of Commitment on a Sentence of Imprisonment or Fine If Passed by a Magistrate
sections 248 and 255 of Criminal Procedure Code)
the Officer in charge of the Jail at....................
on the day of, (name of prisoner), the (1st, 2nd, 3rd, as the case may be)
prisoner in case No. of the Calendar for 19, was convicted before me (name and
official designation) of the offence of (mention the offence or offences
concisely under section (or sections) of the Indian Penal Code (or of Act), and
was sentenced to (state the punishment fully and distinctly);
is to authorise and require you to receive the said (prisoner's name) into your
custody in the said Jail, together with this warrant, and thereby carry the
aforesaid sentence into execution according to law.
this ...........day of .........19.
of the Court) (Signature)