"City of Port Coquitlam Pound and Animal Regulation By-law, 1970, No. 1020,
Amendment By-law, 1975, No. 1355"

SCHEDULE "Cc"

REPORT OF CONVICTION

Name of person convicted:

(Name)

(Address)

COURT ACTION

For Crown: : For Defence:

Court Reporter:

Adjourned to: Reasou:

Failed to Appear
Warrant Issued:

Not Guilty

Charge Read: Plea:

Fine of
Souk . . Fine:
Costss
Total:

Under

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tion made)

Dismissed : Withdrawn Suspended Sentence

Time to pay: Jailed: Days In:

HEARD ON » 19 » in the Provincial Court of British .
Columbia,far the City of Port Coquitlam.

(Recommendations or Comments)

I HEREBY CERTIFY that the informatior. herein
under Court Action is a true extract from the
Court Record.

CONVICTING JUDGE OR JUSTICE