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C-25.1, r. 1 - Regulation respecting the form of statements of offence
Schedule
Disposition versions
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or officers is required to sign. “Director” means the president, chief executive officer, chief operating officer, chief financial officer or secretary of the legal person or a person holding a similar position at that legal person. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
In accordance with section 8.1 of the Code of Penal Procedure (chapter C-25.1), from each contribution collected, the first $10 shall be credited to the fund dedicated to assistance for persons who are victims of criminal offences established under the Act to assist persons who are victims of criminal offences and to facilitate their recovery (chapter P-9.2.1), and the following $8 shall be credited to the Access to Justice Fund established under the Act respecting the Ministère de la Justice (chapter M-19).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
A defendant who transmits the whole amount of the fine and costs requested without entering a plea is deemed to have transmitted a plea of guilty.
A defendant who transmits the total amount of the fine and costs requested after having entered a plea of not guilty and before the trial is deemed to have transmitted a plea of guilty.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
| Information |
DEFENDANT
CASHIER’S STAMP
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or officers is required to sign. “Director” means the president, chief executive officer, chief operating officer, chief financial officer or secretary of the legal person or a person holding a similar position at that legal person. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
In accordance with section 8.1 of the Code of Penal Procedure (chapter C-25.1), from each contribution collected, the first $10 shall be credited to the Crime Victims Assistance Fund established under the Act respecting assistance for victims of crime (chapter A-13.2), and the following $8 shall be credited to the Access to Justice Fund established under the Act respecting the Ministère de la Justice (chapter M-19).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
A defendant who transmits the whole amount of the fine and costs requested without entering a plea is deemed to have transmitted a plea of guilty.
A defendant who transmits the total amount of the fine and costs requested after having entered a plea of not guilty and before the trial is deemed to have transmitted a plea of guilty.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
| Information |
DEFENDANT
CASHIER’S STAMP
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or other officers is required to sign. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
In accordance with section 8.1 of the Code of Penal Procedure (chapter C-25.1), from each contribution collected, the first $10 shall be credited to the Crime Victims Assistance Fund established under the Act respecting assistance for victims of crime (chapter A-13.2), and the following $8 shall be credited to the Access to Justice Fund established under the Act respecting the Ministère de la Justice (chapter M-19).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
A defendant who transmits the total amount of the fine and costs requested after having entered a plea of not guilty and before the trial is deemed to have transmitted a plea of guilty.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make, together with your plea of not guilty, the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
_________________________________________________________________________________
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| Information |
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|_________________________________________________________________________________|
DEFENDANT
CASHIER’S STAMP
___________________________
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|___________________________|
___________________________
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|___________________________|
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or other officers is required to sign. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
In accordance with section 8.1 of the Code of Penal Procedure (chapter C-25.1), from each contribution collected, the first $10 shall be credited to the Crime Victims Assistance Fund established under the Act respecting assistance for victims of crime (chapter A-13.2), and the following $8 shall be credited to the Access to Justice Fund established under the Act respecting the Ministère de la Justice (chapter M-19).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make, together with your plea of not guilty, the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
_________________________________________________________________________________
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| Information |
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|_________________________________________________________________________________|
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| Information |
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|_________________________________________________________________________________|
DEFENDANT
RETURN FORM
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
CASHIER’S STAMP
___________________________
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|___________________________|
___________________________
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|___________________________|
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or other officers is required to sign. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
The amount of the contribution provided for in article 8.1 of the Code of Penal Procedure (chapter C-25.1) is, in a proportion of 10/14, used to provide assistance to victims of crime and, in a proportion of 4/14, credited to the Access to Justice Fund established under the Act respecting the Ministère de la Justice (chapter M-19).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make, together with your plea of not guilty, the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
_________________________________________________________________________________
| |
| Information |
| |
| |
|_________________________________________________________________________________|
| |
| Information |
| |
| |
|_________________________________________________________________________________|
DEFENDANT
RETURN FORM
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
CASHIER’S STAMP
___________________________
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|___________________________|
___________________________
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|___________________________|
SCHEDULE II
(s. 23, 1st par., subpar. 2)
STATEMENT OF OFFENCE
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
Judicial district
Court office: record No.
Prosecutor
A Defendant
1- Mr.
2- Mrs.
3- Legal person
Surname
Given name(s)
Address Apt.
Locality
Province/State Postal code Minor Date of birth (Y-M-D)
Confirmation of identity
B Offence
Statute/Regulation
Section Code
Description of offence
Date of offence (Y-M-D)
Time (H-M)
C Place
Place
Location Zone
D$
Sentence
Minimum sentence Costs Contribution Amount requested
$ + $ + $ = $
E
ATTESTATION
I, the undersigned, attest that I have personally observed the facts mentioned in
c A c B c C
and I have reasonable grounds to believe that the offence described in B has been committed.
Name (In block letters)
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
SERVICE
I remitted c when the offence was committed
c after the offence was committed
c to the defendant c to the driver
c in a conspicuous place on the vehicle
c otherwise:
Name (In block letters) c Same as attestation
Peace officer Officer’s number Unit
Person responsible for enforcement of the law Quality
c I did not remit a duplicate of the statement of offence
c I observed the facts and serviced a duplicate of the statement of offence Date of service Y-M-D Time (H-M)
(only one signature required below)
Signature Signature
*CR-88A (93-07)
DEFENDANT
STATEMENT OF OFFENCE
Penal proceedings are instituted by means of a statement of offence and commence at the time statement is served.
TRANSMISSION OF PLEA
You are required to enter a plea of guilty or not guilty within 30 days following the date of service indicated in the part entitled SERVICE in section E of the statement of offence or in the reference document identified in that same part of Section E.
If the defendant is a legal person, one of its directors or other officers is required to sign. The signatory must indicate his quality.
PLEA OF GUILTY AND PAYMENT
If you plead guilty to the offence alleged, use the return form attached hereto in order to:
· enter you plea, and
· pay (in Canadian funds) the total amount of the fine, the costs and the contribution.
The contribution is used to provide assistance to victims of crime under article 8.1 of the Code of Penal Procedure (c. C-25.1).
The plea and the payment may be transmitted to the address indicated on the return form or to ..........
Payment may be made by cheque or postal order made out to ..........
Unless the total amount of the fine, the costs and the contribution is transmitted together with this plea, additional costs may be imposed.
If the defendant transmits a plea of guilty, he is deemed to have been convicted of the offence.
PLEA OF NOT GUILTY
If you plead not guilty to the offence, enter your plea on the return form attached hereto. Your plea must be transmitted to the address indicated on the return form.
You will be notified by the clerk of the court of competent jurisdiction of the place, date and time fixed for trial of the proceeding.
FAILURE TO TRANSMIT A PLEA AND THE AMOUNT OF THE FINE AND COSTS
A defendant who does not transmit a plea or the whole amount of the fine and costs requested is deemed to have transmitted a plea of not guilty. In such a case, the proceeding will be tried and judgment rendered without further notice.
PRELIMINARY APPLICATIONS
To provide for your defence, you may make, together with your plea of not guilty, the preliminary applications provided for in articles 168 to 186 of the Code of Penal Procedure.
RIGHT TO COUNSEL
You have a right to counsel before transmitting a plea or making a preliminary application.
_________________________________________________________________________________
| |
| Information |
| |
| |
|_________________________________________________________________________________|
| |
| Information |
| |
| |
|_________________________________________________________________________________|
DEFENDANT
RETURN FORM
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
PLEA
IMPORTANT: CONCERNING THE CONSEQUENCES OF THIS PLEA, SEE BACK OF THE STATEMENT OF OFFENCE
TO THE INFRACTION DESCRIBED IN PART B OF THE STATEMENT OF OFFENCE
No. , I PLEAD:
c Guilty c Not guilty
(If you wish to provide explanations, write them below)
Signature Date Y-M-D
If address has changed indicate new address
Postal code
RETURN MAILING ADDRESS FOR PLEA AND ANY PAYMENT
REQUEST FOR SENTENCE
Minimum sentence Costs Contribution Amount requested
$+ $+ $= $
Sum paid $
Date de signature
Y M D
CASHIER’S STAMP
___________________________
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|___________________________|
___________________________
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