3067650035 IAUSASKC PEN Wortham, — 03-24-2016 1 FORMA [Rule 9) ACR, NOTICE OF APPEAL (All Offenders) ‘THE COURT OF APPEAL FOR SASKATCHEWAN, BETWEEN: A in Evic Cotes Appellant AND: HER MAJESTY THE QUEEN Respondent A. THE APPELLANT WISHES TO APPEAL FROM: _—— CONVICTION CONVICTION AND SENTENCE SENTENCE ALONE __— DANGEROUS OFFENDER OR LONG-TERM OFFENDER DESIGNATION OTHER of eppeal other than abave) B, PARTICULARS OF APPELLANT: wane Ccborth _ Kelis Ef iat same Fist ame Mie ame Date of Birth: 25 / OF | 3O yeer month day If the appellant is a corporation: ‘penal instisosreseoas Iausase Pen FO:1T 56am, 09-24-2016 2M “2. If the appellant is not in custody: aires ay provinge ostal code = Phone number: ( ) Email address: Fax number: (~) — C. PARTICULARS OF CONVICTION AND SENTENCE, 1, Locetion of Conviction: Provincial Court Rea na ey or wa or ‘Court of Queen's Bench . fadesl Genet eng 2, Name oftuike: Jickge Ellen Gua 3. Offence(s) the offender was convicted of:_(7#Insvaugh te and vinta rE hy fausing BeBiile Hacrn 4, Sentence imposed: [4 pars 5, Date of Conviction: Ifa | O22 / DG year ‘oath ay 6, Dateof Sentence; _Jt> /_O3 o4 yest ‘ont ay3087650035, IAUSASK PEN sar1@09a.m, 03-24-2016 au rl D. GROUNDS OF APPEAL: PPELLANT WISHES TO APPEAL FOR THE FOLLOWING REASONS: i 7 (this section may be expanded or additional pages may be attached) E, LEGAL REPRESENTATION: 1. The Appellant is represented on appeal by: Name of Lawyer: Tas name Address: tres ay provinee postal code Phone number: ( ) Email address: Fax number: (~) -OR- 2. ‘The appellant does not presently have a lawyer but he or she intends to: arrange for legal representation or ct for himself/terself on appeal.¥. PRESENCE AT APPEAL HEARING (MARK ONE ONLY): ‘At the eppeal hearing, the Appellant wishes to: be personally present or appear by video conference connection fi lable at penal institution) or not be present G. IF ANEW TRIAL IS DIRECTED, THE APPELLANT WISHES TO BE TRIED: by judge and jury by single judge. To: REGISTRAR COURT OF APPEAL FOR SASKATCHEWAN 2425 VICTORIA AVENUE REGINA, SASKATCHEWAN se aws Telephone: 306-787-5382 Fox: 306-787-5815 e-file: hitpsf/ecourtsasklaweourts.ca