A6
CAP.237]
[Subsidiary]
L.N. 90/84
Fixed Penalty (Traffic Contraventions) [1984 Ed.
Regulations
PAYMENT BY POST
用郵寄方式繳款
This form (intact) must accompany the
payment.
It will be returned with a receipt.
本表格必須保持原狀，連同罰款一併付上
經機印收訖後，即發回作為收據。
If payment is made by post, state the name and address of the person to whom
the receipt should be forwarded-
用郵寄方式繳款者，請寫明接受收據人之姓名地址，以便寄回收據——
Name:
姓名:
Address:
地址:
RECEIVED the sum imprinted below-
下列機印所示款項收訖--
To:
致:
of
FORM 2
[reg. 2(2).]
表格二
【規例第二條第(2)款】 Serial No. 編號
FIXED PENALTY (TRAFFIC CONTRAVENTIONS) ORDINANCE 定額罰款(交通違例事項)條例
(Chapter 237)
(香港法例第二三七章)
NOTICE DEMANDING PAYMENT OF FIXED PENALTY 繳付定額罰款通知書
(Section 15(3))
(條例第十五條第(3)款)
Surname first
先寫姓氏
地址
On
at about
在
約
於
a contravention of
section
發生一宗違反本條
of the Ordinance was committed for which you, as the
條之事件而 台端須對此事件負責因 台端當時為
at the time are liable.
$200
例第
IN B3/9
registered owner/driver of motor vehicle No.
時為
汽車之登記車主/司機。
I hereby demand payment of the Fixed Penalty of $140 and inform you that, if
茲特通知 台端繳付定額罰款二百四十元。倘台端欲提出抗辯，則應通知本人口