AN CHUIRT DUICHE THE DISTRICT COURT

NOTICE OF INTENTION TO APPLY FOR AN EXTENSION OF TIME TO APPEAL

TO: (1) The Chief Clerk/Clerk in Charge, insert address of district court

and

TO: (2) The Complainant insert complainant's name

Case/Fine No. insert fine number or case number

TAKE NOTICE that the Defendant insert defendant's name of insert defendant's address

Will apply on the (a) insert date @ 10.30a.m./ 2.00 p.m. to the District Court Judge sitting at Court (b) insert court number or name for an extension of Time to Appeal and/or to fix Recognise of Appeal in the above case which was heard in Court insert court number or name on the insert the original court date here .

Signed ______

Solicitor/Defendant

Date insert date

______

JUDGES ORDER

Time for appeal refused/extended to/for (c)* ______

Recognisance for Appeal Self € ______Surety € ______

Signed ______

Judge of the District Court

Date

Notes for Completion of Form

*(a) You can pick your own date to go to Court, but you MUST SERVE a copy of this notice on the Complainant and The Chief Clerk of the District Court of the area where the case is to be appealed, at least 48 hours before your chosen Court date.

*(b) Your application should be made to the Court in which the original penalty was imposed.

*(c) THIS IS NOT THE DATE OF YOUR APPEAL but the date by which you MUST HAVE SERVED COMPLETED NOTICE OF APPEAL FORMS ON BOTH THE COMPLAINANT AND THE CHIEF CLERK OF THE DISTRICT COURT OF THE AREA WHERE THE CASE IS TO BE APPEALED. When your application has been heard you should bring this form to the Appeals Office, where you originally made the application, IMMEDIATELY in order that the Appeal Papers can be completed. If the Appeal Papers are not completed the penalty imposed will be enforced.