Page 74 - Main Second Asbo Book1
P. 74
RESTRICTED (when complete} Form MG11
WITNESS STATEMENT
(CJ Act 1967, s.9; MC Act 1980, ss.5A(3) (a) and 5B; MC Rules 1981, r.70)
.--r-- URN
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Statement oL_.:Ju_£a ____ .f\:no ef.@] _________ /)_ .·~ '-_-:_~ _ __.__ ________ _'-------1
~
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Age if under 18 .............. ~ ............. (If over18 insert 'over 18') Occupation .. -,.-../-:.at.c.i.e_.~17~-L.-·-·
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This statement (consisting of - .......... / .............. page(s) each signed by me) is true to the best of my knowledge
and belief and! make it knowing that, if it is tendered in evidence, I shall be liable to prosecution if I have wilfully
stated in it anything which ! know to be false or do not believe to be true.
•ot• ,._,_ OOO ♦ ♦ f - .... ·••-•• •··• .. -• H-0 0,000- • ♦ O• ·••-- · -••M• ■ _,.._,,,.,o .... , .. ___ , .. ,.~ 4, ... Oot O •OO 0♦-, .. - ..... 0 ♦-
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Signature._./.~-._,~> - Signature witnessed hy .......................... ·-········--···--·"·· .. ········--······ ........................ .
r.o.
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