Here is a sample, based on an unlawful arrest at

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IN THE <convenient town/city> CROWN COURT
URN NUMBER
B E T W E E N:
REGINA
.v.
<DEFENDANT (CAPITALS)>
The Information
COUNT 1
STATEMENT OF OFFENCE
Common Assault contrary to The Common Law
PARTICULARS OF OFFENCE
On <date> you <DEFENDANT> unlawfully entered the home of <ACCUSER> at
<Accuser’s full address & Postcode> and threatened unlawful violence against the
occupants. You were on the property as a trespasser and threatened to smash down the
door. You threatened and used a battering ram to support your threat of violence. The
occupants were caused fear for their personal safety by your threats of unlawful
violence.
COUNT 2
STATEMENT OF OFFENCE
Misconduct in Public office contrary to The Common Law
PARTICULARS OF OFFENCE
On <date> you <DEFENDANT> wilfully failed to perform your duty to such a
degree that it amounted to an abuse of the public's trust which has been placed with
you. You were tasked to carry out enquires, and were offered by <ACCUSER> a
peaceful, honourable, equitable, and amicable method for assisting you in that respect.
However when lawfully refused actual entry to the home of <ACCUSER> you did
without lawful authority force an entry to this private home.
Once on the property you were informed on numerous occasions that you were a
trespasser and properly asked to leave. You ignored these demands and instead used
the threat of unlawful violence against the occupants of the property.
COUNT 3
STATEMENT OF OFFENCE
Kidnap contrary to The Common Law
PARTICULARS OF OFFENCE
On <date> you <DEFENDANT>, at the address known as <Accuser’s full address &
Postcode>, you <DEFENDANT> did with the assistance of <2ND DEFENDANT>
forcibly removed <ACCUSER> and carry him away, you had no lawful authority to
do so.
There was no consent from the victim and you used unlawful violence to carry out
this kidnap.
COUNT 4
STATEMENT OF OFFENCE
False Imprisonment contrary to The Common Law
PARTICULARS OF OFFENCE
On <date> you <DEFENDANT>, at the address known as <Accuser’s full address &
Postcode>, you <DEFENDANT> did with the assistance of <2ND DEFENDANT>
forcibly removed <ACCUSER> and did carry him away, in doing so you detained
him without lawful authority, thereby falsely imprisoning him.
A) Overview
The Informant is laying information for the purpose of seeking the “granting
of a process” for warrant of arrest (or in alternative) a summons. The
Informant for the purpose of this Private Prosecution is <NAME OF
INFORMANT>. The Defendants subject of the information laid is a/are
person(s) known as <NAME(s) OF DEFENDANT(s)>, hereinafter referred to
as the “Defendant(s)”.
The Defendant’s address is <FULL ADDRESS AND POSTCODE OF
DEFENDANT>. It is requested that any summons be sent to that address.
B) Legal framework
The Private Prosecution sought by the Informant satisfies the provisions of
section 6(1) Prosecution of Offences Act 1985 and is not a restricted
prosecution in that:
1. The offence alleged against the Defendant is not one where the consent of the
Attorney General is required
2. The offence is an indictable offence and therefore it is not time barred by
statute
3. The offence alleged against the Defendant is not an offence where the DPP
has a statutory duty over the conduct of the proceedings
4. The allegation constitutes an offence in English law and there is prima faci
grounds that the essential ingredients are present
5. The court has jurisdiction over the allegation subject of the information
6. The Informant is not statute barred to lay the information1
7. There is no impending prosecution by the CPS against the Defendant based
on the information subject of this prosecution.
8. The Courts have repeatedly emphasised that the discretion to refuse to
issue a summons must be sparingly exercised, and only if the prosecution
undermines the rule of law or is an affront to justice: for example, R v
Milton Keynes Magistrates’ Court, ex p Roberts [1995] Crim LR 224. There is
nothing in this information before the court to suggest that prosecuting any
Defendant will undermine the rule of law or be an affront to justice.
C) Background
<A ‘sketch’ of the background behind the request, with sufficient detail, and
in multiple paragraphs. (DO NOT LUMP IT ALL INTO ONE –
‘UNREADABLE’ – PARAGRAPH!>
The presentation of this Indictment is not a frivolous act on my part. <Give
reason for grievance>.
It may be considered that my request for Grant is considered “vexatious”. In
R v Durham Stipendiary Magistrates ex parte Davies (1993) The Times, May 25,
1993 the judgment was: “The fact that a private prosecutor is motivated by
personal hostility and obsessed with his case is insufficient reason to justify
a decision not to commit a defendant to trial”.
1
R V West London Justices, ex parte Klahn [1979] 2 ALL ER 221
Furthermore, there is a House of Lords ruling in Elman v Myers 1940: “An
order issued by any Judicial chair occupant who elects to ignore the evidence
or acts in contempt of the evidence presented to the judicial chair occupant;
amounts to a false instrument, which is abuse of office and leading to the
imposition of costs attached to the false instrument”
D) CONCLUSION
<Write why you think the Defendant(s) should be prosecuted. Again … create
muliple paragraphs as necessary>
The CPS threshold test2 is not a pre requisite to a Private Prosecution.
However, the fact that there is incontrovertible evidence in the form of the
various Witness Statements, is a clear indication that there is a realistic
prospect of conviction if this matter proceeds to Trial. In other words, whilst
this prosecution is brought privately, it is submitted that the CPS threshold
test is met in any event.
Information laid by:
<NAME OF INFORMANT>
<DATE>
Judge’s Signature: ______________________________________________
Dated: ______________________________________
2
Also known as the “Full Code Test”
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