Form IV

Criminal Appeal Act 1912

NOTICE OF APPEAL

OR APPLICATION FOR LEAVE TO APPEAL

APPELLANT'S NAME: FRED BLOGGS

THE APPELLANT DESIRES TO APPEAL AGAINST:

CONVICTION []
CONVICTION AND SENTENCE [X]
SENTENCE ONLY []


ON THE GROUNDS SET OUT ON PAGE 2


PLEA AT TRIAL: NOT GUILTY

CONVICTED IN THE : DISTRICT COURT AT SYDNEY

NAME OF JUDGE AT TRIAL: JUDGE McNEILD

DATES OF TRIAL: 1, 2, 3 AND 4 APRIL 2002

CONVICTED OF: ARMED ROBBERY

SENTENCE IMPOSED: 6 YEARS IMPRISONMENT, WITH A NON-PAROLE PERIODOF 4 YEARS

RESIDENTIAL ADDRESS: 67A JOHNSTON STREET ANNANDALE

DID THE JUDGE GIVE A CERTIFICATE THAT THE CASE IS FIT FOR APPEAL? NO

DOES THE APPELLANT WANT LEGAL AID? YES

DOES THE APPELLANT DESIRE TO BE PRESENT WHEN THE COURT CONSIDERS THE APPEAL?YES

NAME AND ADDRESS OF APPELLANT'S SOLICITOR AT TRIAL:

JULIA KEEN,

175 LIVERPOOL STREET SYDNEY

DX 9999 SYDNEY DOWNTOWN


NAME AND ADDRESS OF SOLICITOR ACTING ON THIS APPEAL

JULIA KEEN,

175 LIVERPOOL STREET SYDNEY

DX 9999 SYDNEY DOWNTOWN


..................................
(Appellant)

Grounds of Appeal or Application

To be advised by my barrister.