Page 76 - Main Second Asbo Book1
P. 76

Form MG11
                                         RESTRICTED (when complete)


                                             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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            Statemeot oL._ ~ t;.,___~,~
            Age if under 18..........  .......   (if over18 insert 'over 18')   Occupation.~.9.~ -~ ···- ~ ·  '  .. . ~ ..... , .. ._ ................ _.a ........... ,.
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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 .














































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            Signature ....   .1..   ·\ '   ~ . , ..... .   Signature w itnessed by ....... .




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