FES ue ey tee as

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

No.
SCHEDULE "A" as
INFORMATICN,
CANADA )
PROVINCE OF BRITISH COLUMBIA )
CITY OF PORT COQUITLAM )

The undersigned, being duly sworm and upon oath, DEPOSES AND SAYS:

On the day cf

(Location)
In the City of Port Coquitlam, in the Province of British Columbia, at (AM/PM)

Name:

(Last:) (First) (Other)
Address: .

(Street) — . (Municipality or Post (Province)
. : office Box) .

Did unlawfully:

and did then and there commit the offence indicated under "City of Port Coquitlam
Pound and Animal Regulation Ey~law, 1970, No. 1020", as amended:

| Allow Dog to Run at large Allow dog to trespass on
private property

Fail to confine bitch in heat Own diseased or vicious dog

unlicenced dog licence tag

[I
[ Keep or have in possession ; Failure to cause dog to wear

Removing licence tag from dog Allow cattle to run at large
without lawful authority Co ~ ;

Other violation:

The informant says thet he has reasonable and probable grounds to believe and does.
believe that the person named above comitted the offence indicated.
Signature of
Informant

Peace Officer

SWORN BEFORE me this day of
in the Province of British Columbia.

JUSTICE
ok = ‘

Ia the name of Her Majesty The Queen, you are therefore commanded to appear in the
Provincial Court of British Columbia,far the City of Port Coquitlam, in the Prov-_
duce of British Columbia, on the day of a », 19 » at :

(AM/PM), to answer the above charge and to be further dealt with according
to law. The said Court is located at’ 3000 Christmas Way, Coquitlam, 8.C.

Indicated
Penalty Signature

Peace Officer

Details
of
Animal

Offender