41. The back of the pages or the data on the corresponding page screens of the return document in the statement of offence must contain at least the headings, key words, texts and spaces allowing the following particulars to be entered:(1) the defendant’s plea of not guilty;
(2) the defendant’s name, address and signature or, as the case may be, his signature affixed electronically or the validation code for his signature so affixed;
(3) the date on which the plea is signed;
(4) the make and model of the vehicle and the vehicle’s registration number;
(5) the place where the defendant must transmit the plea and the deadline by which he must transmit it to the place indicated;
(6) (paragraph revoked); and
(7) depending on the type of payment required, one or more of the following:(a) a box where a cashier’s stamp may be affixed attesting that a payment has been received;
(b) a payment receipt form;
(c) a record or an attestation of an electronic transaction; and
(d) the reference to the document attesting to the receipt of a payment.