Page 75 - Main Second Asbo Book1

RESTRICTED (when complete) Form MG11

WITNESS STATEMENT

(CJ Act 1967, s.9; MC Act 1980, ss.5A(3)(a) and 58; Criminal Procedure Rules 2005, Rule 27.1)
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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 I 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 I know to be false or do not believe to be true.

Signatur~~' __

Tick if witness evidence is visually recorded D (supply witness details on rear)
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Signature witnessed by
Signature
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