FORM 81A-Y
rule 81A.41(18)
File No: [file number]
ORDER RELEASING PERSON FROM CUSTODY
TO   THE OFFICER IN CHARGE OF/ SUPERINTENDENT OF
[DARWIN CORRECTIONAL CENTRE / ALICE SPRINGS CORRECTIONAL CENTRE / HOLTZE YOUTH DETENTION CENTRE / DON DALE YOUTH DETENTION CENTRE / OTHER]

I, Justice [name], a Judge of the Supreme Court of the Northern Territory of Australia
ORDER that [name of offender who is imprisoned/detained] be released from [Darwin Correctional Centre / Alice Springs Correctional Centre / Holtze Youth Detention Centre / Don Dale Youth Detention Centre / Other] on [date] [and subject to the following condition(s): [state conditions of release].]
Date: [date]
JUDGE