Page 70 - tmp

CONDITIONAL BAIL TO POLICE STATION GRANT Form MG 4A
RESTRICTED (when complete)
Variation No
Custody No. | 01YD | 259 | 18 URN ____________________________________
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 person and/or their legal representative.

If this record is not part of the custody record, a note of the reason(s) must be made on the custody record.

I understand that I am granted bail with conditions and must surrender to the police station. 1 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, 1 may be arrested; and that if I wish to vary any of the conditions I may apply to the police station,
stating my reasons. I have been given a copy of this form.

Details of Police Station (Grant of Bail only): Wood Green Police Station Police Station at

347 High Road, Wood Green, London N22 4HZ on 05/02/2018 at 9:00 am

For variations: If bail is unconditional enter “all previous conditions cancelled, released
on unconditional bail

If surety or security is changed enter “surety/security changed” and complete MG4C.
0001.0 Page 1 of 2
69