Sworn Statement Supporting a Reopening Application (Provincial Offences Act)

Sworn Statement Supporting a Reopening Application

I, ______, residing in the city of ______, in the province of ______, DO SOLEMNLY SWEAR/AFFIRM AND STATE AS FOLLOWS:

1. I reside at ______.

2. I was convicted without a hearing on ______ of the offence of ______ contrary to ______ section ______.

3. ______

4. The conviction first came to my attention on: ______.

5. I make this affidavit in support of my application to request reopening of my matter and to request a new trial date and for no other or improper purpose.

Supplementary details

Province of Residence: ______