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BETWEEN:
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-and-
(Name of Appellant)
RESPONDENT
f)p,a..k) Srl r* n2. Placeof ,"i"r, S<linf &hn, NIS s. Nameofcourr:(seenot"rt ITlclSe O{ -fhe. Pr-rr;,rrt,..t C.oUrJ*
1.
Name of apperrant: 4.
5.
Name of judge:
Offence(s) of which convicted: (See note
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o. 7. 8. 9.
d lor,ffct
imposed:
<:ic
Plea at trial:
sentence
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Date of conviction:
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11.
I. t'he above named appeilant, hereby give you notice that I wish to appeal and if it is necessary for me to do so, appiy for leave to appealagainst my (See note
./-\ B) -) tl{g_nC*
on the grounds hereinafter set forth.
I wish
i,o
{a}
If
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in writing and in -
(fngiawSer,^,1:-rd, alfuor
(check
person
(b}
(,,,"1
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in writing only
(c)
ft11hehr4F
bo:<)
in person
a new
uppropJur.
fi/A
trial by judge and jury.
*ish to have
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(0verl
GROUNDS OF APPEAL
(These grounds must be.filled in before the notice is sent to the-Regist1a1. Th.e appellant must here set out the grounds or reasons why the conviction should be quashed o. ir',u't"rtun.. ."or..J.ifip?.. u"ro* insuffient, please use additional pages and attach.)
Dated this
'= ;3f 3t
day
of OC,l-t]}-td
(See note Sand 6)
Appellant's signature
NOTES
(1)
e.g', Court of Queen's Bench of New Brunswick or a Judge of the Provinciaj Court or Deputy Judge of the provincial Courf
e.g., Theft, {orgery, rape.
Ql
(3) If you rvish t.9 appeal against convic.tion, you must write the word "conviction". If .vou wish toappeal againstsentence, you -must write the word "sentence", If .you wish to appeal against both convi&ion and senteide vou'-ust write the words "conviction_and se1!9n99' If an appeliant convicted oT'moru rlhan one offence *iJ;; Io ;pp.;l iluiiJionfy io*.".i fil,
convictions and sentences, he must state clearly the convictions or sentenc"r
iguin.i;hi;lii;*i:[.ti"?riii.rfl
(4
) if you wis h to su-bmit.your Sasg and argument ,in writi ng you m ay serve your written
within
1.1
days of receiving the transcript and the appeal-bbok from the Aftorney Generall
(5)
{6
You must sign this noiice. If you cannot rvrite you must affix your mark in the presence of a witness. The name and address of the witness must be given. To comme nce y ou r appeal, ;rou n eed only serve the original an d fo ur copies oi this notice on th e senior officer ol the institution rn lvhich you are imprisoned.