ILLUSTRATIVE EXAMPLE – NOT LEGAL ADVICE.
Adapt to your force / legal services and the current Home Office statutory guidance before use. Source: Thinking About Policing.

COMMUNITY PROTECTION NOTICE
Anti-social Behaviour, Crime and Policing Act 2014, section 43

To: [full name and address]
Date: [date]
Issued by: [name, role, authorising organisation]

The grounds
I am satisfied on reasonable grounds that your conduct – namely [describe conduct] – is having a detrimental effect, of a persistent or continuing nature, on the quality of life of those in the locality, and that the conduct is unreasonable. A written warning was issued to you on [date]. Despite having had a reasonable opportunity to deal with the matter, your conduct is still having that effect.

What this notice requires
This notice requires you to:
	(a) stop [specified behaviour];
	(b) do [specified thing(s)] by [date];
	(c) take the following reasonable step(s) to achieve specified results: [step(s)].

Time for compliance
You must comply by [time/date].

Your right to appeal
You may appeal against this notice to the magistrates' court within 21 days of being issued with it, on the grounds set out in section 46 of the Act.

If you do not comply
Failing to comply with this notice without reasonable excuse is a criminal offence. You may be issued a fixed penalty notice of up to £100, or prosecuted and fined up to £2,500 (up to £20,000 for an organisation). The court may also make a remedial or forfeiture order.

Signed: [name / collar number]	Contact: [details]