Western Australian Consolidated Regulations

MAGISTRATES COURT (FEES) REGULATIONS 2005 - SCHEDULE 2

[r. 4(6), 8(6), 13(2)]

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

Form 1 Magistrates Court (Fees) Regulations 2005 (Regulation 4)
Declaration that a person is a small business or a non‑profit association
In the Magistrates Court of Western Australia			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 Magistrates Court (Fees) Regulations 2005 .
Signature of applicant:
Date:
Note:  It is an offence under Magistrates Court (Fees) Regulations 2005 regulation 4(12) for a person to make a statement or representation in this declaration that the person knows or has reason to believe is false or misleading in a material particular. The maximum fine is $1 000.
1 Under the Magistrates Court (Fees) Regulations 2005 regulation 3 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 within the meaning of 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 within the meaning of the Statutory Corporations (Liability of Directors) Act 1996 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 Magistrates Court (Fees) Regulations 2005 regulation 3 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 the words that are not applicable.

2 .         Application to remit fees

Form 2 Magistrates Court (Fees) Regulations 2005 (Regulation 8) Application to remit fees
In the Magistrates Court of Western Australia			No.         of  2
Claimant:         ...................................................................................................
Defendant: ....................................................................................................
Applicant:	........................................................................................ Full name
	........................................................................................ Address
	........................................... Date of birth				...................................... MDL No.
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 Magistrates Court (Fees) Regulations 2005 regulation 8(10) for a person to make a statement or representation in this application that the person knows or has reason to believe is false or misleading in a material particular. The maximum fine is $1 000.

3 .         Application for determination of dispute about fees

Form 3 Application for determination of dispute about fees
In the Magistrates Court of Western Australia		No.         of         20
Claimant/ Applicant:         ................................................................................................
Defendant:         ................................................................................................
Application:	To the Principal Registrar for a determination under the Magistrates Court (Fees) Regulations 2005 regulation 13(1) of a question regarding fees.
Applicant:	...................................................................................... Full name
	...................................................................................... Address
	.......................................... Date of birth		......................................MDL No.
Disputed fee:	The disputed fee is for ................................................. ............................................................................................................................................................................
	Payable under the Magistrates Court (Fees) Regulations 2005 Schedule 1 Division 1/2/3* item …
	I dispute — □         that the fee is payable □         the amount of the fee □         other [give details] .................................................         ..........................................................................
I dispute the fee because ........................................................................... ................................................................................................................... ................................................................................................................... ................................................................................................................... ...................................................................................................................
Signature of applicant:	......................................................................................
Date:	........./ ......../20........
*         Strike out numbers that are not applicable.