| FORM 2 |
| (Regulation 4) |
| FRONT OF TICKET |
| TICKET |
| COVID-19 (PREVENTION AND CONTROL) ACT, NO. 9 OF 2020: SECTION 63E |
| Ticket Number: |
| Date: | |
| Time: |
| Location: | |
| Name: | |
| Address: | |
| I, the undersigned police officer, believes on reasonable grounds that the following ticketable offence has been committed: |
| Ticketable Offence | Section/Regulation | Fixed Penalty |
| Failure to comply with an Order for the prohibition of assembly | Section 16 | $250 |
| Failure to comply with an Order imposing physical distancing | Section 17 or 21(1)(b) | $250 |
| Contravention of protocol issued for the operation of a business, establishment, office, motor vehicle, vessel or aircraft in Regulations made for that purpose | Section 20 | $250 |
| Failure to wear a mask or suitable covering over the nose and mouth when in public | Section 21(1)(a) | $250 |
| Business, establishment, office, public omnibus or tourism transport operating in contravention of protocols issued under section 20 or protocols under this Act | Section 25 | $850 |
| Failure of a national or resident to remain at a quarantine facility or in quarantine at his or her home | Section 36(2) or 38(4) | $850 |
| Failure to comply with a restriction or requirement | Section 40 | $250 |
| Failure of parent or guardian in relation to a child to ensure compliance with a restriction or requirement | Section 40 (4) | $250 |
| Failure to remain in isolation | Section 41 | $850 |
| Provision of false information | Section 44 | $250 |
| Public omnibus or tourism transport operating in contravention of protocols issued under section 20 or protocols under the Act | Section 25 | $500 |
| Failure to comply with confinement to residence under an Order imposing physical distancing | Section 17 or 21(1)(b) | $500 |
| CERTIFICATE OF SERVICE |
| I, the undersigned police officer, hereby certify that on the date specified above that I served this ticket on the person named above by leaving a copy with that person. |
| Name of Police Officer: |
| Police Officer's Rank and Police Number: |
| Signature of police officer | Date: |
| BACK OF TICKET |
| PLEASE READ CAREFULLY |
| 1. PAYMENT |
| You may plead guilty by delivering the ticket, along with the total amount of the fixed penalty for the offence set out in the ticket, to the District Court Office specified below. |
| If you wish to pay the penalty, bring or mail this ticket, together with payment in the amount of the penalty, to the court at the address indicated below prior to the Court date displayed on the back of this ticket. |
| Payments by mail are to be by cheque or money order made payable to the Accountant General. Do not send cash. Please print the ticket number on the front of the cheque or money order. |
| Note: Only manager's or company cheques will be accepted. No personal cheques. |
| 2. PLEA OF NOT GUILTY |
| If you wish to plead not guilty, you must notify the Court at the address and telephone number as shown below WITHIN 14 DAYS after being served with this ticket. When responding to this ticket, you may indicate that the attendance of the police officer who completed the ticket is required for the purpose of cross-examination at trial. Tick box for attendance of police officer: |
| | |
| 3. FAILURE TO PAY |
| Consequent on your failure to pay the fixed penalty specified in paragraph 1, you are hereby bound over to appear before the magistrate of the District Court sitting at the address shown below at 9:00 a.m. on the day of |
| 20 to answer the complaint. |
| If you fail to appear, the magistrate will increase the penalty and a notice of conviction will be served on you through ordinary mail. Non-payment by the stipulated time will result in a warrant being issued for your arrest. |
| NOTICE |
| THIS TICKET MAY BE USED AS EVIDENCE OF THE POLICE OFFICER |
| Sent payment to: | First District Court | General hours of operation |
| Cnr. Of Peynier and St. | 8:00 a.m. – 12:30 p.m. |
| Louis St. Castries, St. Lucia | 1:30 p.m. - 4: 30 p.m. |
| Phone: | Cashier hours of operation |
| Fax: | 9:00 a.m. – 3:00 p.m. |
| Second District Court |
| Cnr. of Commercial and Church St. |
| Vieux Fort, St. Lucia |
| Phone: |
| Fax: |