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Only the person to whom the notice is addressed should complete the form and sign the declaration in Part E

If the Notice is addressed to a company, the nominated driver cannot complete, or sign the Notice. This MUST be done by another representative of the company.

Part A

If YOU where the driver tick yes.

  • Tick yes if your name and address at the top of the Notice are correct – If not, tick no and complete part D with the correct details.

If you were NOT the driver at the time of the alleged offence, but have received the Notice of Intended Prosecution, tick No.

Move to Part C and tick the box which is applicable.

Part B

Should only be completed if YOU were the driver admitting to driving the vehicle at the time of the alleged offence and you wish to be considered for the Speed Awareness Course.

Please include your Driving Licence number and Date of Birth. If you do not provide this information we are unable to register you for a course. 
 

Part C

If you were NOT the driver at the time of the alleged offence, please select one of the options listed on the form, which best describes your situation.
 

Part D

This section is to be completed to let us know of a change in your details, or if you were not the driver: - Nominated driver / Hirer / Owner details are to be completed in Part D.

Section 177 of the Road Traffic NI Order 1981 places a legal responsibility on the registered keeper of a vehicle to supply the name and address of the driver at the time of the offence.

Part E

Please ensure that you sign and date the declaration in Part E in ALL cases.

Only the person to whom the notice was addressed to may sign the declaration, or if addressed to a company, then any representative other than the nominated driver may sign.

Please be advised that failure to complete the form correctly may result in delays in processing your offence.