Fillable Form TE9: Witness statement unpaid penalty charge (Cabinet Office)

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Form TE9: Witness statement unpaid penalty charge (Cabinet Office)

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TE9 Witness statement (04.19) © Crown Copyright 2019
Form TE9
Witness statement – unpaid penalty charge
(Parking)
Please complete this form in black ink using BLOCK CAPITALS and return it to the address below
Traffic Enforcement Centre
County Court Business Centre
St. Katharine’s House
21 – 27 St. Katharine’ Street
Northampton, NN1 2LH
Penalty Charge No.
Vehicle Registration No.
Applicant
Location of Contravention
Date of Contravention
You must ensure that all details above are correctly entered from the form TE3 - Order for Recovery of
unpaid penalty charge (Parking).
Title
Mr.
Mrs
Miss
Ms.
Other
Postcode
Company name (if vehicle owned
and registered by a company)
The above named witness, declares that:
Tick all boxes that apply to you
.
Note: If your penalty charge relates to a London Borough Parking Contravention tick only ONE box
I did not receive the Notice to Owner /
Penalty Charge Notice
(Parking contravention).
I appealed against the local authority’s
decision to reject my representation, within
28 days of service of the rejection notice,
but have had no response to my appeal.
I made representations about the penalty
charge to the enforcing authority concerned
within 28 days of the service of the Notice to
Owner, but did not receive a rejection notice.
The penalty charge has been paid in full.
Date it was paid
How was it paid
Cash/Cheque/Debit/Credit card
To whom was it paid
Proceedings for contempt of court may be brought against you if you make or cause to be made
a false statement in an application verified by a statement of truth without an honest belief in its
truth.
Statement of truth
(I believe) (The witness believes) that the facts stated in this application are true.
Signed
(witness) (person signing on behalf of the witness)
Date
Print full name
If you are signing on behalf of the witness, are you
An officer of
the company
A Partner
of the firm
A Litigation friend acting on behalf of a protected party
within the meaning of the Mental Capacity Act 2005
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TE9 Witness statement (04.19) © Crown Copyright 2019
You may make a witness statement under the following grounds, which apply to you:
Note: If your penalty charge relates to a London Borough Parking Contravention you may make a
witness statement under ONE of the following grounds
• You paid the penalty charge notice in full. You must provide details of the date payment was made,
the method of payment i.e. cash, cheque etc and who the payment was made to. Please note you
may be asked to provide proof of payment upon request.
• You did not receive the notice to owner/penalty charge notice.
• You made representations about the penalty charge notice to the Local Authority within 28 days of
service of the notice to owner but did not receive a reply (rejection notice).
• You appealed against the Local Authority’s decision to reject your representation within 28 days, but
you had no response to your appeal.
Proceedings for contempt of court may be brought against you if you make or cause to be made
a false statement in a witness statement verified by a statement of truth without an honest belief
in its truth
You must file the witness statement by the date shown on the Order for recovery.
Once completed send to the Traffic Enforcement Centre at
County Court Business Centre
St Katharine’s House,
21 – 27 St Katharine’s Street
Northampton
NN1 2LH
or tec@justice.gov.uk
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Form TE9: Witness statement unpaid penalty charge (Cabinet Office)

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Completed 21 April 2022

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