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Inciales, Cour de justice de l'Ontario, Regl. de l'Ont. 108/11 Certificate of Offence Proc s-verbal d'infraction I, Je soussign (e) (print name / nom en lettres moul es) Y/A M/M D/J Time / Heure believe and certify that on the day of crois et atteste que le Name Nom (family / nom de famille) (given / pr nom) Address Adresse (initials / initiales) (number and street / num ro et nom de la rue) (municipality / municipalit ) (P.O. / C.P.) (province) (postal code / code postal).
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