Ns Form 57 - Fine Order Form - Nova Scotia, Canada
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2Canada
NS Form 57
IN THE
COURT
Province of Nova Scotia
Revised 07/02
Her Majesty The Queen
Order # _________________
v.
Approved:
_______________________________
_______________________
Judge
(Name & I.D. Number of Defendant)
_______________________
FINE ORDER
D/M/Y
(Sec. 734.1 CC)
YOU,
____
hav e been found guilty of the following offence(s) and ordered to
pay
(Name of Offender)
the following amount(s):
Case No(s). and Brief
Section
Fine
Costs
Victim
Time in
Remarks
Description of Offence(s)
Surcharge
Default
TOTALS
YOU SHALL pay the total amount of $ ______________ (fine, costs and victim surcharge) to the Clerk of the Court at
_______________________________________________________________________________________________
( complete address, including mailing address )
? (a) on or before ________________________________________________________________________ ;
( due date)
? (b) or at the rate of $ _______________ per month, on the ___________ day of each month, starting on
____________________________, 20 _____, for a period of _______ months, the total amounts to be
paid by ____________________________________________________________________________;
(due date)
? (c)
YOU SHALL, if you hav e not paid the total amount by the due date, appear before the Court on __________________
_______________________, 20_____ at _________ ? a.m. / ? p.m.at ______________________________________
(
complete address and courtroom number if known)
______________________________________________________________________________________________________________
__.
TO EXPLAIN WHY YOU SHOULD NOT BE SENT TO JAIL.
DATED at _____________________________________, Nov a Scotia, on ____________________________, 20____.
____________________________________________
Judge, Provincial Court Judge, Justice of the Peace, Clerk
F:\WP\COURTFORMS-pdf\57-FineOrder-July-02.wpd
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