CR Form 5.01 (Rule 5.01)
In the Supreme Court of Newfoundland and Labrador
Trial Division (General)
Court File No. _____________________CR
In the Supreme Court of Newfoundland and Labrador, Trial Division (General)
CR FORM 5.01
Supreme Court File #:__________________CR
BETWEEN:
HER MAJESTY THE QUEEN v. ____________________________________________
(name of accused)
DESIGNATION OF COUNSEL
Under section 650.01 of the Criminal Code, I, ________________________________, hereby
(name of accused)
appoint: (check and complete only those that apply)

the law firm of ____________________________________________________;

__________________________________________________, my lawyer;

any other lawyer who acts as an agent so long as he or she is specifically
instructed to do so by either the law firm or the lawyer named above,
(name of law firm)
(name of the accused’s lawyer)
to represent me in connection with the proceedings relating to charges of:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
which occurred on or about ___________________________ .
(date of offence)
I designate my counsel (or counsel acting on his/her behalf) to appear on my behalf: (choose one)

at all proceedings where my attendance is not required by law or the direction of a
judge of the Supreme Court of Newfoundland and Labrador, Trial Division
(General).
OR

on the following date(s): _____________________________________.
I undertake to remain in communication with my appointed counsel and to appear before
the court on any date requested by the court, and I agree that notice of such date to my
counsel is notice to me of that date.
My current address is ____________________________________________________________
Criminal Proceedings Forms
Page 1 of 2
Form Last Updated: Friday, October 1, 2010
CR Form 5.01 (Rule 5.01)
In the Supreme Court of Newfoundland and Labrador
Trial Division (General)
Court File No. _____________________CR
and my telephone number is _______________________________. I undertake to advise my
appointed counsel if I change either my address or telephone number.
DATED this ________ day of _________________________, 20___.
_______________________________________
(signature of accused)
Address: _______________________________
_______________________________________
Tel: ___________________________________
Fax: __________________________________
I, ____________________________________________, a barrister and solicitor, hereby accept
the appointment of ____________________________________as his/her counsel of record, to
fully represent the accused’s interests, in the absence of the accused, in relation to the charges
identified above.
I undertake to fully instruct any other lawyer who may appear in my place in accordance
with this designation in relation to all matters in this proceeding to which the appearance
relates.
DATED this ________ day of _________________________, 20___.
_______________________________________
(signature of counsel)
Address: _______________________________
_______________________________________
Tel: ___________________________________
Fax: __________________________________
Criminal Proceedings Forms
Page 2 of 2
Form Last Updated: Friday, October 1, 2010