RSCC-1-E (2003/04)

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDERYOUTH JUSTICE COURT CANADA

PROVINCE OF ONTARIO

(Region)

Form 1, Parental Responsibility Act, 2000. O. Reg. 402/00 Paragraph 119(1)(r) of the Youth Criminal Justice Act

AFFIDAVIT Case/File No.

(Check as applicable)

Individual (Victim or Litigation Guardian)

I,(insert full name)

of the(City, etc.)

of

in the (Country, etc.)

of

Corporation

I,(insert name and title of representative)

for the (name of corporation)

of the(City, etc.)

of

in the (Country, etc.)

of

Insurer

I,(insert name and title of representative)

of the(name of Insurer)

of the (City, etc.)

of in the (Country, etc.)

of

MAKE OATH AND SAY (OR AFFIRM) as follows:I am a victim of the offence(s) described below.

I am the litigation guardian for a victim of the offence(s) described below.

I am a representative of a corporation that is a victim of the offence(s) described below.

I am a representative of an insurer of property affected by the offence(s) described below.

I have (or the corporation has or the insurer has) commenced an action under the Parental Responsibility Act, 2000 at

(location)Small Claims Court

I believe that(name, address and date of birth of young person)

was charged with the following offence(s)

(brief description of incident)

I believe that the young person named above was found guilty by the(name of court)

at(complete mailing address)

I am entitled under section 163 and paragraph 119(1)(r) of the Youth Criminal Justice Act and the Parental Responsibility Act to obtain a copy of the Youth Criminal Justice Act Sentence Order or the Young Offenders Act Order of Disposition.I would like a copy of the Sentence Order/Order of Disposition to be mailed to me at the following address:

(complete mailing address)NOTE: The document requested can be provided only if a complete mailing address is provided.

Sworn before me this day of , yr.

at the of

in the Province of Ontario

Commissioner for Taking Affidavits Signature of Deponent

RSCC-1-E (2003/04)

WARNINGS1 The information in the Sentence Order/Order of Disposition is subject to the publication prohibitions and disclosure provisions of the Youth Criminal Justice Act (Canada). It is an offence punishable by up to two years imprisonment to publish, disclose or use the information contained in the sentence order/order of disposition in any way that contravenes the Youth Criminal Justice Act.2 You may use a copy of the Sentence Order/Order of Disposition as evidence in a claim under the Parental Responsibility Act, 2000.

3 It is a criminal offence knowingly to swear a false affidavit.

THIS SPACE TO BE COMPLETED BY COURT STAFF

A copy of the Order(Case/File No.)

was mailed to above address on

by

Signature of Clerk

OR

Order(Case/File No.)

not provided because:

Appeal Undertaken

Appeal period not expired

Time periods set out in ss.119(2) of the YCJA have expired.

Signature of Clerk

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDERREQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER - Page 2

RSCC-1-E (2003/04)

RSCC-1-E (2003/04)

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER

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REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER

YOUTH JUSTICE COURT CANADAPROVINCE OF ONTARIO

Form 1,Parental Responsibility Act, 2000. O. Reg. 402/00 Paragraph 119(1)(r) of theYouth Criminal Justice Act

AFFIDAVIT

(Check as applicable)

I,

of the

of

in the

of

I,

for the

of the

of

in the

of

I,

of the

of the

of

in the

of

MAKE OATH AND SAY (OR AFFIRM) as follows:

Small Claims Court

I believe that

was charged with the following offence(s)

I believe that the young person named above was found guilty by the

at

I am entitled under section 163 and paragraph 119(1)(r) of theYouth Criminal Justice Actand theParental Responsibility Actto obtain a

copy of theYouth Criminal Justice ActSentence Order or theYoung Offenders ActOrder of Disposition.

I would like a copy of the Sentence Order/Order of Disposition to be mailed to me at the following address:

NOTE:The document requested can be provided only if a complete mailing address is provided.

Sworn before me this

day of

, yr.

at the

of

in the Province of Ontario

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER - Page 2

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WARNINGS

1 The information in the Sentence Order/Order of Disposition is subject to the publication prohibitions and disclosure provisions of the

Youth Criminal Justice Act(Canada). It is an offence punishable by up to two years imprisonment to publish, disclose or use the

information contained in the sentence order/order of disposition in any way that contravenes theYouth Criminal Justice Act.

2 You may use a copy of the Sentence Order/Order of Disposition as evidence in a claim under theParental Responsibility Act, 2000.

3 It is a criminal offence knowingly to swear a false affidavit.

THIS SPACE TO BE COMPLETED BY COURT STAFF

was mailed to above address on

by

OR

not provided because:

8.0.1291.1.339988.308172

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER

REQUEST FOR A COPY OF A YOUTH CRIMINAL JUSTICE ACT (CANADA) SENTENCE ORDER

TextField1: (Region): Case/File No.: Individual (Victim or Litigation Guardian): Commissioner for Taking Affidavits: (City, etc.): of: (Country, etc.): of: Corporation: (insert name and title of representative): (name of corporation): (City, etc.): of: (Country, etc.): of: Insurer: (insert name and title of representative): (name of Insurer): (City, etc.): of: (Country, etc.): of: I am a victim of the offence(s) described below.: I am the litigation guardian for a victim of the offence(s) described below.: I am a representative of a corporation that is a victim of the offence(s) described below.: I am a representative of an insurer of property affected by the offence(s) described below.: I have (or the corporation has or the insurer has) commenced an action under the Parental Responsibility Act, 2000 at: (location): (name, address and date of birth of young person): (brief description of incident): (name of court): (complete mailing address): (complete mailing address): Sworn before me this. Day of.: Month: Year : Signature of Clerk: A copy of the Order: was mailed to above address on. : by.: Order: Appeal Undertaken: Appeal period not expired: Time periods set out in ss.119(2) of the YCJA have expired.: Save Form: Print Form: Clear Form: