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RESTRICTED (when complete Form MG 4 A
Variation No
CONDITIONAL BAIL TO POLICE STATION GRANT

Custody No. 01 YD | 1984 18 URN 1 1
Statement of Truth
Station Wood Green Police Station
Surname and initials CORDELL S.

The above-named person has been granted bail as the custody officer is satisfied that releasing them on bail is necessary
and proportionate in all the circumstances (having regard, in particular, to any conditions of bail which would be imposed),
and an Inspector or above has authorised their release on bail, having taken into account any representations made by the
I believe the facts in this Witness Statement are true. person and/or their legal representative.

Signed If this record is not part of the custody record, a note of the reason(s) must he made on the custody record.
Signed .............. /Th? ...........
I understand that I am granted hail with conditions and mast surrender to the police station. I have been informed that if I
fail to surrender to custody or if I fail to comply with any of the conditions set out above, I may be arrested; and that if 1
Dated this 8 day of August 2017 wish to vary any of the conditions 1 may apply to the police station, stating my reasons. I have been given a copy of this
th

th
Dated this 8 day of August 2017 form.
Derails of Police Station (Grant of Bail only): Wood Green Police Station Police Station at 347 High Road, Wood Green,
London N22 4HZ on 05/04/2018 at 10:00 am

Grounds for imposing conditions
The above-named person has been granted bail subject to the following conditions (number each separately). These conditions are
1
imposed because they appear necessary to prevent that person from: Tailing to surrender to custody

interfering with witnesses or otherwise obstructing the course, of justice
Committing an offence whilst on bail or:
interfering with witnesses or otherwise obstructing. the, course of justice for
*For that person's own welfare or own interests \if child or young person)
+For that person's own protection
that person's own welfare or own interests (if child or young person
(* tick as appropriate)

No- Conditions Season’s) why conditions appear necessary
1 Not to attend 117 BURNCROFT Ave EN3 to prevent further offences and interference with justice Not to
2
contact any of the Markandu family to prevent further offences and interference with justice

Signed Signed
(person bailed) (appropriate adult)
Officer in case Surname SEFIL Ran k/Job title PC No. P235331

Station Enfield Borough

Officer Granting Bail Time Surname ROSS Rank PS No. PI 99321
23:42 Date 15/(13/2(118

For variations: If bail is unconditional enter "all previous conditions cancelled, released an unconditional bail"
If surety or security is changed enter ’’surety/security changed" and complete MG4C.
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