1964_FIXED_PENALTY_(CRIMINAL_PROCEEDINGS)_REGULATIONS — Page 17

1989 Ed.]

Fixed Penalty (Criminal Proceedings) Regulations

[CAP. 240

A 17

[Subsidiary]

E. On the

the registered address of the person

specified at

F. Before the

above was-

Fixed Penalty in respect of the offence shown at item

full payment of the

in the Schedule to the Fixed Penalty (Criminal Proceedings) Ordinance specified in a notice under section 3(3) of the Ordinance, bearing the number

G. Before the

at

was not made.

and dated

the person specified

above had not notified the Commissioner of

Police that he wished to dispute liability for the offence specified at F above.

(Date)

FORM 4

表格四

(Signature)

(Full Name)

for Commissioner of Police.

(L.N. 89 of 1984)

[reg. 5]

【規例第五條

FIXED PENALTY (CRIMINAL PROCEEDINGS) ORDINANCE 定額罰款(刑事訴訟)條例

(Chapter 240)

(香港法例第二四○章)

CERTIFICATE OF CLEARANCE

記錄清白證明書

(Section 10(3))

(條例第一○條第(三)款)

This is to certify that there are no fines or costs unpaid by

the registered owner of motor vehicle registration mark

ZU........

*

即登記號碼(車牌).

註冊車主,並無未繳付之罰款或訴訟費。

號摩托車輛之

Issued on the

day of

19........ at

..... a.m./p.m.

簽發日期及時間:一九

年

月

日上午/下午

for Commissioner for Transport. 運輸署署長

(

代行)

NOTE: This certificate remains valid for not more than 72 hours from the time of issue. 注意: 本證明書之有效期限,由發出之時起計,不超過七十二小時。