Version 1

Form 32

QUEENSLAND

Corrective Services Act 2006(ss. 176, 187 and 194)

EXCEPTIONAL CIRCUMSTANCES PAROLE ORDER

[Name of Board]Parole Board (the Board)

Prisoner: / [name of prisoner]
Date of Birth: / [insert DOB] / Identification Number: [insert ID number]

The abovementioned prisoner was convicted of [offence/s] at [location of convicting court] on [date of conviction]andsentenced to a term/period of [years or months]imprisonment.

The Board, being satisfied that exceptional circumstances exist, directs that the prisonerbe granted exceptional circumstances parole on [date of release].

The prisoner's release is subject to the following conditions, that the prisoner—

a)be under the supervision of the Queensland Corrective Services-

  1. until the end of the prisoner’s period of imprisonment; or
  2. if the prisoner is being detained in an institution for a period fixed by a judge under the Criminal Law Amendment Act 1945, part 3- for the period the prisoner was directed to be detained; and

b)report to his or her supervising probation and parole office immediately after release unless otherwise directed by a corrective services officer in writing;

c)shall be under the supervision of a corrective services officer assigned from time to time in respect of the parole period;

d)carry out the lawful instructions of a corrective servicesofficer;

e)to give a test sample as directed by a corrective services officer;

f)report to and receive visits as directed by a corrective servicesofficer;

g)notify a corrective services officer within 48 hours of any change of address or employment during the parole period;

h)not commit an offence;

i)shall not leave or remain out of the State unless permitted to do so under the terms and conditions of a permit in writing of the board or of the chief executive;

j)not take preparatory steps to breach, or otherwise evidence an intention to breach, this order;

k)sign the declaration contained in this order;

l)secure employment as directed by a corrective servicesofficer;

m)attend courses, programs, meetings, counselling, and any other activity at such places and times as directed by a corrective servicesofficer;

n)comply with the conditions included in this order; and

o)+ other conditions considered reasonably necessary tosecure the prisoner's good conduct orstop the prisoner committing an offence, namely—

(i)[insert other conditions as per above];

(ii)[insert other conditions as per above]; and

(iii)[insert other conditions as per above].

Unless otherwise determined by the board this order will expire on[date order due to expire].

Signature: ______

Secretary

Date:

I,[prisoner's name] , the abovementioned prisoner declare that I thoroughly understand and will comply withthe conditions of this parole order.

Dated at …………...... this …………...... day of ……...... 20

Signature: ______