Western Australian Consolidated Regulations

FOOD REGULATIONS 2009 - SCHEDULE 5

[r. 54(2)]

Food Act 2008 s. 126(7) and Food Regulations 2009 r. 54(2) Withdrawal of infringement notice				Notice No.
Alleged offender	Family name or body corporate name and ACN
	Other names
	Address	No.	Street name
					Postcode
Infringement notice	Infringement notice No.
	Date of issue
Alleged offence [*delete whichever is not applicable]	Description of offence ___________________________________
	* Food Act 2008 s. ________ * Food Regulations 2009 r. _________
Designated officer withdrawing notice	Name and title of officer and name of enforcement agency
	Signature
	Date of notice
Withdrawal of infringement notice [*delete whichever is not applicable]	The above infringement notice issued against you has been withdrawn. If you have already paid the modified penalty for the alleged offence you are entitled to a refund. *Your refund is enclosed. or *If you have paid the modified penalty but a refund is not enclosed, to claim your refund sign this notice and post it to [ details of relevant enforcement agency ]. Signature