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(h) A fee nov excee~irg five doi'lars shall be allowed the person withdra~ir~ a blood s~npte in accords~nce with this section, which fee shall be paid out of the appropriation for crLminat chs_~ges. If the p~som whose blood s~ple was withd~a~.~vl is subs~[uent~G~ convicted £or viola- tion of section 18-52, the ~aovunt cbm~rged by the person withdrawi..~ the sample shall be ~axed as p~t of the costs of t~.e crL~inal case ar~ shall be paid into the ~e ~nere~ f~d of tine state vreasu_~j. (i) In a~ trial for a violation of section 18-52 of tlnis section shall no~ othe~-~ise the intuoduction of ~ reiev~nt ev~dence besa~- ing upon ar~ question at issue before the court, arid the cour~ shall, regardless of the result of the blood test or vesvs, if ~ny~ cor~ider such other rele~mat evidence of the con~tion of the accused as shall be a~missible in evi- dence. T~e fsi!ure of s~ accused to pe~t a sample of his blood vo be ~itY~L~a~.~rn for a cha.~ical ~es~ ~o dete~.~ine the alcoholic con- ~ent tlnereof is not evidence e~nd shall not be subject vo cc~z~ent at the trial of the case, nor s~%ll the fact that a blood test nas been offered the accused be evidence or the subjecv of co~aent. (J) ~ae fo_~m referred =o in paragraph (c) shall contain a brief stateaent of the law requiring the tskir~ of a blood sample and the penalty for refusal, a declaration of refusal and lines for the sig~m~ure of the pe~son frmm wham the blood sample is sought, the date ~ the signa- ture of a ~.~itness ~o the s~r~. If such person refuses or fsils vo execute SUCh dec- lsmation~ the ca~ttir~ justice, clerk or assistant clerk shall certi~J such fact s~d that the c~_ttti~g justice, clerk or assistant cle~n advised the person a~rested tb~t such re- fusal or failure, if four~ to oe mL~easormbte, -19-