| (Section 3) |
| Licence |
| Saint Lucia. |
| I, ........................................ Governor General of Saint Lucia and its Dependencies, in exercise of the powers in this behalf in me vested, do hereby grant to ........................................ who was convicted of ........................................ at the High Court on the ..................... day of ........................................ 20 ..................., and was then and there sentenced to be kept to ........................................ imprisonment (or penal servitude) and is now confined in the Bordelais Correctional Facility, This My Licence to be at large from the day of liberation under this my Order during the remaining portion of the said term of imprisonment, unless the said ........................................ shall, before the expiration of the said term, be convicted of some indictable offence within Saint Lucia, in which case this licence will be immediately forfeited by law, or unless the licence shall be revoked by me in accordance with the provisions of the Convicts Licence Act. |
| This Licence is given subject to the conditions endorsed below, and upon the breach of any such conditions, this licence will be liable to be revoked, whether such breach is followed by a conviction or not. |
| And I, the said Governor General, do hereby order that the said ........................................ be set at liberty within ........................................ days from the date of this my Order. |
| Given under my hand, at the Governor General's Office in Saint Lucia, this ..................... day of ........................................ 20 ..................... |
| ............................................ |
| Governor General. |