C-25.1, r. 2 - Regulation respecting the form of offence reports

À jour au 1^er septembre 2012

Ce document a valeur officielle.

chapter C-25.1, r. 2

Regulation respecting the form of offence reports

Code of Penal Procedure

(chapter C-25.1, art. 367, par. 1).

CHAPTER I METHODS OF GENERATING AN OFFENCE REPORT

DIVISION I GENERAL

1. The purpose of this Regulation is to establish the form of offence reports, whether on paper or electronically-generated.

In addition, it is also intended to ensure that the paper and electronic forms of an offence report are interchangeable, to allow the concomitant use of either form, and to establish that the computer data that constitute the report in electronic form have the same legal force as the report in paper form.

O.C. 1210-97, s. 1.

2. This Regulation governs the form of an offence report, where it is used to disclose or to adduce evidence in a penal proceeding or where it is conserved and filed in the court record.

O.C. 1210-97, s. 2.

3. The expression “offence report” refers to the document in paper or electronic form comprised of the offence report form and the particulars that may be recorded therein.

An offence report may comprise as many pages as necessary to enable the persons responsible for enforcing the law or peace officers to describe the relevant facts that they have observed.

O.C. 1210-97, s. 3.

4. An offence report is a document containing headings, key words, pre-printed or pre-programmed texts and spaces allowing the optional or compulsory particulars prescribed by this Regulation relative to the penal proceeding to be entered by hand, mechanically or by computer.

It may also contain computer codes, marks or particulars, either underlying or visible, that are specific to the electronic form or are designed to ensure the security of electronic data and documentation in penal matters.

O.C. 1210-97, s. 4.

5. An offence report may be generated in paper form or in electronic form. It may also be drawn up in paper form, then transferred into electronic form by means of digitization, and may then be converted into hard copy.

Thus an offence report may be in paper form, either originally or after conversion from electronic form into hard copy; an offence report may also be in electronic form, either originally or after digitization from the paper form.

O.C. 1210-97, s. 5.

6. Where the offence report is originally generated in electronic form, or transferred into electronic form by means of digitization, the computer data that make it possible to display the report or convert into hard copy the report and the particulars recorded therein, have the same force as an original, if the report meets the standards provided for in this Regulation.

The computer data have the same force as an original during electronic transfer, transmission, consultation, use, storage and archiving in electronic form or by electronic means, if they meet the standards provided for in this Regulation. The foregoing also applies to computer data comprising the digitized offence report, whether the form or particulars comprising it were digitized simultaneously or separately.

Where an offence report generated in electronic form is converted into hard copy on a pre-printed or pre-programmed form, the hard-copy offence report has the same force as an original. In addition, where a digitized offence report is converted into hard copy, the hard-copy offence report stands in lieu of the original.

O.C. 1210-97, s. 6.

7. An offence report in paper form is composed of pages, whereas an offence report in electronic form is composed of computer data displayed on page screens.

The form and the particulars displayed on the page screens in an offence report may be electronically attached or referenced. However, the page screens in an offence report or the sections they contain shall be intelligible and shall be accessible on a display surface, either in whole or in part, sequentially or thematically.

O.C. 1210-97, s. 7.

8. An offence report originally generated in electronic form or transferred into such a form by means of digitization may remain in electronic form and be use used on a display surface, or be converted into hard copy on a pre-printed or pre-programmed offence report or, if digitized, on a page intended to reconstitute the report.

O.C. 1210-97, s. 8.

DIVISION II OFFENCE REPORTS ORIGINALLY IN PAPER FORM, IN ELECTRONIC FORM, DIGITIZED OR CONVERTED INTO HARD COPY

9. The general offence report provided for in subparagraph 1 of the first paragraph of section 16 and originally drawn up in paper form shall be on sheets measuring not less than 10 cm wide by 20 cm high nor more than 21.5 cm wide by 35.5 cm high.

The abridged offence report provided for in subparagraph 2 of the first paragraph of section 16 and originally drawn up in paper form shall be on detachable sheets of the same dimensions as the statement of offence to which it may be attached.

O.C. 1210-97, s. 9.

10. An offence report form may be pre-printed or pre-programmed. The type size of the printer of the printings press, as the case may be, shall be no smaller than 6 point.

The offence report made up of pages comprising computer data constitutes an offence report in paper form subject to the standards of this Division and must be signed by hand.

O.C. 1210-97, s. 10.

11. An offence report originally generated in electronic form is displayed on page screens containing computer data and corresponding to the form and the particulars contained in the pages of an offence report in paper form.

O.C. 1210-97, s. 11.

12. An offence report originally drawn up in paper form may be digitized. Furthermore, the form and the particulars contained in that offence report may be digitized either simultaneously or separately. In the latter case, the digitized offence report is composed of super-imposed page screens.

O.C. 1210-97, s. 12.

13. An offence report originally generated in electronic form and a digitized offence report may be converted into hard copy on sheets measuring not less than 9 cm wide by 20 cm high nor more than 21.5 cm wide by 35.5 cm high.

Where an offence report is converted into hard copy, it results from the combination of a virtual part and a material part. The virtual part is comprised of the particulars and the pre-programmed form contained in the offence report generated in electronic form; in case of digitization, the virtual part is comprised of the digitized form and particulars. The material part is comprised of the offence report form in paper form, which may be pre-printed or pre-programmed; in case of digitization, the material part is comprised of either a pre-printed or pre-programmed form or the reconstitution in paper form of the digitized form and particulars in the offence report.

O.C. 1210-97, s. 13.

14. The paper used to convert a report into hard copy shall be such that the report can be recognized as an original, either by use of paper of a special grain, or by means of a seal, an acronym, a code, a number, a mark or a distinctive indication.

O.C. 1210-97, s. 14.

15. The type size of the printer of the printing press, as the case may be, used to convert an offence report into hard copy shall be no smaller than 6 point.

O.C. 1210-97, s. 15.

CHAPTER II SPECIAL PROVISIONS

DIVISION I TYPES OF OFFENCE REPORTS

16. The two types of offence reports that may be used are the following:

(1)  a general offence report, a model for which appears in Schedule I, applies to all offences and may be adduced as evidence with any statement of offence referred to in the Regulation respecting the form of statements of offence (chapter C-25.1, r. 1); and

(2)  an abridged offence report, a model for which appears in Schedule II, applies to all offences and may be attached to the statement of offence referred to in subparagraph 2 of the first paragraph of section 23 of the Regulation respecting the form of statements of offence or to the statement of offence referred to in subparagraph 3 of the first paragraph of section 23 of that Regulation.

A model for the offence report bearing an attestation of hard-copy conversion appears in Schedule III.

O.C. 1210-97, s. 16.

DIVISION II GENERAL OFFENCE REPORT

17. The first page or the corresponding page screens in a general offence report shall comprise at least 7 sections containing the headings, key words, texts and spaces allowing the following particulars to be indicated:

(1)  in respect of the origin of the report:

(a)  the name of the department, public body, municipality or authority having jurisdiction over the peace officer or person responsible for enforcing the law who prepares the offence report;

(b)  the investigation file number of the department, public body, municipality or authority;

(c)  the name and address of the person responsible for the investigation; and

(d)  optionally, the event code number used for statistical purposes;

(2)  in respect of the defendant’s identity:

(a)  his or its name, address and telephone number;

(b)  whether the defendant is a legal or natural person and, in the latter case, whether male or female;

(c)  the type of document or file and the items in the document or file confirming his identity; and

(d)  optionally, his birthdate, his distinguishing features, his occupation or the type of activity carried out by the enterprise;

(3)  in respect of the offence in question:

(a)  the reference to the legislative provisions creating the offence to which the offence report pertains;

(b)  a description of the offence; and

(c)  the date and the time when the offence was committed;

(4)  in respect of the place where the offence was committed:

(a)  the place where the offence is alleged to have been committed;

(b)  the address and description of the place;

(c)  the location code, if relevant; and

(d)  the judicial district in which the place is located;

(5)  in respect of the property seized and related documents or events, in particular:

(a)  mention of the fact that property was seized, a description of the property and mention of the existence of a record of the seizure;

(b)  mention of the existence of any other document added to the offence report and, if that document is in electronic form, the computer codes, marks or particulars making it possible to locate the document electronically attached or referenced to the offence report;

(c)  the type of intervention by the peace officer or person responsible for enforcing the law; and

(d)  where applicable, the type of documents from which particulars were obtained;

(6)  in respect of the facts: both the relevant facts observed in regard to the essential aspects of the offence and the actions taken by the peace officer or person responsible for enforcing the law, who shall present them in one or more of the following ways, as appropriate for paper form or electronic form:

(a)  a lined space in which the facts are to be typed or written by hand, as provided for in model 1 in Schedule IV;

(b)  a blank space in which a statement of the facts may be typed or a graphic representation of a fact may be drawn, as provided for in model 2 in Schedule V;

(c)  pre-printed or pre-programmed texts within which blanks are provided for the purpose of entering the particular facts of the case, as provided for in model 3 in Schedule VI; and

(d)  multiple-choice pre-printed or pre-programmed texts describing the observable facts in respect of the offence to which the offence report pertains, among which a selection is to be made by checking off the appropriate boxes, as provided for in model 4 in Schedule VII; and

(7)  in respect of the attestation of the facts:

(a)  the attestation of the facts, with mention of the facts to which the attestation pertains;

(b)  the name, quality and signature of each person responsible for enforcing the law or each peace officer who attests to those facts or, as the case may be, their respective signatures affixed electronically or the validation code for their signatures so affixed, and the peace officer’s number; and

(c)  the date and, where the signature is affixed electronically, the time when the attestation is signed.

O.C. 1210-97, s. 17.

18. Where a general offence report originally generated in electronic form is converted into hard copy, the hard-copy page of the offence report shall also contain the following particulars:

(1)  in the section concerning the conversion of the report into hard copy:

(a)  the attestation of hard-copy conversion;

(b)  the name and quality of the person attesting to the hard-copy conversion, and the date and exact time of conversion; and

(c)  the signature of the person attesting to the hard-copy conversion or, as the case may be, his signature affixed electronically or the validation code for his signature so affixed;

(2)  the computer codes, marks or particulars making it possible to locate the documents electronically attached or referenced to the offence report; and

(3)  the computer codes, marks or particulars making it possible to ensure the security of the data contained in the offence report.

O.C. 1210-97, s. 18.

DIVISION III ABRIDGED OFFENCE REPORT

19. The first page or the corresponding page screens in an abridged offence report shall comprise at least 3 sections containing the headings, key words, texts and spaces allowing the following particulars to be indicated:

(1)  in respect of the origin of the report:

(a)  the number of the statement of offence to which it may be attached;

(b)  the investigation file number of the department, public body, municipality or authority having jurisdiction over the peace officer or person responsible for enforcing the law who prepares the offence report; and

(c)  optionally, the event code number used for statistical purposes;

(2)  in respect of the facts: both the relevant facts observed in regard to the essential aspects of the offence and the actions taken by the peace officer or person responsible for enforcing the law, who shall present them in one or more of the ways provided for in paragraph 6 of section 17; and

(3)  in respect of the attestation of the facts, the particulars provided for in paragraph 7 of section 17.

Where an abridged offence report originally generated in electronic form is converted into hard copy, the hard-copy page of the offence report shall also contain the particulars provided for in section 18.

O.C. 1210-97, s. 19.

DIVISION IV SUPPLEMENT TO AN OFFENCE REPORT

20. Each additional page in an offence report originally drawn up in paper form shall allow at least the following particulars to be indicated:

(1)  in the section concerning the origin:

(a)  the origin of the offence report, that is, the name and address of the department, public body, municipality or authority having jurisdiction over the peace officer or person responsible for enforcing the law who prepares the offence report; and

(b)  the investigation file number of the department, public body, municipality or authority;

(2)  in the section concerning the facts:

(a)  a selection of texts, one of which is to be checked off in order to indicate that the facts are:

— the continuation of the statement on the first page of the report;

— an additional statement by peace officers or persons who did not report facts on the first page; and

— the continuation of the additional statement; and

(b)  the description of the facts, which shall be presented in one or more of the ways provided for in paragraph 6 of section 17; and

(3)  in the section concerning the attestation of the facts:

(a)  the attestation of the facts, with mention of the facts to which the attestation pertains;

(b)  the name, quality and signature of each person responsible for enforcing the law or each peace officer who attests to those facts or their respective signatures affixed electronically or the validation code for their signatures so affixed, and the peace officer’s number; and

(c)  the date and, where the signature is affixed electronically, the time when the attestation is signed.

O.C. 1210-97, s. 20.

21. Where the offence report is originally generated in electronic form, it requires additional pages only if it is converted into hard copy. In such case, each additional page shall reproduce the sections provided for in section 20 and shall contain the particulars provided for in section 18.

Notwithstanding the foregoing, the section provided for in paragraph 3 of section 20 shall allow a signature affixed electronically or the validation code for a signature so affixed to be entered therein. That signature shall be affixed at the end of the statement of the facts by the person who observed them and shall be reproduced on each of the additional pages in the hard-copy offence report containing the statement made by that person.

A model for a supplement to an offence report bearing an attestation of hard-copy conversion appears in Schedule VIII.

O.C. 1210-97, s. 21.

CHAPTER III TRANSITIONAL AND FINAL PROVISIONS

22. Offence report forms pre-printed in accordance with the provisions of the Regulation respecting the form of offence reports (O.C. 1411-93, 93-10-06) may continue to be used to generate offence reports originally in paper form.

O.C. 1210-97, s. 22.

23. This Regulation replaces the Regulation respecting the form of offence reports (O.C. 1411-93, 93-10-06).

O.C. 1210-97, s. 23.

24. (Omitted).

O.C. 1210-97, s. 24.

SCHEDULE I

(s. 16, 1st par., subpar. 1)

GENERAL OFFENCE REPORT

General Offence Report
(Code of Penal Procedure)
(a. 367, par. 1)

ORIGIN
Department, municipality, public body or other authority	Record No.
Name and address of person responsible		Event code

A DEFENDANT
Surname, given name or legal person	Date of birth (Y-M-D)	Minor c	c F	c H
Height m	Weight kg	Eyes	Hair	Other features
Address (No., street, apt., citym province)					Postal code
Telephone (residence)			Telephone (work)	Occupation of person or activity of enterprise
Identification paper 		cPermit	c Licence	No.	Social insurance No.
		c Certificate	c Other

B OFFENCE
Date and time of offence (Y-M-D) (H-M)				Title of Statute or Regulation
chapter or regulation			Section No.	Description of offence

C PLACE OF OFFENCE
Place		Code		c Permit	c Licence
				c Certificate	c Other
Address (No., street, apt., city, province)				Municipal code	Judicial district
Description of the place

D PROPERTY SEIZED, RELATED DOCUMENTS OR EVENTS
c Property seized		Description
c Documents		Description				c Attached

E RELEVANT FACTS AND ACTIONS

					c Continued on another page

SIGNATURES
I have personally observed the facts mentioned in
c A	c B	c C	c D	c E	c F
c Peace officer 		or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.					Date (Y-M-D)
Signature

I have personally observed the facts mentioned in
c A	c B	c C	c D	c E	c F
c Peace officer 		or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.					Date (Y-M-D)
Signature

*CR-89A (93-10)		(Form prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. I.

SCHEDULE II

(s. 16, 1st par., subpar. 2)

ABRIDGED OFFENCE REPORT

ABRIDGED OFFENCE REPORT FOR STATEMENT OF OFFENCE NO.
Record No.
Event code
A RELEVANT FACTS AND ACTIONS
B
SIGNATURES
I have personally observed the facts mentioned in
c A	c B	
c Peace officer 		or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.					Date (Y-M-D)
Signature

I have personally observed the facts mentioned in
c A	c B	
c Peace officer 		or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.					Date (Y-M-D)
Signature

O.C. 1210-97, Sch. II.

SCHEDULE III

(s. 16, 2nd par.)

ABRIDGED OFFENCE REPORT FOR STATEMENT OF OFFENCE No.

ABRIDGED OFFENCE REPORT FOR STATEMENT OF OFFENCE No.
(Indicate the origin of the report in this space)
Event code
Record No.

A Identification of defendant

B Vehicle
V.R.N.
Number of occupants
Colour of vehicle

C Lighting
Day
1   c Daylight
2   c Semi-darkness
Night
3   c Lighted highway
4   c Unlighted highway

Weather
5   c Clear
6   c Cloudy
7   c Fog
8   c Rain
9   c Sleet
10 c Snow

Zone
11 c School
12 c Residential
13 c Commercial
14 c industrial
15 c Rural
16 c Park

Roadway
Type
17 c Concrete
18 c Asphalt
19 c Gravel
20 c Dirt

Condition
21 c Dry
22 c Wet
23 c Snow
24 c Ice
25 c Mud
26 c Construction

Configuration
70 c Flat/straight
71 c Flat/curve
72 c Downhill/straight
73 c Downhill/curve
74 c Uphill/straight
75 c Uphill/curve

Presence of road
27 c None
28 c Veh. same direction
29 c Veh. app. direction
30 c Veh. inters. road
31 c Pedestrian(s)
32 c Worker(s)
33 c Cyclist(s)

Type of vehicle
41 c Automobile
42 c Light truck
43 c Truck
44 c Truck tractor
45 c Vehicle transporting hazardous materials
46 c Specialized mobile equipment
47 c Specialized vehicle
48 c Bus
49 c School bus
50 c Minibus
51 c Taxi
52 c Emergency veh.
53 c Motocycle
54 c Moped
55 c Recreational veh.
56 c Snowmobile
57 c Bicycle
99 c Other

D Radar
Speed recorded km/h
Speed zone km/h
Radar device		c moving		c stationary
Make		Model		Series

1st radar check
c Electronic		c Tuning fork
	time	time		km/h	km/h
2nd radar check
c Electronic		c Tuning fork
	time	time		km/h	km/h

c In proper working order
c Other vehicles present in radar beam
Distance at which the radar device clocked vehicle speed
c Certified operator
c No source of interference with operation
c Visual estimate				metres

E Relevant facts, details or particulars
					c Continued on another page

F Relevant facts, details or particulars
					c Continued on another page

Attestation of the facts
I have personally observed the facts mentioned in

Name
1- Peace officer c
2- Other 		Quality
Officer’s No. 		Unit		Date (Y-M-D)
Validation code
I have personally observed the facts mentioned in
Name
1- Peace officer c
2- Other 		Quality
Officer’s No. 		Unit		Date (Y-M-D)
Validation code

Attestation of hard-copy conversion
I attest that this document is true to its duplicate in electronic form.
Authorized person
Surname
Given name
Quality
Date (Y-M-D)			Time (H-M-S)
Validation code

(Reference)

O.C. 1210-97, Sch. III.

SCHEDULE IV

(s. 17, par. 6)

SUPPLEMENT TO AN OFFENCE REPORT – MODEL 1

Supplement to an offence report
(additional page)
This page may be used for: 	- The continuation of E.
	- An additional statement of facts (section F) by officers or persons different from those who presented a report on the preceding page.
	- The continuation of F.
MODEL 1
ORIGIN
Department, municipality, public body or other authority				Record No.
Name and address of person responsible					Event code

RELEVANT FACTS AND ACTIONS
Check off the appropriate box
c Continuation of E
c New section F
c Continuation of 

		c Continued on another page

SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
ICR-89A-1 (93-10)	(From prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. IV.

SCHEDULE V

(s. 17, par. 6)

SUPPLEMENT TO AN OFFENCE REPORT – MODEL 2

Supplement to an offence report
(additional page)
This page may be used for: 	- The continuation of E.
	- An additional statement of facts (section F) by officers or persons different from those who presented a report on the preceding page.
	- The continuation of F.
MODEL 2
ORIGIN
Department, municipality, public body or other authority				Record No.
Name and address of person responsible					Event code

RELEVANT FACTS AND ACTIONS
Check off the appropriate box
c Continuation of E
c New section F
c Continuation of 

		c Continued on another page

SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
* CR-89A-2 (93-10)	(From prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. V.

SCHEDULE VI

(s. 17, par. 6)

SUPPLEMENT TO AN OFFENCE REPORT – MODEL 3

Supplement to an offence report
(additional page)
This page may be used for: 	- The continuation of E.
	- An additional statement of facts (section F) by officers or persons different from those who presented a report on the preceding page.
	- The continuation of F.
MODEL 2
ORIGIN
Department, municipality, public body or other authority				Record No.
Name and address of person responsible					Event code

RELEVANT FACTS AND ACTIONS
Check off the appropriate box
c Continuation of E
c New section F
c Continuation of 

Weighing report
A- Vehicle class
Check off in thaw or rain period c 
Check off if dump, garbage or maintenance truck c 
Check off if modified or without GAWR c 
Check off if special travel permit (overload) c 

Axle Class
B-
A	kg
B
C
Load authorized 	kg
Load recorded	kg
Axle Class
B-
A	kg
B
C
Load authorized 	kg
Load recorded	kg

Axle Class
B-
A	kg
B
C
Load authorized 	kg
Load recorded	kg

Axle Class
B-
A	kg
B
C
Load authorized 	kg
Load recorded	kg

Axle Class
B-
A	kg
B
C
Load authorized 	kg
Load recorded	kg
TLM	Authorized	kg		Recorded		kg

TLM according to special permit	kg	Special permit No.
Configurations
Scales	Make	Model	c Series	c MTQ		Location
Check off if scale are used in compliance with Minister’s Order in force c
Operator		Surname		Given name
Type of load
*Legend
X Axles under vehicle
TLM Total loaded mass
* Mark an “X” for each axle seen
** Draw each axle seen
A The load limit specified by the manufacturer
B Load authorized for its class
C Axle load limit specified by vehicle manufacturer
		c Continued on another page

SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
*CR-89A-4 (93-10)	(From prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. VI.

SCHEDULE VII

(s. 17, par. 6)

SUPPLEMENT TO AN OFFENCE REPORT – MODEL 4

Supplement to an offence report
(additional page)
This page may be used for: 	- The continuation of E.
	- An additional statement of facts (section F) by officers or persons different from those who presented a report on the preceding page.
	- The continuation of F.
MODEL 4
ORIGIN
Department, municipality, public body or other authority				Record No.
Name and address of person responsible					Event code

RELEVANT FACTS AND ACTIONS
Check off the appropriate box
c Continuation of E
c New section F
c Continuation of F

LIGHTING
Day
1  c Daylight
2  c  Semi-darkness
Night
3   c Lighted highway
4   c Unlighted highway
WEATHER
5   cClear
6   c Cloudy
7   c Fog
8   c Rain
9   c Sleet
10 c Snow
ZONE
11 c School
12 c Residential
13 c Commercial
14 c Industrial
15 c Rural
16 c Park
ROADWAY
Type
17 c Concrete
18 c Asphalt
19 c Gravel
20 c Dirt
Condition
21 c Dry
22 c Wet
23 c Snow
24 c Ice
25 c Mud
26 c Construc.
PRESENCE ON ROAD
27 c None
28 c Veh. same direction
29 c Veh. opp. direction
30 c Veh. inters. road
31 c Pedestrian(s)
32 c Cyclist(s)
TYPE OF VEHICLE
41 c Automobile
42 c Light truck
43 c Truck
44 c Truck tractor
45 c Vehicle transporting hazardous materials
46 c Specialized mobile equipment
47 c Specialized vehicle
48 c Bus
49 c School bus
50 c Minibus
51 c Taxi
52 c Emergency veh.
53 c Motorcycle
54 c Moped
55 c Recreational veh.
56 c Sowmobile
57 c Bicycle
99 c Other
RADAR DEVICE
c Moving	Make
c Stationary	Model 
1st RADAR CHECK
c Electronic	c Tuning fork
Time	km/h
	km/h
2nd RADAR CHECK
c Electronic	c Tuning fork
Time	km/h
	km/h
c In proper working order
c Certified operator
Other vehicles present in radar beam		c Yes	c No
c Visual estimate
c No source of interference
Distance at which the radar device clocked vehicle speed ____________________metres
			c Continued on another page
SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
SIGNATURE
I have personally observed the facts mentioned in 		c A	c B	c C	c D	c E	c F
c Peace officer 	or	c Person responsible for enforcement of the law
Surname and given name (in block letters)
Officer’s No.	Date (Y-M-D)
Signature
*CR-89A-3 (93-10)	(From prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. VII.

SCHEDULE VIII

(s. 21, 3rd par.)

SUPPLEMENT TO AN OFFENCE REPORT – MODEL 5

This page may be used for: 	- The continuation of E.
	- An additional statement of facts (section F) by officers or persons different from those who presented a report on the preceding page.
	- The continuation of F.
Supplement to an offence report of offence No.
(additional page)

MODEL 5
ORIGIN
Department, municipality, public body or other authority			Event code			Record No.
Name of person responsible		Address of person responsible

RELEVANT FACT, DETAIL OR PARTICULARS

c Continuation of E
c New section F
c Continuation of F
			c Continued on another page
ATTESTATION OF THE FACTS
I have personally oberved the facts mentioned in
Name
1- Peace officer c
2- Other	Quality
Officer’s No.	Unit	Date (Y-M-D)
Valiation code
Name
1- Peace officer c
2- Other	Quality
Officer’s No.	Unit	Date (Y-M-D)
Valiation code
ATTESTATION OF HARD-COPY CONVERSION
I attest that this document is true to its duplicate in electronic form
Authorized person
Surname
Given name
Quality
Date (Y-M-D)	Time (H-M-S)
Validation code
(Reference)	(From prescribed by regulation to be used as documentary evidence)

O.C. 1210-97, Sch. VIII.

REFERENCES

O.C. 1210-97, 1997 G.O. 2, 5061