Your Name (required)

Your Email (required)

Your Phone Number (required)

DAY BEFORE INCIDENT

Briefly describe day before the incident [include the day of the week, where you went, who you talked to and what you did.]. Use additional space as required.

DAY OF INCIDENT

Note 1: Remembering what you did earlier in the day is important. If you testify at trial that something happened with the police during the incident but can�t tell the court what you did earlier that day, it is unlikely that the Judge will believe you.

Note 2: Break the day down into different parts. It will help you write and remember what happened.

Morning of Incident

[Tell us when you got up, what you ate, what you wore, who you talked to, where you went. If you have a day timer, photocopy the day-it will help you remember things months down the road]. Use additional space as required.

Lunch Time

[Where you went for lunch, what you ate (specifics), what time, how you got there]. Use more space if required.

During Work/During the Day

[Tell us what you did, specifics of work, specifics of T.V., specifics of where you went and with you]. Use more space if required.

Off Work/6pm

[What did you do after work until you went out and were stopped by the police, eg; shopping, dinner- who you were with etc]. Use more space if required.

Evening/When You Commenced Drinking

[What time, in what amounts, with who, had you made plans, where were you drinking, when did you start/stop]. Use additional space if required.

Stopped by Police

[Tell us the whole story but also answer the specific questions below]. Use additional space if required.

Additional Questions

1. Once stopped by the police, did you show any signs of impairment by alcohol e.g; slurring, stumbling, staggering, swaying, vomiting?

2. Prior to being stopped, did you have any problems operating your motor vehicle, or were you showing any signs of impairment by alcohol?

3. Were you in your vehicle when the police arrived? If not why not?

4. Once stopped, how long passed until you were taken to the Checkstop bus/Division/Hospital?

5. If there was delay at the scene, what was the apparent reason for it- waiting for tow truck, waiting for breath instrument, other?

6. If there was delay, did the police read you, your Rights to Counsel?

7. Once at the Checkstop bus/Division/Hospital, did you want to call a lawyer?

8. Did you call a lawyer of your choosing?

9. If not why not?

10. If it is alleged that you did not provide a breath sample [Refusal], did you refuse to do so and if so, why?

11. What happened after you provided your breath samples?

12. Did you exhibit any signs of impairment by alcohol while in police custody?

13. Were you kept overnight-is so why and what happened?

14. Where you provided any paper work and if so, what?