Western Australian Consolidated Regulations

FAIR TRADING (INFRINGEMENT NOTICES) REGULATIONS 2006 - SCHEDULE 2

[r. 3]

Form 1 — Infringement notice

Fair Trading Act 1987 Infringement notice		Infringement notice no.
Alleged offender	Name:         Family name
	Given names
	or         Company name ____________________________________                 ACN
	Address ________________________________________________         Postcode
Alleged offence	Description of offence _____________________________________
	Fair Trading Act 1987 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. If you do not want to be prosecuted in court for the offence, pay the modified penalty within 21 days after the date of this notice. How to pay By post: Send a cheque or money order (payable to ‘Designated Officer — Fair Trading Act 1987 ’) to: Designated Officer — Fair Trading Act 1987 Department of Consumer and Employment Protection Locked Bag 14 Cloisters Square Perth WA 6850 In person: Pay the cashier at: Department of Consumer and Employment Protection 219 St George’s Terrace, Perth WA If you do not pay the modified penalty within 21 days, you may be prosecuted or enforcement action may 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 need more time to pay the modified penalty, you can apply for an extension of time by writing to the Commissioner for Consumer Protection at the above postal address. If you want this matter to be dealt with by prosecution in court , sign here _______________________________________ and post this notice to the Commissioner for Consumer Protection at the above postal address within 21 days after the date of this notice.

        [Form 1 amended in Gazette 12 Jan 2007 p. 47.]

Form 2 — Withdrawal of infringement notice

Fair Trading Act 1987; s.73(7) Withdrawal of infringement notice		Withdrawal no.
Alleged offender	Name:         Family name
	Given names
	or         Company name _____________________________________                 ACN
	Address _________________________________________________         Postcode
Infringement notice	Infringement notice no.
	Date of issue         /         /20
Alleged offence	Description of offence ____________________________________
	Fair Trading Act 1987 s.
	Date         /         /20         Time         a.m./p.m.
Officer withdrawing notice	Name
	Signature
	Office
Date	Date of withdrawal         /         /20
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:         Designated Officer — Fair Trading Act 1987 Department of Consumer and Employment Protection Locked Bag 14 Cloisters Square Perth WA 6850 Signature         /         /20

Form 3 — Certificate of authorisation

Fair Trading Act 1987 Certificate of authorisation

This is to certify that _________________________________________________________________ [Full name] is authorised under the Fair Trading Act 1987 section 73(10)(a) to issue infringement notices under that Act. _________________________________________ Commissioner for Consumer Protection Date of authorisation ________________________

        [Form 3 amended in Gazette 12 Jan 2007 p. 47.]