Western Australian Consolidated Regulations

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MOTOR VEHICLE REPAIRERS REGULATIONS 2007 - SCHEDULE 1

[r. 14]

        [Heading inserted in Gazette 24 Jun 2008 p. 2831.]

Form 1

Motor Vehicle Repairers Act 2003 , s. 101(1)
Infringement notice

Infringement
notice no.

Alleged offender

Name:         Family name

        Given names

or         Company name ____________________________________
                ACN

Address _________________________________________________
        Postcode

Alleged offence

Description of offence ______________________________________


Motor Vehicle Repairers Act 2003 s.
OR
Motor Vehicle Repairers Regulations 2007 r.  


Date         /         /20         Time         a.m./p.m.

Modified penalty $

Authorised officer issuing notice

Name

______________________________________
Signature

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 28 days after the date of this notice.


How to pay
By post:         Send this notice (or a copy) with a cheque or money order (made payable to the Commissioner) to:
        Department of Commerce - Consumer Protection
        Locked Bag 14 Cloisters Square
Perth WA 6850


In person: Present this notice and your payment to the cashier at:
        Department of Commerce - Consumer Protection
        219 St George’s Terrace, Perth WA
If you do not pay the modified penalty within 28 days, you may be prosecuted.


If you need more time to pay the modified penalty, you can apply for an extension of time by writing to:
        The Commissioner
        Department of Commerce - Consumer Protection
        Locked Bag 14 Cloisters Square
        Perth WA 6850
If you want this matter to be dealt with by prosecution in court , sign here _______________________________________
and, within 28 days after it was given, post this notice to the above postal address.

        [Form 1 inserted in Gazette 24 Jun 2008 p. 2831-2; amended in Gazette 30 Jun 2011 p. 2665-6.]

Form 2

Motor Vehicle Repairers Act 2003 , s. 103(1)
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 ______________________________________

Motor Vehicle Repairers Act 2003 s.
OR
Motor Vehicle Repairers Regulations 2007 r.  

Date         /         /20         Time         a.m./p.m.

Person giving this notice

Name

______________________________________
Signature

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:
                The Commissioner
        Department of Commerce - Consumer Protection
        Locked Bag 14 Cloisters Square
        Perth WA 6850
Signature         /         /20

        [Form 2 inserted in Gazette 24 Jun 2008 p. 2832-3; amended in Gazette 30 Jun 2011 p. 2666.]




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