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Any additional remarks : Entries checked with warrant Dated Superintendent Jail _____ Jail, ______. HARYANA GOVT. GAZ. (EXTRA.), APR. 11, 2022 (CHTR. 21, 1944 SAKA) 95 FORM B [see section 12(7)] Warrant for the temporary release of prisoners Whereas prisoner (Number, Name, Father’s Name and Address) at present confined in ____ Jail, ____ under warrant dated ____ (date of conviction) of _____(name of sentencing court) has applied for his temporary release under section 3 or 4 or 5 of the Haryana Good Conduct Prisoners (Temporary Release) Act, 2022; And whereas the releasing authority is satisfied that the applicant is entitled to be released under the Act; Now, therefore, Releasing Authority hereby authorise the temporary release of the said prisoner from custody on emergency parole/regular parole/furlough for a period of _______ (period of release) subject to the conditions specified below:– (1) The prisoner shall during the period of his temporary release reside at ______ (complete address). He shall not without obtaining the prior permission of the District Magistrate visit any place not specified in the release warrant during the said period. (2) At the time of his release on emergency parole/regular parole/furlough, the prisoner shall give to the District Magistrate _______ full particulars of the place where he intends to reside during the period of his temporary release and shall keep the District Magistrate informed of any subsequent changes of his residence during the said period. (3) The prisoner shall during the period of temporary release keep peace and maintain good behavior. (4) After the expiry of the said period of _____ (period of release) for which the prisoner has been temporary released on emergency parole/regular parole/furlough, the said prisoner shall surrender himself to the Superintendent Jail from which he is so released to undergo the unexpired period if his sentence. (5) The prisoner shall before his release on emergency parole/regular parole/furlough furnish to the satisfaction of the District Magistrate, _______, a personal bond and _____ (number of sureties) in the sum of Rs. __________________ (Rupees______________) (in words) each for faithful observance of the conditions specified in the release warrant. (6) When the surety furnished becomes insolvent or dies, the State Government may order the prisoner to furnish fresh surety immediately and if such surety is not furnished, the State Government may proceed as if there had been a non-compliance of the conditions of this order. (7) In addition to the action under sub-sections (2) and (3) of section 9 and section 10 of this Act, the amount of bond shall stand forfeited to the State Government in case any condition of the bond is not fulfilled. Given under my hand this ________ day of _______________ SEAL Signature of the Releasing Authority Endst. No. Dated A copy is forwarded to :- (1) The Superintendent Jail, _______________ Jail _____________ for necessary action. (2) The District Magistrate,_______________ for execution and necessary action. (3) The Superintendent of Police, _____ with the direction to keep a close watch on the activities of the said prisoner during the temporary release. Signature of the Releasing Authority I _________________________ son of ____________________ hereby acknowledge receipt of the above warrant and understand the conditions specified in the above warrant of release and I accept them. Signature and thumb impression of the Prisoner. 96 HARYANA GOVT. GAZ. (EXTRA.), APR. 11, 2022 (CHTR. 21, 1944 SAKA) FORM C [see section 12(8)] Personal Bond of the Prisoner In the Court of the District Magistrate, _____________________________________________ This bond is made on the _______________________ by __________________________ (Number, Name, Father’s Name and Address of the Prisoner). Whereas the Releasing Authority is pleased to order my release on emergency parole/regular parole/furlough for a period of _____________ (period of release) under section 3 or 4 or 5 of the Haryana Good Conduct Prisoners (Temporary Release) Act, 2022, on conditions of my furnishing a personal bond and a surety bond, each for a sum of Rs.__________________ to observe the condition specified below. Now, therefore, I do hereby bind myself to faithfully observe all the conditions mentioned here below and in case of my making default in observing any of them, I bind myself to forfeit the State Government the sum of Rs.___________________ . (1) I shall during the period of my temporary release reside at _________________________________ (complete address) and shall not without obtaining the permission of the District Magistrate, ______________, visit any place not specified in the release warrant. (2) I shall during the period of my temporary release keep peace and maintain good behavior. (3) After the expiry of the period of _______________________ (period of release) for which I have been temporarily released, I shall surrender myself to the Superintendent Jail, _____________ Jail, ___________________ to undergo the unexpired period of my sentence. (4) In case my sureties becomes insolvent or dies, I shall furnish fresh security immediately. Signature and thumb impression of the Prisoner Accepted for and on behalf of the Releasing Authority. HARYANA GOVT. GAZ. (EXTRA.), APR. 11, 2022 (CHTR. 21, 1944 SAKA) 97 FORM D [see section 12(8)] Surety Bond In the Court of the District Magistrate, ______________ This Bond is made on the __________________________ by __________________________________ (1st surety) and _______________________________ (2nd Surety) (hereinafter collectively referred to as the “Sureties”). (Number of sureties as decided by the releasing authority); Whereas the releasing authority is pleased to order the release of ________(Number, Name, Father’s Name and address of the prisoner) (hereinafter referred to as the “prisoner”) on emergency parole/regular parole/furlough for a period of ________ Weeks) under section 3 or 4 or 5 of the Haryana Good Conduct Prisoners (Temporary Release) Act, 2022, on the condition of the prisoner furnishing a bond as well as a surety bond each for the sum of Rs. ____________________ to observe the conditions on which the prisoner has been temporarily released; And whereas the prisoner has on _________ (date of execution of personal bond of the prisoner) executed a personal bond for the sum of Rs.____________________ to observe the conditions specified therein. Now, therefore, the sureties jointly and severally do hereby bind themselves to forfeit to State Government the sum of Rs. __________________ in case the prisoner makes a default in observing any of the conditions specified in the warrant for temporary release. Signature of the First Surety. Signature of the Second Surety. Accepted for and on behalf of the Releasing Authority 98 HARYANA GOVT. GAZ. (EXTRA.), APR. 11, 2022 (CHTR. 21, 1944 SAKA) FORM E [see section 12(9)] Certificate of conditional release In exercise of the powers conferred by section 3/4/5 of the Haryana Good Conduct Prisoners (Temporary Release) Act, 2022, the Releasing Authority, subject to conditions hereinafter setforth, hereby directs the release of prisoner ______ (Number, Name, Father’s Name and Address of the prisoner), at present confined in _____, Jail, ________, for _______ (period of release) in pursuance of warrant, dated _______ (date of warrant of Releasing Authority). He has been permitted to visit the below noted places following the specified route:- Proceed from _________ Jail,_____, to __________ (full address) Return from ______ (full address) to ______ Jail,________ Conditions to be observed by the released prisoner:-