with.

Dated at the [specify] Court at [place] on [date].


................................................. Judge Schedule form 5: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).

Schedule form 5: amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).
19 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 6 Order for sentence of home detention Section 80A, Sentencing Act 2002 Case No: To [full name] of [address], [occupation] At a sitting of the [court and place] this [date] you were sentenced to home detention for a period of [specify period] for [offence] to be served at the home detention resi‐ dence at [address].

*This sentence is cumulative on [specify cumulative sentences].

*Delete if inapplicable.


*The start date of the sentence is the date of this order, or the expiry of any sentence this order is cumulative upon (if applicable).

*The start date of your sentence was deferred under section 80W of the Sentencing Act 2002.

The start date of your sentence is [deferred start date].
*The start date of your sentence is the date you finish serving your current sentence of [sentence type], because your sentence of home detention has been deferred under section 20A(2)(b) of the Sentencing Act 2002.

*Delete if inapplicable.

*You must go to and remain at the residence where the sentence is to be served imme‐ diately upon receiving this order, unless a probation officer has authorised you to be absent for a particular reason.
Or if sentence is deferred: *You must go to and remain at the residence where the sentence is to be served on [deferred start date], unless a probation officer has authorised you to be absent for a particular reason.

*Delete if inapplicable.

The standard conditions of home detention are set out in section 80C of the Sentenc‐ ing Act 2002 (a list of which is attached to this form).
*In addition to the standard conditions for home detention, the Court imposed the fol‐ lowing special conditions under section 80D of the Sentencing Act 2002: [specify special conditions].

*Post-detention conditions apply or have been imposed by the Court under section 80N of the Sentencing Act 2002 (a list of which is attached to this form) and will apply to your home detention sentence for a period of [duration] from the detention end date.
*In addition to the standard post-detention conditions the Court imposed the follow‐ ing special post-detention conditions under section 80O: [specify special post-deten‐ tion conditions].

*Delete if inapplicable.


20 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Consequences of non-compliance Failure to comply with the terms of this sentence, without reasonable excuse, may result in you being charged under section 80S of the Sentencing Act 2002 with an offence punishable by a maximum of 1 year’s imprisonment or a fine not exceeding $2,000.
Any person who refuses or fails, without reasonable excuse, to allow a probation offi‐ cer to enter the home detention residence at a time when you are required to be at the residence, may be charged under section 80T of the Sentencing Act 2002 with an offence punishable by a maximum of 3 months’ imprisonment or a fine not exceeding $5,000.
Any person who refuses or fails, without reasonable excuse, to allow an authorised person to enter the home detention residence at any time for the purpose of servicing or inspecting the electronic monitoring equipment, may be charged under section 80T of the Sentencing Act 2002 with an offence punishable by a maximum of 3 months’ imprisonment or a fine not exceeding $5,000.
Failure to comply with the post-detention conditions, without reasonable excuse, may result in your being charged under section 80T of the Sentencing Act 2002 with an offence punishable by a maximum of 6 months’ imprisonment or a fine not exceeding $1,500.
Variation or cancellation of sentence You, or your probation officer, may apply under section 80F of the Sentencing Act 2002 for variation or cancellation of this sentence if you are unable to comply with its terms, or if one of the other grounds for variation or cancellation in that section applies.

If the home detention residence becomes unsuitable, the Chief Executive of the Department of Corrections may approve an alternative home detention residence under section 80FA of the Sentencing Act 2002.
Variation or discharge of post-detention conditions You, or your probation officer, may apply under section 80Q of the Sentencing Act 2002 for variation or discharge of your post-detention conditions.

Dated at the [specify] Court at [place] on [date].
................................................. (Deputy) Registrar 21 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Standard conditions of sentence of home detention Under section 80C of the Sentencing Act 2002, the following conditions apply to every sentence of home detention: (a) (b) (c) (ca) (cb) (d) (da) (e) (f) (g) the offender is under the supervision of a probation officer and must co-operate with the probation officer and comply with any lawful direction given by that probation officer: the offender must not leave the home detention residence at any time except in the circumstances set out in section 80C(3), (4), and (5) of the Sentencing Act 2002 (see below): the offender must keep in his or her possession this order and, if requested to do so by a constable or a probation officer, must produce the order for inspec‐ tion: the offender must not leave or attempt to leave New Zealand without the prior written consent of a probation officer: the offender must, if a probation officer directs, allow the collection of biomet‐ ric information: the offender must, when required by a probation officer, submit to the elec‐ tronic monitoring of compliance with his or her detention conditions: the offender must, if required to submit to the electronic monitoring of his or her sentence, remain within the area defined by the probation officer: the offender must not engage, or continue to engage, in any employment or occupation in which a probation officer has directed the offender not to engage or continue to engage: the offender must not associate with any specified person, or with persons of any specified class, with whom the probation officer has, in writing, directed the offender not to associate: the offender must take part in a rehabilitative and reintegrative needs assess‐ ment if and when directed to do so by a probation officer.
Section 80C(3) of the Sentencing Act 2002 provides that the offender must not leave the home detention residence at any time except in the following circumstances: (a) (b) to seek urgent medical or dental treatment: to avoid or minimise a serious risk of death or injury to the offender or any other person; or (c) with the approval of a probation officer— to comply with any special condition; or to seek or engage in employment; or to attend training or other rehabilitative or reintegrative activities or pro‐ grammes; or • • • 22 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule • • • to attend a restorative justice conference or other process relating to the offender’s offending; or to carry out any undertaking arising from any restorative justice process; or for any other purpose specifically approved by the probation officer.
Section 80C(4) of the Sentencing Act 2002 provides that a probation officer may approve an alternative residence pending determination of an application to vary the home detention residence under section 80F.
Section 80C(5) of the Sentencing Act 2002 provides that a probation officer may authorise an offender, who has served three-quarters of a sentence of 6 months or more, to be absent from the home detention residence for up to 4 hours per day with‐ out a specified purpose for any or all remaining days under the sentence.
Standard post-detention conditions of sentence of home detention Section 80O of the Sentencing Act 2002 provides that the following conditions apply to every offender subject to post-detention conditions: (a) (b) (c) (d) (e) (ea) (eb) (f) the offender must report to a probation officer as and when required to do so by a probation officer and must notify the probation officer of his or her residen‐ tial address and the nature and place of his or her employment when asked to do so: the offender must not move to a new residential address in another probation area without the prior written consent of the probation officer: if consent is given under paragraph (b), the offender must report in person to a probation officer in the new probation area in which the offender is to reside as soon as practicable, and not later than 72 hours, after the offender’s arrival in the new area: if an offender intends to change his or her residential address within a proba‐ tion area, the offender must give the probation officer reasonable notice before moving from his or her residential address (unless notification is impossible in the circumstances) and must advise the probation officer of the new address: the offender must not reside at any address at which a probation officer has directed the offender not to reside: the offender must not leave or attempt to leave New Zealand without the prior written consent of a probation officer: the offender must, if a probation officer directs, allow the collection of biomet‐ ric information: the offender must not engage, or continue to engage, in any employment or occupation in which the probation officer has directed the offender not to engage or continue to engage: 23 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 (g) (h) the offender must not associate with any specified person, or with persons of any specified class, with whom the probation officer has, in writing, directed the offender not to associate: the offender must take part in a rehabilitative and reintegrative needs assess‐ ment if and when directed to do so by a probation officer.
Schedule form 6: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).

Schedule form 6: amended, on 22 August 2017, by section 66 of the Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42).

Schedule form 6: amended, on 22 January 2014, by regulation 8 of the Sentencing Amendment Regulations 2013 (SR 2013/491).
Schedule form 6: amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).

24 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 7 Order for minimum period of imprisonment within determinate sentence or sentence of imprisonment for life Sections 86 and 103, Sentencing Act 2002 Complete this form and attach it to form 9 (warrant of commitment).
To every constable and to the Manager of the prison at [place] 1 [Full name, address, occupation] (the offender) was, on [date], convicted of [offence] by the [specify] Court at [place] and was this day/on [date]* sen‐ tenced to imprisonment for a term of [specify period]/imprisonment for life*.

*Select one.

2 For this paragraph select the statement that applies.
Section 86(2) of the Sentencing Act 2002 applies to the offender as I am satis‐ fied that the period of imprisonment otherwise applicable to the offender’s determinate sentence under section 84(1) of the Parole Act 2002 is insufficient for all or any of the following purposes: holding the offender accountable for the harm done to the victim and the community by the offending: denouncing the conduct in which the offender was involved: deterring the offender or other persons from committing the same or a similar offence: protecting the community from the offender.
• • • • or Section 103(1)(a)(i) of the Sentencing Act 2002 applies to the offender, and I consider that the minimum term of imprisonment specified below is necessary to satisfy all or any of the following purposes: • • • • holding the offender accountable for the harm done to the victim and the community by the offending: denouncing the conduct in which the offender was involved: deterring the offender or other persons from committing the same or a similar offence: protecting the community from the offender.
25 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 3 The court orders, under section 86/103* of the Sentencing Act 2002, that the offender must serve a minimum period of imprisonment of [specify period].

*Select one.

Dated at [specify] Court at [place] on [date] Signature: (Judge) Schedule form 7: substituted, on 26 August 2010, by regulation 5 of the Sentencing Amendment Regulations (No 2) 2010 (SR 2010/207).
Schedule form 7 heading: amended, on 16 August 2022, by section 34(1)(a) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).

Schedule form 7 : amended, on 16 August 2022, by section 34(1)(b) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).

Schedule form 7 : amended, on 16 August 2022, by section 34(1)(c) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
26 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 8 Order for minimum period of imprisonment within sentence of preventive detention Section 89, Sentencing Act 2002 Complete this form and attach it to form 9 (warrant of commitment).

To every constable and to the Manager of the prison at [place] 1 [Full name, address, occupation] (the offender) was, on [date], convicted of [offence] by the [specify] Court at [place] and was this day/on [date]* sen‐ tenced to preventive detention.
*Select one.

2 For this paragraph select the statement that applies.

I have considered the matters referred to in section 89(2) of the Sentencing Act 2002, and consider that a minimum period of imprisonment of [specify period] is appropriate.

3 The court orders, under section 89 of the Sentencing Act 2002, that the offender serve a minimum period of imprisonment of [specify period].
Dated at [specify] Court at [place] on [date] Signature: (Judge) Schedule form 8: substituted, on 26 August 2010, by regulation 5 of the Sentencing Amendment Regulations (No 2) 2010 (SR 2010/207).

Schedule form 8 : amended, on 16 August 2022, by section 34(2) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
27 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 9 Warrant of commitment for sentence of imprisonment Section 91, Sentencing Act 2002 Case No: To every constable and to the Manager of [specify prison] [Full name] of [address], [occupation] (the offender) was on the [date] convicted of [specify offence] by the [court and place] and was sentenced in [court and place] this [date] to— *imprisonment for a term of [specify period].
*imprisonment for a term of [specify period], cumulative on [specify cumulative sen‐ tences].

*imprisonment for life.

*preventive detention.

*Delete if inapplicable.

*The offender has been granted leave to apply to the court for cancellation of the sen‐ tence of imprisonment and substitution of a sentence of home detention if the offender finds a suitable residence.

*Delete if inapplicable.


Start date of sentence *The start date of the sentence is the date of this order or the expiry of any sentence this order is cumulative upon (if applicable).

*The start date of the sentence was deferred under section 100 of the Sentencing Act 2002.

The start date of the sentence is [deferred start date].

*Delete whichever is inapplicable.


Legal representation *The offender was legally represented (as contemplated by section 30(1) of the Sen‐ tencing Act 2002) at the stage of the proceedings at which the offender was at risk of conviction.
*The offender was not legally represented (as contemplated by section 30(1) of the Sentencing Act 2002) at the stage of the proceedings at which the offender was at risk of conviction but the Court was satisfied, in accordance with section 30(2) of the Sen‐ tencing Act 2002, that the offender refused or failed to exercise his or her rights relat‐ ing to legal representation (or engaged counsel but subsequently dismissed him or her).

*Delete whichever is inapplicable.


You, the constables, are directed to deliver the offender to the manager of [specify prison].

28 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule And you, the Manager, are directed to receive the offender into your control and to detain the offender for the purposes of the sentence.
Release conditions imposed by the Court *The offender is a person to whom section 93(1) of the Sentencing Act 2002 applies, and the Court imposed— *(a) the standard release conditions set out in section 14 of the Parole Act 2002, which expire on [date]: *(b) the special conditions listed below, which expire on [date].
*(c) [list special conditions] *The offender was a person to whom section 93(2) of the Sentencing Act 2002 applies, and— *(a) the standard release conditions set out in section 14 of the Parole Act 2002 apply until they expire on [specify]: *(b) the special conditions listed below apply until they expire on [specify].

*(c) [list special conditions] *Delete if inapplicable.

Dated at the [specify] Court at [place] on [date].


................................................. Judge Period spent on remand The period spent by the offender in control on remand is specified for the purpose of section 92 of the Parole Act 2002 as [number] days.

Dated at the Prison at [place] on [date].

.................................................

Manager Schedule form 9: substituted, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regulations 2007 (SR 2007/255).
Schedule form 9: amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).

29 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 10 Summons to offender subject to an order to come up for sentence if called on Section 111(3)(a), Sentencing Act 2002 To [full name] of [address], [occupation] On [date] you were convicted of [offence] (the original offence), and ordered to come up for sentence if called on within [specify period] months.
On [date], an application was made for you to be brought before this Court to be dealt with for the original offence on the following ground(s): *That, on [date], you were convicted by the Court at [place] of [offence], being an offence punishable by imprisonment for a term of more than 3 months.

*That you have failed to comply with an order made by the Court under section 110(3) of the Sentencing Act 2002.
*That you failed to comply with an agreement or failed to take any measure or action of a kind referred to in section 10(1)(b), (d), or (e) of the Sentencing Act 2002 that was brought to the attention of the Court at the time the Court made the order under section 110 of the Sentencing Act 2002.

*Delete if inapplicable.

You are summoned to appear on [date and time] in [specify] Court at [place] to show cause why you should not be dealt with for the original offence.
Dated at the [specify] Court at [place] on [date].

Schedule form 10: added, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regula‐ tions 2007 (SR 2007/255).
................................................. (Deputy) Registrar 30 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 11 Warrant to arrest offender subject to an order to come up for sentence if called on Section 111(3)(b) or (c), Sentencing Act 2002 To every constable On [date], [full name] of [address], [occupation] (the offender), was convicted of [specify offence] (the original offence), and ordered to come up for sentence if called on within [specify period].
*On [date], a summons was issued to the offender requiring the offender to appear in this Court on [date] to show cause why the offender should not be dealt with for the original offence, but the offender failed to appear before this Court in answer to the summons.

*On [date], an application was made for the offender to be brought before this Court to be dealt with for the original offence.

*Delete if inapplicable.


You are directed to arrest the offender and have the offender brought before this Court so that the offender may show cause why the offender should not be dealt with for the original offence.

Dated at the [specify] Court at [place] on [date].

................................................. Judge Schedule form 11: added, on 1 October 2007, by regulation 4 of the Sentencing Amendment Regula‐ tions 2007 (SR 2007/255).
Schedule form 11: amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).

31 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 11AA Protection order Section 123B, Sentencing Act 2002 *In the High Court of New Zealand, [name of registry] Registry *In the District Court, [name of registry] Registry *Select one.
No: [number(s) of proceeding] To [full name, address, occupation], the offender The court on [date] makes a protection order against you under section 123B of the Sentencing Act 2002.
Person(s) protected by order This order protects the following person(s) (the protected person(s)): [full name of person against whom the offence was committed by the offender] *[full name of each child who ordinarily or periodically resides with the person against whom the offence was committed by the offender], and any other child who ordinarily or periodically resides with the person against whom the offence was com‐ mitted by the offender.

*Omit if it does not apply.
1 A Conditions of order Standard conditions: no family violence, no contact, no having others breach order The offender must not— (a) engage in behaviour that amounts to any form of family violence against the protected person (whether physical abuse, sexual abuse, or psycho‐ logical abuse); or (b) make any unauthorised contact with the protected person; or (c) encourage a person to engage in behaviour against, or to make contact with, a protected person if the behaviour or contact, if engaged in or made by the offender, would be prohibited by this protection order.
B Exceptions to standard no-contact condition, with consent The protected person can suspend or reinstate the no-contact condition by giv‐ ing or cancelling consent to contact.

The protected person’s consent is valid only if given in writing or in a digital communication, but the protected person may withdraw consent at any time and in any way.
The protected person cannot consent to any contact inconsistent with— 32 Version as at 16 August 2022 (a) (b) Sentencing Regulations 2002 Schedule any order for supervised contact in relation to a child; or no-contact conditions imposed by a direction under section 168A of the Criminal Procedure Act 2011.
C Other exceptions to standard no-contact condition Contact by the offender with the protected person is authorised, and not in breach of the no-contact condition, if the contact is— (a) (b) (c) (d) (e) reasonably necessary in any emergency; or permitted under any order or written agreement relating to the role of providing day-to-day care for, or contact with, or custody of— (i) (ii) any child (within the meaning of section 8 of the Care of Chil- dren Act 2004); or any child or young person (within the meaning of section 2 of the Oranga Tamariki Act 1989); or permitted under any special condition of this protection order; or necessary for the purposes of attending a family group conference (within the meaning of section 2 of the Oranga Tamariki Act 1989); or necessary to attend any proceeding (of any kind) in or before any court or person acting judicially, or to attend any other matter that is associated with such a proceeding and that is a matter that the parties to the pro‐ ceeding jointly attend (for example, a restorative justice conference, or a settlement conference convened under section 46Q of the Care of Children Act 2004).
D Standard conditions about weapons The offender— (a) must not possess or have under their control, any weapon; and (b) must not hold a firearms licence; and (c) must, as soon as practicable after being served with a copy of this order, but in any case no later than 24 hours after such service; and on demand made, at any time, by any constable, surrender to a constable— (i) any weapon in their possession or under their control, whether or not any such weapon is lawfully in their possession or under their control; and (ii) any firearms licence held by them.
On the making of this protection order, any firearms licence held by the offender is deemed to be revoked.

33 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Note: The Family Violence Act 2018 defines a weapon as any firearm, airgun, pistol, prohibited magazine, prohibited part, restricted weapon, ammunition, or explosive, as those terms are defined in the Arms Act 1983.
[Note: If the court has modified the terms of the standard condition relating to weapons, or directed that the standard condition relating to weapons is not a condition of the order (whether absolutely or only to the extent that the order relates to the respondent), set out the terms of the court’s decision.]
E Special conditions The court also imposes the following special conditions on the offender [set out any special conditions imposed]: *Special conditions to protect the protected person from further violence by the offender: *Special conditions to address the inflicting of family violence against protec‐ ted people who are particularly vulnerable (for example, due to age, disability, or health condition): *Person who may consent to contact on behalf of the protected person and to withdraw such consent [name of person who may consent]: *Other [insert any other special condition]: Unless otherwise stated, these conditions last for the duration of this order.
*Omit if it does not apply.

2 Assessment for, and attendance at, non-violence programme/Assessment for prescribed services and engagement with prescribed standard service* The court directs [full name of offender] to undertake an assessment for a non- violence programme, and attend a non-violence programme, provided by a ser‐ vice provider, that an assessor determines is an appropriate non-violence pro‐ gramme for the offender to attend.
* The court directs [full name of offender] to undertake an assessment for pre‐ scribed services, and engage with any prescribed standard service, provided by a service provider, that an assessor determines may be appropriate for and may benefit the offender.
* The Registrar of the court will arrange for the offender to be referred to an assessor, and the offender must meet with the assessor so that the assessor may— (a) (b) undertake an assessment of the offender; and determine, if the direction in the notification is that the offender under‐ take an assessment for a non-violence programme, whether there is an appropriate non-violence programme, provided by a service provider, for the offender to attend; and 34 Version as at 16 August 2022 (c) Sentencing Regulations 2002 Schedule determine, if the direction in the notification is that the offender under‐ take an assessment for prescribed services, whether (and, if so, which of) the types of services specified in regulations made under section 249(a) of the Family Violence Act 2018 (if any), provided by a service provider, may be appropriate for and may benefit the offender.
If there is an appropriate non-violence programme for the offender to attend, the service provider of that programme will settle in writing with the offender the terms of attendance, which must include— (a) (b) the number of programme sessions that the offender must attend; and details and arrangements about the programme venue, sessions, and times.
Before providing a prescribed standard service to an offender directed to engage with the service, the service provider must settle in writing with the offender the terms of the offender’s engagement with the service.

* *Omit if it does not apply.

Date: Registrar: Effect of protection order This order is a final protection order that lasts indefinitely.

Certain conditions of this order may have a limited duration.
Modification or discharge of order You or the protected person may apply to the Family Court at any time— (a) for the modification or discharge of the standard condition about weapons.
(The Family Court may make a change to this standard condition only if it is satisfied that the condition, or a term of the condition, is not needed to protect the persons for whose benefit this order applies from further family violence): (b) for a variation or discharge of any special conditions of this order, or for the imposition of a new special condition: (c) for this order to be discharged.
You or the protected person may apply to the Family Court for a variation or dis‐ charge of a direction to undertake an assessment and attend a non-violence pro‐ gramme or engage with a prescribed standard service, or for such a direction to be made.
Consequences of breach of order You commit an offence if you breach this order by— (a) doing an act in contravention of this order; or 35 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 (b) (c) (d) (e) (f) failing to comply with any condition of this order; or contravening, or failing to comply with any term and condition of, a related occupation order (for example, by failing to leave the dwellinghouse to which the order relates); or contravening a related tenancy order (for example, by failing to leave the dwellinghouse to which the order relates); or contravening, or failing to comply with any term and condition of, a related ancillary furniture order (for example, by preventing possession and use of all or any items to which the order relates); or contravening, or failing to comply with any term and condition of, a related furniture order (for example, by preventing possession and use of all or any items to which the order relates).
You have a defence to proceedings for this offence if you can prove that you had a reasonable excuse for breaching the order.

The maximum penalty for this offence is 3 years’ imprisonment.

If a constable has good cause to suspect that you have breached this order, you may be arrested without warrant.

Police bail is not available during the 24 hours immedi‐ ately following an arrest.

During that period, any bail application must be made to a Judge.
*Consequences of failing to comply with direction You commit an offence if, without reasonable excuse, you fail on any occasion to comply with a direction made under section 188 or 198 of the Family Violence Act 2018— (a) to undertake an assessment for, and attend, a programme; or (b) to undertake an assessment for, or engage with, a prescribed service.

The maximum penalty for this offence is 6 months’ imprisonment or a fine not exceeding $5,000.

*Omit if it does not apply.


Advice If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz Ministry of Justice call centre: 0800 268 787 See also the information sheet accompanying this order.
Schedule form 11AA: replaced, on 1 July 2019 (immediately after being amended by section 259(2) of the Family Violence Act 2018 (2018 No 46)), by regulation 5 of the Sentencing (Family Violence) Amendment Regulations 2019 (LI 2019/98).
36 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 11A Warning notice to party to security agreement or lease Section 129F, Sentencing Act 2002 Note: In this form, illegal street racing offence means an offence against section 36A(1)(a) or (c) of the Land Transport Act 1998.
To every party to a security agreement or lease relating to the following vehicle: Make and model: Year of first registration: Registration number: 1 [Full name, address, occupation, date of birth] (the offender) was convicted on [date] of an offence against section 36A(1)(a)/36A(1)(c)* of the Land Trans‐ port Act 1998 involving this vehicle by the High Court/District Court* at [place].

*Select one.

2 Omit this paragraph if it does not apply.


3 4 5 6 The following substitute/substitutes* for the offender has/have* an interest in the vehicle: [For each substitute, specify full name, address, occupation, and date of birth.]

*Select one.

This is the second illegal street racing offence committed by the offender within 4 years.
On [date], the High Court/District Court* at [place] convicted the offender of an offence against section 36A(1)(a)/36A(1)(c)* of the Land Transport Act 1998 (the previous offence).

*Select one.

The previous offence was committed on [date].
You are warned that the court may, in accordance with section 129A of the Sentencing Act 2002, order that any vehicle that the offender/a substitute* owns or in which the offender/a substitute* has an interest (including a vehicle other than the vehicle involved in the current offence or the previous offence) be confiscated and destroyed if— (a) the offender commits another illegal street racing offence before the expiry of 4 years from the commission of the previous offence; and the offender is driving or in charge of that vehicle at the material time.
(b) *Select one.

37 Sentencing Regulations 2002 Version as at 16 August 2022 Schedule Date: Place: Signature: (Registrar/Deputy Registrar*) *Select one.

Schedule form 11A: inserted, on 1 December 2009, by regulation 6 of the Sentencing Amendment Regulations 2009 (SR 2009/360).

Schedule form 11A heading: replaced, on 1 August 2012, by regulation 8(1)(a) of the Sentencing Amendment Regulations 2012 (SR 2012/132).
Schedule form 11A: amended, on 1 August 2012, by regulation 8(1)(b) of the Sentencing Amend‐ ment Regulations 2012 (SR 2012/132).

38 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 11B Written caution Section 129B, Sentencing Act 2002 Note: In this form, illegal street racing offence means an offence against section 36A(1)(a) or (c) of the Land Transport Act 1998.
To [full name, address, occupation, date of birth] (being a person registered in respect of the motor vehicle described in paragraph 3 or believed to have an interest in that vehicle) [Full name, address, occupation, date of birth] (the offender) was convicted on [date] of [offence] (the current offence) by the High Court/District Court* at [place].

*Select one.

The current offence was committed on [date].


At the material time, the offender was driving or in charge of the following vehicle that you are believed to own or have an interest in: Make and model: Year of first registration: Registration number: The court is not satisfied that any of the exceptions from service of a written caution in section 129B(3) of the Sentencing Act 2002 apply to you.
* *The exceptions in section 129B(3) of the Sentencing Act 2002 are the same as grounds (a) to (d) outlined below under Right of review.
Part A Caution in respect of confiscation of vehicle You are warned that the court may order that any vehicle that you own or in which you have an interest (including a vehicle other than the vehicle involved in the current offence) be confiscated in accordance with section 128 of the Sentencing Act 2002 if— (a) the offender commits another offence specified in section 128(1) of the Sentencing Act 2002 (including an illegal street racing offence) within 4 years after the commission of the current offence; and (b) the offender is driving or in charge of that vehicle at the material time.
Part B Caution in respect of confiscation and destruction of vehicle Complete Part B only if the current offence is an illegal street racing offence.

6 For this paragraph select the statement that applies.

Statement A The offence committed by the offender on this occasion is an illegal street rac‐ ing offence.
39 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Statement B The offence committed by the offender on this occasion is— (a) (b) an illegal street racing offence; and the second illegal street racing offence committed by the offender within 4 years.

On [date], the High Court/District Court* at [place] convicted the offender of an offence against section 36A(1)(a)/36A(1)(c)* of the Land Transport Act 1998 (the previous offence).

*Select one.

The previous offence was committed on [date].


7 For this paragraph select the statement that applies.

Statement A (Select this statement if the current offence is the first illegal street racing offence committed by the offender within the last 4 years.)

The offender will have committed 3 illegal street racing offences within 4 years if the offender commits 2 further illegal street racing offences within 4 years after [date of commission of current offence].
Statement B (Select this statement if the current offence is the second illegal street racing offence committed by the offender within the last 4 years.)

The offender will have committed 3 illegal street racing offences within 4 years if the offender commits 1 further illegal street racing offence within 4 years after [date of commission of previous offence].
8 You are warned that the court may order that any vehicle that you own or in which you have an interest (including a vehicle other than the vehicle involved in the current offence) may be confiscated and destroyed in accordance with section 129A of the Sentencing Act 2002 if— (a) (b) the offender commits 3 illegal street racing offences within 4 years; and at the material time (in respect of the third illegal street racing offence) the offender is driving or in charge of that vehicle.
Date: Place: Signature: (Judge) 40 Version as at 16 August 2022 Right of review Sentencing Regulations 2002 Schedule You have the right to seek a review of the decision to serve you with this written cau‐ tion on 1 or more of the following grounds: (a) (b) (c) (d) the motor vehicle was stolen or converted at the material time: you did not own or have an interest in the motor vehicle at the material time: you are a secured party under a security agreement relating to the motor vehicle or the lessor of the motor vehicle under a lease, but have no relation‐ ship of another kind with the offender: the motor vehicle was let on hire at the material time in accordance with a rental service licence under the Land Transport Act 1998.
To apply for a review, you must send an application to the court that issued this cau‐ tion within 20 working days of the date that this written caution was served on you.

Your application must include a statutory declaration stating why 1 or more of the grounds above applies.

Schedule form 11B: inserted, on 1 December 2009, by regulation 6 of the Sentencing Amendment Regulations 2009 (SR 2009/360).
Schedule form 11B: amended, on 1 July 2013, by regulation 15 of the Summary Proceedings Amend‐ ment Regulations 2013 (SR 2013/183).

Schedule form 11B: amended, on 1 August 2012, by regulation 8(2) of the Sentencing Amendment Regulations 2012 (SR 2012/132).
41 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 12 Warrant for confiscation of motor vehicle Section 132, Sentencing Act 2002 To every constable and every bailiff, and to the Registrar of the High Court/District Court* at [place] *Select one.

1 [Full name, address, occupation, date of birth] (the offender) was convicted on [date] of [offence] by the High Court/District Court* at [place].

*Select one.

Omit this paragraph if it does not apply.


At the material time the offender was driving or in charge of a vehicle in which [full name, address, occupation, date of birth] (the substitute) has an interest.

On [date], an order was made by the High Court/District Court* at [place] for the confiscation of the following motor vehicle in which the offender/substi‐ tute* has an interest: Make and model: Year of first registration: Registration number: *Select one.
Under the confiscation order, the offender/substitute* was required to surrender the motor vehicle to a constable or bailiff or the Registrar at [place, date, time].

*Select one.

The offender/substitute* has failed to surrender the motor vehicle.

*Select one.

I direct you, unless the motor vehicle is sooner surrendered to a constable or bailiff or the Registrar, to seize the motor vehicle and to deliver it into the cus‐ tody of the Registrar of the High Court/District Court* at [place].

*Select one.
*Select one.

Entry to premises For the purpose of executing this warrant, you may enter any premises, by force if necessary, if you have reasonable cause to believe that the motor vehicle is on those premises.

You must show this warrant to any person who is on the premises.

42 Sentencing Regulations 2002 Schedule Version as at 16 August 2022 Date: Place: Signature: (Judge) Schedule form 12: replaced, on 1 August 2012, by regulation 8(3) of the Sentencing Amendment Regulations 2012 (SR 2012/132).
43 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 12A Warrant for recovery of motor vehicle Section 137B, Sentencing Act 2002 To every constable and every bailiff, and to the Registrar of the High Court/District Court* at [place] *Select one.

1 On [date], an order was made by the High Court/District Court* at [place] for the confiscation and destruction of the following motor vehicle: Make and model: Year of first registration: Registration number: *Select one.
The vehicle was sold to [full name, address, occupation, date of birth] (the pur‐ chaser) on [date].

The sale was subject to a condition that the vehicle be dismantled for any sale‐ able parts and the remainder destroyed to the satisfaction of the Registrar within 30 working days or any longer period specified in writing by the Registrar.
The purchaser did not comply with that condition of sale and the person in pos‐ session of the vehicle was required to surrender the vehicle to a constable or bailiff or the Registrar at [place, date, time].

The person in possession of the vehicle has failed to surrender the motor vehicle.
I direct you, unless the motor vehicle is sooner surrendered to a constable or bailiff or the Registrar, to seize the motor vehicle and to deliver it into the cus‐ tody of the Registrar of the High Court/District Court* at [place].

*Select one.

Entry to premises For the purpose of executing this warrant, you may enter any premises, by force if necessary, if you have reasonable cause to believe that the motor vehicle is on those premises.

You must show this warrant to any person who is on the premises.
Date: Place: Signature: (Judge) 44 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Schedule form 12A: replaced, on 1 August 2012, by regulation 8(3) of the Sentencing Amendment Regulations 2012 (SR 2012/132).
45 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 12AB Warrant for recovery of motor vehicle from secured party Section 141C, Sentencing Act 2002 To every constable and every bailiff, and to the Registrar of the High Court/District Court* at [place] *Select one.

1 On [date], an order was made by the High Court/District Court* at [place] for the confiscation of the following motor vehicle: Make and model: Year of first registration: Registration number: *Select one.
The vehicle was transferred to [full name, address, occupation, date of birth] (the secured party) on [date].

The transfer was made under a court order that the vehicle be sold within a reasonable period.

The secured party has not complied with that order and the person in posses‐ sion of the vehicle was required to surrender the vehicle to a constable or bail‐ iff or the Registrar at [place, date, time].

The person in possession of the vehicle has failed to surrender the motor vehicle.
I direct you, unless the motor vehicle is sooner surrendered to a constable or bailiff or the Registrar, to seize the motor vehicle and to deliver it into the cus‐ tody of the Registrar of the High Court/District Court* at [place].

*Select one.

Entry to premises For the purpose of executing this warrant, you may enter any premises, by force if necessary, if you have reasonable cause to believe that the motor vehicle is on those premises.

You must show this warrant to any person who is on the premises.
Date: Place: Signature: (Judge) Schedule form 12AB: inserted, on 1 August 2012, by regulation 8(3) of the Sentencing Amendment Regulations 2012 (SR 2012/132).

46 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 12B Notice of consequences of first warning [Revoked] Schedule form 12B: revoked, on 16 August 2022, by section 34(3) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
47 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 12C Notice of consequences of final warning [Revoked] Schedule form 12C: revoked, on 16 August 2022, by section 34(3) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).

48 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 12D Notice of cancellation of warning [Revoked] Schedule form 12D: revoked, on 16 August 2022, by section 34(3) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
49 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 12E Notice of substituted warning [Revoked] Schedule form 12E: revoked, on 16 August 2022, by section 34(3) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
50 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 12F Order that offender serve full term of imprisonment Sections 86 and 103, Sentencing Act 2002 Complete this form and attach it to form 9 (warrant of commitment) Case No: To every constable and to the Manager of the prison at [place] 1 2 [Full name, address, occupation] (the offender) was, on [date], convicted of [offence] by the [specify] court at [place] and was this day/on [date]* sentenced to imprisonment for a term of [specify period]/imprisonment for life.
*Select one.

I consider that section 103(2A) applies to the offender and no minimum term of imprisonment would be sufficient to satisfy any or all of the following pur‐ poses: • • • • holding the offender accountable for the harm done to the victim and the community by the offending: denouncing the conduct in which the offender was involved: deterring the offender or other persons from committing the same or a similar offence: protecting the community from the offender.
3 The court orders, under section 103(2A) of the Sentencing Act 2002, that the offender must serve the full term of imprisonment.

Dated at [specify] Court at [place] on [date] Signature: (Judge) Schedule form 12F: inserted, on 26 August 2010, by regulation 6 of the Sentencing Amendment Regulations (No 2) 2010 (SR 2010/207).

Schedule form 12F heading: amended, on 16 August 2022, by section 34(4)(a) of the Three Strikes Legislation Repeal Act 2022 (2022 No 40).
Schedule form 12F: amended, on 16 August 2022, by section 34(4)(b) of the Three Strikes Legis‐ lation Repeal Act 2022 (2022 No 40).

Schedule form 12F: amended, on 16 August 2022, by section 34(4)(c)(i) of the Three Strikes Legis‐ lation Repeal Act 2022 (2022 No 40).

Schedule form 12F: amended, on 16 August 2022, by section 34(4)(c)(ii) of the Three Strikes Legis‐ lation Repeal Act 2022 (2022 No 40).
51 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 13 General heading for proceedings that relate to instrument forfeiture orders *In the High Court of New Zealand, [name of registry] Registry *In the District Court, [name of office] Office *Select one.
CRI [number of proceeding] Under sections 142A to 142Q of the Sentencing Act 2002 and subpart 4 of Part 2 of the Criminal Proceeds (Recovery) Act 2009 In the matter of an instrument forfeiture order Schedule form 13: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
52 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 14 Prosecutor’s notice that court should consider making instrument forfeiture order Section 142B, Sentencing Act 2002 Complete and insert the heading as set out in form 13.

To the Registrar This document notifies the court that— 1 2 In the [specify] Court at [place, date], [offender’s full name] was convicted of the following qualifying instrument forfeiture offence(s): [specify].
[Prosecutor’s name and description] is of the opinion that the court should con‐ sider whether to make an instrument forfeiture order in respect of the following property used to commit, or to facilitate the commission of, the above qualify‐ ing instrument forfeiture offence(s): [details of property, including its value if known to the prosecutor, the names and identifying details of any persons (including persons other than the offender) who, to the knowledge of the pros‐ ecutor, have an interest in that property, and the nature and extent of that inter‐ est, and summarising how the property was, in the prosecutor’s opinion, used to commit, or to facilitate the commission of, the above qualifying instrument forfeiture offence(s)].
Date: Signature: Prosecutor: [name and description] Schedule form 14: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

53 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 15 Notice of court’s decision and directions in response to prosecutor’s notice Section 142C, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [prosecutor’s name and description] This document notifies you that— 1 2 The prosecutor’s notice given under section 142B of the Sentencing Act 2002 by [prosecutor’s name and description] on [date] was considered by the court on [date].

For this paragraph select the statement that applies.

Statement A The court will on [date] consider making an instrument forfeiture order in respect of the property specified in that prosecutor’s notice.
Statement B The court is not of the opinion that it should consider making an instrument forfeiture order in respect of the property specified in that prosecutor’s notice.

3 Omit this paragraph if statement B is selected for paragraph 2.

You are directed— (a) to issue and serve any notice required by section 142E of the Sentencing Act 2002 as soon as practicable after the court gives, and in any event not later than 5 working days after the giving of, this direction.
Omit this paragraph if it does not apply.

(b) to provide to the court before [deadline] further information about the following matter(s): Select the paragraph(s) that apply.
(i) (ii) (iii) the value of the property that constitutes the instrument of crime: the nature, extent, and value of the offender’s interest in the prop‐ erty that constitutes the instrument of crime: the name of any other person with an interest in the instrument of crime, the nature and extent of that person’s interest, and whether or not that person has been notified of the proceedings: (iv) the name of any person who may suffer undue hardship if the property is confiscated, and the nature of that hardship: (v) [any other matter specified by the court].
54 Sentencing Regulations 2002 Schedule Version as at 16 August 2022 Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Schedule form 15: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
55 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 16 Notice to interested persons that court to consider making instrument forfeiture order Section 142E, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [every person (other than the offender) whose name was included in the prosecutor’s notice given to the court under section 142B of the Sentencing Act 2002, and any other person who the prosecutor believes has an interest in the property in question] and To the Commissioner This document notifies you that— 1 2 3 4 In the [specify] Court at [place, date], [offender’s full name] was convicted of the following qualifying instrument forfeiture offence(s): [specify].
The court, in a document signed on [date], directed the prosecutor to issue and serve this notice that the following property may be made the subject of an instrument forfeiture order: [details of property specified in the prosecutor’s notice given under section 142B of the Sentencing Act 2002, including the names of any persons having an interest in that property and the nature and extent of that interest].

You may, within 10 working days of the date of this notice, apply to the court for relief.
The grounds on which you may apply to the court for relief are set out in sec‐ tion 77(1)(a) and (b) of the Criminal Proceeds (Recovery) Act 2009, and are that— (a) (b) you claim an interest in any of the property described in this notice; or having regard to all the circumstances, undue hardship is reasonably likely to be caused to you or another person (other than the person who has been convicted of the qualifying forfeiture offence to which this notice relates) by the operation of the instrument forfeiture order.
Date: Signature: Prosecutor: [name and description] Schedule form 16: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

56 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 17 Order to enter on register notice of possible instrument forfeiture order Section 142D(2), Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [the authority responsible for administering the New Zealand enactment that enables the registration of title to, or charges over, the specified property] 1 2 The court on [date] gave a direction under section 142C of the Sentencing Act 2002 relating to, and will on [date] consider making an instrument forfeiture order under section 142N of the Sentencing Act 2002 against, the following property: [specify].
The court by this order requires you to enter on the register a note of the fact that the court will consider whether an instrument forfeiture order may be made against that property.

Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Sealed: [date] Schedule form 17: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
57 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 18 Order to cancel entry on register noting possible instrument forfeiture order Section 142D(3), Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [the authority responsible for administering the New Zealand enactment that enables the registration of title to, or charges over, the specified property] 1 2 You were required by an order of the court made under section 142D(2) of the Sentencing Act 2002 on [date] to make an entry on the register noting that the court was to consider whether an instrument forfeiture order under section 142N of the Sentencing Act 2002 may be made against the following property: [specify].
The court by this order requires you to cancel any entry made on the register in accordance with that order.

Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Sealed: [date] Schedule form 18: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
58 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 19 Direction to provide further information to court Section 142F, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [prosecutor’s full name, the offender, or any person who applies for relief] 1 2 The court on [date] gave a direction under section 142C(a) of the Sentencing Act 2002 relating to, and will on [date] consider whether an instrument forfei‐ ture order under section 142N of that Act may be made against, the following property: [details of property specified in the prosecutor’s notice given under section 142B of the Sentencing Act 2002, including the names of any persons having an interest in that property and the nature and extent of that interest, and summarising how, in the prosecutor’s opinion, the particular property was used to commit, or to facilitate the commission of, the particular qualifying instrument forfeiture offence(s)].
You are required by this direction to provide to the court before [deadline] fur‐ ther information about the following matter(s): Select the paragraph(s) that apply.
(a) (b) (c) (d) the value of the property that constitutes the instrument of crime: the nature, extent, and value of [offender’s full name]’s interest in the property that constitutes the instrument of crime: the name of any other person with an interest in the instrument of crime, the nature and extent of that person’s interest, and whether or not that person has been notified of the proceedings: the name of any person who may suffer undue hardship if the property is confiscated, and the nature of that hardship: (e) [any other matter specified by the court].
Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Schedule form 19: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

59 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 20 Order requiring offender or other person to complete declaration of ownership Section 142H, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [full name of offender or other person ordered to complete declaration] 1 2 The court on [date] gave a direction under section 142C of the Sentencing Act 2002 relating to, and will on [date] consider whether an instrument forfeiture order under section 142N of that Act may be made against, the following prop‐ erty: [details of property specified in the prosecutor’s notice given under sec‐ tion 142B of the Sentencing Act 2002].
You are required by this order to complete a declaration of ownership specify‐ ing the following matters: (a) whether, at [date of offender’s conviction for the qualifying instrument forfeiture offence], [offender’s full name] owned, or had any interest in, the following property: [specify property]: (b) whether, at [date of offender’s conviction for the qualifying instrument forfeiture offence] any other person owned, or had an interest in, [specify property], and, if so, the name of that person and the nature of that inter‐ est: (c) (d) whether [offender’s full name] ceased to be the owner of, or to have any interest in, the following property at any time subsequent to the commis‐ sion of the offence but before [date of offender’s conviction for the offence]: [specify property]: if the offender disposed of his or her interest in the property in question during the period referred to in paragraph (c), to whom the ownership or interest in the property was disposed, the relationship of that person to [offender’s full name], and the consideration received by [offender’s full name].
Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Sealed: [date] Schedule form 20: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

60 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 21 Declaration of ownership Section 142H, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To the Registrar and To [every person who has given an address for service] I, [full name, address, occupation], declare the following: 1 For this paragraph omit any statement that does not apply.
Statement A At [date of offender’s conviction for the qualifying instrument forfeiture offence] [offender’s full name] owned, or had an interest in, the following prop‐ erty: [specify which, if any, of the property referred to in the order for declar‐ ation of ownership that the offender owned or had an interest in].
Statement B At [date of offender’s conviction for the qualifying instrument forfeiture offence] [offender’s full name] did not own or have an interest in the following property: [specify which, if any, of the property referred to in the order for dec‐ laration of ownership that the offender owned or had an interest in].

2 For this paragraph omit any statement that does not apply.
Statement A (repeat for as many other people as have an interest) At [date of offender’s conviction for the qualifying instrument forfeiture offence] [full name] owned, or had an interest in, the following property: [spe‐ cify which, if any of the property referred to in the order for declaration of ownership that the person named owned or had an interest in and the nature of that interest].
Statement B At [date of offender’s conviction for the qualifying instrument forfeiture offence] no other person owned, or had an interest in, the following property: [specify which, if any of the property referred to in the order for declaration of ownership that no other person owned or had an interest in].

3 For this paragraph select the statement that applies.
Statement A [Offender’s full name] ceased to be the owner of, or to have an interest in, the following property at a time subsequent to the commission of the offence but before [date of offender’s conviction for the qualifying instrument forfeiture offence]: [specify the relevant property, referred to in the order for declaration of ownership, the offender’s ownership or interest in which was disposed of, the 61 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 person to whom it was disposed of, the relationship of that person to the offender, and the consideration received by the offender].
Statement B There is no property that [offender’s full name] ceased to be the owner of, or to have an interest in, at a time subsequent to the commission of the offence but before [date of offender’s conviction for the qualifying instrument forfeiture offence].

Sworn/Affirmed* at [place, date] Before me: [name, signature] *Select one.

(a solicitor of the High Court of New Zealand or Registrar/Deputy Registrar* of a District/the High* Court or Justice of the Peace) *Select one.
Schedule form 21: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

62 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 22 Instrument forfeiture order Section 142N, Sentencing Act 2002 and sections 70 and 71, Criminal Proceeds (Recovery) Act 2009 Complete and insert the heading as set out in form 13.
To [full name] (the prosecutor) and To [full name] (the offender) and To the Commissioner and To the Official Assignee and *To [every other person who has given an address for service, or who is named in the notice given to the court under section 142B of the Sentencing Act 2002, or who is or may be affected by the order, or who the court directs is to be served] *Omit if it does not apply.
and To the Official Assignee 1 At [place, date] the court made the following instrument forfeiture order under section 142N of the Sentencing Act 2002: The following property is subject to this instrument forfeiture order and there‐ fore, under section 70(1)(a) and (b) of the Criminal Proceeds (Recovery) Act 2009, vests in the Crown absolutely (subject to the interests protected by sec‐ tion 70(2) of that Act), and is in the Official Assignee’s custody and control: [specify the forfeited property in a comprehensive list, with a description adequate to identify each asset and, for property (other than money), specify (in accordance with section 142N(4) of the Sentencing Act 2002) the amount that the court considers to be the value of that property at the time this order is made].
2 Include this paragraph only if the court, by this order, makes or gives any fur‐ ther declarations or directions under section 142N(3)(a), (3)(b), or (5) of the Sentencing Act 2002 or section 71(1)(a) or (b) of the Criminal Proceeds (Recovery) Act 2009.

The court made or gave the following declarations or directions: [specify].

63 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Date: Signature: (Registrar/Deputy Registrar*) *Select one.
Sealed: [date] Schedule form 22: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
64 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 23 Warrant authorising officer of court to search for and seize document(s) to effect transfer of property Section 71(2) and (3), Criminal Proceeds (Recovery) Act 2009 To [full name] (an officer of the court directed by the court) 1 I am satisfied, on an application in writing made on oath under section 71(2) and (3) of the Criminal Proceeds (Recovery) Act 2009 by [name of applicant for warrant], an officer of the court, that there are reasonable grounds for believing that there is in or on/will come into or onto* [address or other description of the place of thing], while the warrant is in force, the following document(s) required to effect the transfer of property subject to an instrument forfeiture order: [specify].
*Select one or include both if appropriate.
2 This warrant authorises you— (a) (b) (c) (d) (e) (f) (g) (h) to enter and search the place or thing specified in the warrant, and any item or items found in that place or thing, at any time that is reasonable in the circumstances: to request any person to assist in the execution of the warrant: to use any force that is reasonable for the purpose of executing the war‐ rant: to seize any thing authorised by the warrant: to bring and use in or on the place or thing searched any equipment, to use any equipment found on the place or thing, and to extract any electri‐ city from the place or thing to operate the equipment that is reasonable to use in the circumstances, for the purposes of executing the warrant: to copy any document, or part of a document, that may be seized under the warrant: to require any person to reproduce, or to assist the person executing the warrant to reproduce, in useable form, any information recorded or stored in any document that may be seized under the warrant: to take photographs or video recordings of the place or thing searched, and of any thing found in that place, if the person executing the warrant has reasonable grounds to believe that the photographs or video record‐ ings may be relevant in any proceedings arising from the execution of the warrant.
3 The power to enter and search pursuant to this warrant may be exercised [spe‐ cify the number of times that, or the period over which, the warrant may be executed] within [specify a period not exceeding 14 days] from the date of issue of this warrant.

65 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 4 Omit this paragraph if it does not apply.
This warrant is issued subject to the following condition(s): [specify any condi‐ tions specified by the Judge under section 116(3)(b) of the Criminal Proceeds (Recovery) Act 2009 (as applied by section 71(3) of that Act)].

Date: Signature: (District/High Court Judge*) *Select one.

Schedule form 23: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
66 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 24 Application for relief from instrument forfeiture order Section 142J, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To the Registrar and To [full name] (the prosecutor) and To [full name] (the offender) and To the Commissioner and To the Official Assignee and *To [every other person who has given an address for service, or who is named in the notice given to the court under section 142B of the Sentencing Act 2002, or who is or may be affected by the order, or who the court directs is to be served] *Omit if it does not apply.
1 [Full name] (the applicant) by this document applies to the court for an order for relief from an instrument forfeiture order that the court may make in respect of [specify property]/the court made on [date] in respect of [specify property]*.

*Select one.

2 For this paragraph select the statement that applies.
Statement A This application for relief is made, in accordance with section 142L of the Sen‐ tencing Act 2002, on the ground set out in section 77(1)(a) of the Criminal Pro‐ ceeds (Recovery) Act 2009.
If the court is satisfied, following a hearing under section 142K of the Sentencing Act 2002, that the applicant has established on the balance of probabilities that the applicant has an interest in the following property to which the instrument forfeiture order relates, namely, [specify the property and the applicant’s interest, including whether the interest is severable and, if it is not, its value], and was not involved in the qualifying instrument forfeiture offence to which the instrument forfeiture order relates, the applicant will seek an order— (a) declaring that [applicant’s full name]’s interest in the property is as fol‐ lows: [specify the nature, extent, and value of the interest]; and (b) For this paragraph select the statement that applies.
Statement (i) 67 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 directing the Crown to transfer that interest to [applicant’s full name]: Statement (ii) declaring that there is payable by the Crown to [applicant’s full name] [an amount equal to the value of the interest declared by the court]: Statement (iii) directing that the interest not be included in any instrument forfeiture order made in respect of the proceedings that gave rise to this applica‐ tion: [specify the property and/or the severable interest in that property that is not to be included in the instrument forfeiture order]: Statement (iv) determining, in accordance with section 142N, not to make an instru‐ ment forfeiture order.
Statement B This application for relief is made, in accordance with section 142M of the Sentencing Act 2002, on the ground (of undue hardship) set out in section 77(1)(b) of the Criminal Proceeds (Recovery) Act 2009.
If, following a hearing under section 142K of the Sentencing Act 2002, the court is satisfied that, hav‐ ing regard to all the circumstances, undue hardship is reasonably likely to be caused to [full name of applicant or of another person (other than the offender)] by the operation of an instrument forfeiture order if relief is not granted, the applicant will seek— (a) an order that [full name] is entitled to be paid $[amount] out of the pro‐ ceeds of sale of the property: (b) Omit this paragraph if it does not apply.
[specify any additional orders made for the purpose of ensuring the proper application of an amount to be paid to a person under the age of 18 years].

3 The application is also made in reliance on [specify any other enactment, prin‐ ciple of law, or judicial decision relied on].

Date: Signature: (solicitor for applicant/counsel for applicant/applicant*) *Select one.

This application is filed by [name of applicant if filing in person, or name of solicitor or counsel representing applicant].
Address for service: [address].

68 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Schedule form 24: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
69 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 25 List of persons served with notice of application for relief from instrument forfeiture order Section 142J(4), Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To the Registrar and To [full name] (the prosecutor) Notice of [full name]’s application for an order for relief from an instrument forfeiture order has been served on the following persons: [specify persons, and whether (and, if so, why) served in accordance with section 142J(3)].

Date: Signature: (solicitor for applicant/counsel for applicant/applicant*) *Select one.
Schedule form 25: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

70 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Form 26 Order for relief from instrument forfeiture order Sections 142L and 142M, Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To [full name] (the applicant) and To [full name] (the prosecutor) and To [full name] (the offender) and To the Commissioner and To the Official Assignee and *To [every other person who has given an address for service, or who is named in the notice given to the court under section 142B of the Sentencing Act 2002, or who is or may be affected by the order, or who the court directs is to be served] *Omit if it does not apply.
1 2 The application for an order for relief from an instrument forfeiture order made by [full name] on [date] was determined by the Honourable Justice/Judge* [name] on [date].

*Select one.
*Select one.

That application was determined, as required by section 142K of the Sentenc‐ ing Act 2002, following a hearing concerning the instrument forfeiture order or a sentencing hearing held on [date(s)] at which the following people appeared: [List names of counsel or solicitors who represented the respective parties at the hearing and state whether any party appeared in person at the hearing.]

3 For this paragraph select the statement that applies.
Statement A The application was made, in accordance with section 142L of the Sentencing Act 2002, on the ground set out in section 77(1)(a) of the Criminal Proceeds (Recovery) Act 2009.
The court was satisfied that the applicant established on the balance of probabilities that the applicant has an interest in the following property to which the instrument forfeiture order relates, namely, [specify the property and the applicant’s interest, including whether the interest is severable and, if it is not, its value], and was not involved in the qualifying instrument forfeiture offence to which the instrument forfeiture order relates.
The court 71 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 therefore made the following order for relief from the instrument forfeiture order: (a) [applicant’s full name]’s interest in the property is as follows: [specify the nature, extent, and value of the interest]; and (b) For this paragraph select the statement that applies.
Statement (i) the Crown is directed to transfer that interest to [applicant’s name]: Statement (ii) there is payable by the Crown to [applicant’s name] [an amount equal to the value of the interest declared by the court]: Statement (iii) the interest must not be included in any instrument forfeiture order made in respect of the proceedings that gave rise to this application: [specify the property and/or the severable interest in that property that is not to be included in the instrument forfeiture order]: Statement (iv) the court has determined, in accordance with section 142N of the Sen‐ tencing Act 2002, not to make an instrument forfeiture order.
Statement B The application was made, in accordance with section 142M of the Sentencing Act 2002, on the ground (of undue hardship) set out in section 77(1)(b) of the Criminal Proceeds (Recovery) Act 2009.

The court was satisfied that, having regard to all the circumstances, undue hardship was reasonably likely to be caused to [full name of applicant or of another person (other than the offender)] by the operation of an instrument forfeiture order if relief was not granted.
The court therefore made the following order(s) granting relief from the instrument forfeiture order: (a) an order that [full name] is entitled to be paid $[amount] out of the pro‐ ceeds of sale of the property: (b) Omit this paragraph if it does not apply.

[specify any additional orders made for the purpose of ensuring the proper application of an amount to be paid to a person under the age of 18 years].
72 Sentencing Regulations 2002 Schedule Version as at 16 August 2022 Date: Signature: (Registrar/Deputy Registrar*) *Select one.

Sealed: [date] Schedule form 26: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).
73 Schedule Sentencing Regulations 2002 Version as at 16 August 2022 Form 27 Notice of application for leave to apply out of time for relief from instrument forfeiture order Section 142J(2)(c)(iii), Sentencing Act 2002 Complete and insert the heading as set out in form 13.
To the Registrar and To [full name] (the prosecutor) and To [full name] (the offender) and To the Commissioner and To the Official Assignee and *To [every other person who has given an address for service, or who is named in the notice given to the court under section 142B of the Sentencing Act 2002, or who is or may be affected by the order, or who the court directs is to be served] *Omit if it does not apply.
This document notifies you that— 1 2 [Full name] will on [date] apply to the court under section 142J(2)(c)(iii) of the Sentencing Act 2002 for leave to apply out of time for relief from an instru‐ ment forfeiture order.

The grounds on which the application is to be made are: [specify].

Date: Signature: (solicitor for applicant/counsel for applicant/applicant*) *Select one.
This notice of application is filed by [full name of applicant if filing in person, or name of solicitor or counsel representing applicant].

Address for service: [address].

Schedule form 27: added, on 1 December 2009, by regulation 5 of the Sentencing (Instrument Forfei‐ ture Orders) Amendment Regulations 2009 (SR 2009/315).

74 Version as at 16 August 2022 Sentencing Regulations 2002 Schedule Marie Shroff, Clerk of the Executive Council.

Issued under the authority of the Legislation Act 2019.
Date of notification in Gazette: 20 June 2002.

75 Sentencing Regulations 2002 Version as at 16 August 2022 Notes Notes 1 General This is a consolidation of the Sentencing Regulations 2002 that incorporates the amendments made to the legislation so that it shows the law as at its stated date.

2 Legal status A consolidation is taken to correctly state, as at its stated date, the law enacted or made by the legislation consolidated and by the amendments.
This presump‐ tion applies unless the contrary is shown.

Section 78 of the Legislation Act 2019 provides that this consolidation, pub‐ lished as an electronic version, is an official version.

A printed version of legis‐ lation that is produced directly from this official electronic version is also an official version.
3 Editorial and format changes The Parliamentary Counsel Office makes editorial and format changes to con‐ solidations using the powers under subpart 2 of Part 3 of the Legislation Act 2019.

See also PCO editorial conventions for consolidations.
4 Amendments incorporated in this consolidation Three Strikes Legislation Repeal Act 2022 (2022 No 40): sections 33, 34 Sentencing (Family Violence) Amendment Regulations 2019 (LI 2019/98) Enhancing Identity Verification and Border Processes Legislation Act 2017 (2017 No 42): section 66 Sentencing Amendment Regulations 2013 (SR 2013/491) Summary Proceedings Amendment Regulations 2013 (SR 2013/183): regulation 15 Sentencing Amendment Regulations 2012 (SR 2012/132) Sentencing Amendment Regulations (No 2) 2010 (SR 2010/207) Sentencing Amendment Regulations 2010 (SR 2010/123) Sentencing Amendment Regulations 2009 (SR 2009/360) Sentencing (Instrument Forfeiture Orders) Amendment Regulations 2009 (SR 2009/315) Policing Act 2008 (2008 No 72): section 116(a)(ii) Sentencing Amendment Regulations 2007 (SR 2007/255) Wellington, New Zealand: Published under the authority of the New Zealand Government—2022 76