Western Australian Consolidated Regulations

METROPOLITAN HEALTH SERVICE BY-LAWS 2008 - SCHEDULE 4

[bl. 12(3) and 13]

        [Heading inserted in Gazette 26 Nov 2010 p. 5945.]

Form 1 — Infringement Notice

Infringement Notice Metropolitan Health Service By‑laws 2008
Notice No.	Issue date		Issue time
Location
Vehicle
Plate no. & type	Make		Model/Style
Alleged Offence
Date		Time
By‑law		Modified penalty
Issuing Officer
Name		Signature/Officer No.
You have 28 days from when this Notice is given to you to pay the modified penalty or elect to go to court. If you don’t, enforcement proceedings will be taken against you.
Paying the modified penalty By post:         Send a cheque or money order payable to “Metropolitan Access and Parking” to —         Metropolitan Access and Parking         PO Box 1135         Osborne Park WA 6916
In person:         Pay at the Metropolitan Access and Parking Department at —         100 Flinders Street         Mt. Hawthorn WA
OR         Pay at any Australia Post Office or agency. By telephone:         Call 1800 753 191
Electing to go to court If you wish to elect to go to court, sign here: .................................................................................. Date: ............. then send this notice to —         The Chief Executive Officer Metropolitan Access and Parking Department 100 Flinders Street Mt. Hawthorn WA 6016 Make sure you keep a copy. If you go to court and are convicted you may be fined $50 and ordered to pay costs.
If enforcement proceedings are taken against you, your driver’s licence and/or vehicle licence may be suspended until you pay the modified penalty and expenses or you elect to go to court.

        [Form 1 inserted in Gazette 23 Dec 2011 p. 5444‑5.]

Form 2 — Withdrawal of infringement notice

Metropolitan Health Service By‑laws 2008 Withdrawal of infringement notice		Notice No.
To [Person to whom infringement notice was issued]	Family name
	Other names
	Address
Infringement notice	Infringement notice no.
	Issued at:         ❑         Graylands Hospital                 ❑         Rockingham Hospital                 ❑         Kalamunda Hospital
	Date of issue ………/……../20…….
	Alleged offence ………………………………………… …………………………………………………………..
	Vehicle plate no.
The infringement notice has been withdrawn. If you paid the modified penalty before the infringement notice was withdrawn, take your receipt and this notice to the cashier at Graylands Hospital, Rockingham Hospital or Kalamunda Hospital (as the case requires) and your payment will be refunded.
Notice withdrawn by	Name
	Signature
	Date ………/……../20…….

        [Form 2 inserted in Gazette 26 Nov 2010 p. 5946.]