Page 78 - Main Second Asbo Book1

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)

URN

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Statement of... ...... t:_ ~ W\ .c rv---\ -1 \\ ~ --- .... l .. -S'1 ___ ( £ .·-·--------·-···-·-··-···--·---·-·~,. ... __ _
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Q
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Age if under 18 .... ~ (if over18 insert 'over 1s·) Occupation ...... !?.Q.~ ~ fil(.£:f-_.: .. ...,., ____ _
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This statement (consisting of ........... d.::: ... : ...... page(s) each signed by me) is true to the best of my know!edge
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 .... _~i-. __ 1 ______ $_9 ___ 'f€~-·-·-· .. -·.·· ..... Date ,_?::o IL-- &u '}-Q.;.... __ o_\f-L-. _______ . -

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