STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS TRAFFIC TRIBUNAL
DATE:________________________
RITT Location:_________________________ Case No.______________________________ Complainant:_______________________________________________________________ Defendant:_________________________________________________________________
WITNESSES
I/We certify that I/we have attended before the above named Court on behalf of the State of Rhode Island, the number of days traveled therefor, the number of miles as stated below, and hereby acknowledge receipt from the Clerk of said Court of the sums set opposite my/our name(s) In full for witness fees as stated. Name Address Days Miles Amount Check No.
OFFICERS
PROSECUTION SIGNATURE:____________________________________________________________