Queensland Consolidated Acts Queensland Consolidated ActsThe evidence of A.B. [and C.D.], a witness [or witnesses] produced at my examination before justices on the charge of , having been read over to me, I hereby state that I do not require the said A.B. [and C.D.] to be produced as a witness [or witnesses] at my trial, and I consent that [his, her or their] deposition [or depositions] and the exhibits [here specify them] annexed thereto shall be admitted as evidence on my trial.
[Signature of accused]
Witnesses to signature of accused:
(Signed by) } Committing justices
This day of , 20