Western Australian Consolidated Regulations

CIVIL JUDGMENTS ENFORCEMENT REGULATIONS 2005 - SCHEDULE 4

[r. 18, 65, 96, 105, 107, 108]

1.         Warrant: the Act section 29(4) or 89(4)

Form 1
WESTERN AUSTRALIA Civil Judgments Enforcement Act 2004 WARRANT FOR ARREST		.............................................COURT
		LOCATION: .....................................
		Court Ref No: ....................................
Judgment creditor	Name: ..........................................................................
Lawyer	Name: ..........................................................................
File Ref No
Contact/Address Details	..........................................................................................................................................................................
Judgment Debtor	Name: ..........................................................................
Person to be arrested	To the Sheriff of Western Australia and the Bailiff delegate at
	..................................................................................... (name)
	..................................................................................... (address)
	was required under summons to attend a means inquiry/default inquiry* and did not so attend as ordered by the summons.
	You are commanded by this warrant issued under the Civil Judgments Enforcement Act 2004 section 29(4)/  89(4) * to arrest the person to be arrested and bring him or her before the court.
The amount of the judgment debt outstanding at the time of issue of this warrant is $
Warrant issued by: ........................................................................................... Signature: .........................................................................................................         Supreme Court Judge/District Court Judge/Magistrate Date: ............................................... Under the Civil Judgments Enforcement Act 2004 section 102 a warrant has effect for 12 months after the day on which it is issued. Its operation may be extended under that section.
Execution details This person arrested on ...../...../..... at .............. hours at: ..................................................................................................................... by: .................................................................................................................... Signature: ......................................................................................................... Date: ............................................ *         Strike out those that are not applicable

2.         Undertaking to appear: regulation 96

Form 2
WESTERN AUSTRALIA Civil Judgments Enforcement Regulations 2005 UNDERTAKING TO APPEAR		........................................ COURT
		LOCATION: .....................................
		Court Ref No: ....................................
Arrested person	Name: ............................................. .........................................................		Date of birth: ........................
	Address: .......................................... .........................................................
Matter in which arrested person is required	[Set out the parties to the matter in which the arrested person is required.]
Undertaking by arrested person	I undertake to appear personally before the above Court on:         [ date of means inquiry/ default inquiry ] at:         [ time of inquiry ] at:         [ place of inquiry ] to give evidence/produce to the court, for use in the inquiry, any record or thing that was detailed in the summons in the above matter*. I agree that if I do not obey the above undertaking I will forfeit $ to the State. Signed: In the presence of: [ Signature, name and official title .] Date:
Is a surety required?	□         Yes                 □         No Amount: $
Surety agreement [If required]	Name: Address: I agree to forfeit $ to the State if the above arrested person does not obey the above undertaking. Signed: In the presence of: [ Signature, name and official title .] Date:
The original to be kept by the Court. Copy to be given to the arrested person and surety (if any). *         Strike out those words that are not applicable

        [Form 2 amended in Gazette 14 Dec 2007 p. 6245.]

3.         Declaration that a person is a small business or a non‑profit association

Form 3 Civil Judgments Enforcement Regulations 2005 (Regulation 105(5))
Declaration that a person is a small business or a non‑profit association
Supreme Court/District Court/Magistrates Court			No.         of  2
Applicant:	........................................................................................... Full name
	........................................................................................... Address
	........................................................................................... Name of small business/non‑profit association*
	........................................................................................... Position held by applicant in the small business/non‑profit association*
I declare that the person in respect of which the application is made is a small business 1 or a non‑profit association 2 within the meaning of that term in the Civil Judgments Enforcement Regulations 2005 .
Signature of applicant:
Date:
Note:  It is an offence under the Civil Judgments Enforcement Regulations 2005 regulation 101 for a person to make a statement or representation in this declaration that is false or misleading. The maximum fine is $1 000.
1 Under the Civil Judgments Enforcement Regulations 2005 regulation 104 a small business is —         an individual or individuals in partnership who wholly own and operate a business undertaking that has less than 20 full‑time equivalent employees and partners;         a corporation that has less than 20 full‑time equivalent employees and that is not a subsidiary of a corporation that has 20 or more full‑time equivalent employees;
a company as defined in the Companies (Co‑operative) Act 1943 that has less than 20 full‑time equivalent employees and that is not, under section 130(1) of that Act, deemed to be a subsidiary company of another company or corporation that has 20 or more full‑time equivalent employees;
a corporation as defined in the Statutory Corporations (Liability of Directors) Act 1996 section 4 that has less than 20 full‑time equivalent employees and that is not a body that would be a subsidiary, if the corporation were a corporation to which the Corporations Act 2001 of the Commonwealth applies, of a corporation within the meaning of the Corporations Act 2001 of the Commonwealth or the Statutory Corporations (Liability of Directors) Act 1996 that has 20 or more full‑time equivalent employees.
2 Under the Civil Judgments Enforcement Regulations 2005 regulation 104 a non‑profit association is a society, club, institution or body that is not for the purpose of trading or securing pecuniary profit for its members from its transactions. *         Strike out those words that are not applicable

4.         Application to remit fees

Form 4 Civil Judgments Enforcement Regulations 2005 (Regulation 107) Application to remit fees
Supreme Court/District Court/Magistrates Court			No.         of  2
Applicant:	........................................................................................... Full name
	........................................................................................... Address
	........................................... Date of birth				........................................... MDL No.
Fee:
The following reason is the reason  1 for applying to have the above fee waived/ reduced/ refunded/ deferred*. .......................................................................................................................... .......................................................................................................................... .......................................................................................................................... 1         The reasons available are financial hardship or that it is in the interests of justice to do so . *         Strike out those that are not applicable .
If the reason is that it is in the interests of justice to do so, why is that so? .......................................................................................................................... .......................................................................................................................... ..........................................................................................................................
If the reason is financial hardship the information required in the following part of this form must be provided by the applicant if the applicant is a natural person.
I am employed as a ................................  by ................................................... Their business address is .................................................................................
I am unemployed/ a pensioner* and registered with the Department of Social Security at .............................................................................................
I am single/ married/ separated.*
I have/ do not have* a dependant wife/ husband/de facto partner* and .............. dependant children.
My weekly/fortnightly* income and expenditure is as follows (in whole dollars) —
Income			Expenditure
Wage/salary/benefit (net)			Rent/board				$
Self		$	Mortgage payment				$
Spouse		$	Maintenance for dependants				$
De facto partner		$	Food				$
Total		$	Electricity/gas				$
Money in bank or other financial institution			Telephone				$
Self		$	Water				$
Spouse		$	Rates and taxes				$
De facto partner		$	Court orders				$
Total		$	Lease or other (give details)				$
Income from investments		$	Other debts owing (give details)				$
Other income		$
Money owed to me		$
TOTAL			TOTAL
ASSETS			VALUE $
My assets and liabilities are as follows —
House or other real property (give addresses)
..................................................................................................... .....................................................................................................							.............. ..............
TOTAL
Motor vehicles (car, utility, motor cycle, truck, etc.)
Make and model				Reg. No.
TOTAL
Home contents
Television				yes / no
Video recorder				yes / no
Stereo system				yes / no
Furniture				yes / no
Dishwasher				yes / no
Microwave oven				yes / no
Collection of coins, stamps, etc.
Other collectables
Interest in business or company
Other assets
TOTAL
LIABILITIES
Mortgage to ....................................................... for $
Other to ............................................................. for $
Time to pay order ............................................. for $
TOTAL
If the reason is financial hardship the information required in the following part of this form must be provided by the applicant if the applicant is a corporation or incorporated association.
INCOME						$
LIABILITIES						$
ASSETS						VALUE $
Signature of applicant:
Date:
*         Strike out words that are not applicable. Note:  It is an offence under the Civil Judgments Enforcement Regulations 2005 regulation 101 for a person to make a statement or representation in this declaration that is false or misleading. The maximum fine is $1 000.

5.         Application for determination of dispute about enforcement costs

Form 5 Civil Judgments Enforcement Regulations 2005 (Regulation 108) Application for determination of dispute about enforcement costs
Supreme Court/District Court/Magistrates Court*			No. ............ of............20............
Application:	To the Principal Registrar for a determination under the Civil Judgments Enforcement Regulations 2005 regulation 108 of a question regarding enforcement costs.
Applicant:	.............................................................................................. Full name
	.............................................................................................. Address
	............................................. Date of birth			........................................... MDL No.
Disputed enforcement cost:	The disputed enforcement cost is ........................................ ..............................................................................................
	Payable under the Civil Judgments Enforcement Regulations 2005 Schedule 1/2/3* item ..............................
	I dispute — π         that the enforcement cost is payable π         the amount of the enforcement cost π         other [give details] ..............................................................         ........................................................................................
I dispute the enforcement cost because: .......................................................... .......................................................................................................................... .......................................................................................................................... ..........................................................................................................................
Signature of applicant:		...........................................................................................
Date:		........./ ......../20........
*         Strike out words or numbers that are not applicable.