Western Australian Consolidated Regulations[r. 344]
[Heading inserted in Gazette 20 Mar 2007
p. 1042.]
Form 1 — Infringement notice
|
Electricity Act 1945 |
Infringement | |
|
Alleged offender |
Name: Family name | |
|
Given names | ||
|
or Company name ____________________________ | ||
|
Address _________________________________________ | ||
|
Alleged offence |
Description of offence _____________________________ | |
|
Electricity Act 1945 s. | ||
|
Date / /20
Time a.m./p.m. | ||
|
Modified penalty $ | ||
|
Officer issuing notice |
Name | |
|
Signature | ||
|
Office | ||
|
Date |
Date of notice / /20 |
|
|
Notice to alleged offender |
It is alleged that you have committed the above offence. | |
| |
By post: Send a cheque or money order (payable to
‘Director of Energy Safety’) to: | |
|
If you do not pay the modified penalty within 28 days, you will be
prosecuted or enforcement action will be taken under the Fines, Penalties and
Infringement Notices Enforcement Act 1994 . Under that Act your
driver’s licence and/or vehicle licence may be suspended. | ||
| |
If you want this matter to be dealt with by prosecution in court, tick this
box ❑ and post this notice to the Director of Energy Safety at the
above address within 28 days after the date of this notice. | |
[Form 1 inserted in Gazette 20 Mar 2007
p. 1042.]
Form 2 — Withdrawal of infringement
notice
|
Electricity Act 1945 |
Withdrawal no. | |
|
Alleged offender |
Name: Family name | |
|
Given names | ||
|
or Company name __________________________________
| ||
|
Address _____________________________________________________ | ||
|
Infringement notice |
Infringement notice no. | |
|
Date of issue / /20 | ||
|
Alleged offence |
Description of offence ____________________________________ | |
|
Electricity Act 1945 s. | ||
|
Date / /20
Time a.m./p.m. | ||
|
Officer withdrawing notice |
Name | |
|
Signature | ||
|
Office | ||
|
Date |
Date of withdrawal /
/20 | |
|
Withdrawal of infringement notice |
The above infringement notice issued against you has been withdrawn. | |
[Form 2 inserted in Gazette 20 Mar 2007
p. 1043.]