Victorian Numbered Regulations

CHILDREN AND YOUNG PERSONS (CHILDREN'S COURT) (AMENDMENT) REGULATIONS 2006 (SR NO 119 OF 2006) - REG 17

r. 17

For Form 1 of Schedule 8 to the Principal Regulations substitute —

"FORM 1

                                        Regulation 21(1)

Children and Young Persons Act 1989
(Schedule 2A clause 3(1)(a))

INFRINGEMENT PENALTY FOR REGISTRATION

[ Name of Enforcement Agency ] seeks to have the infringement penalty, as detailed below, registered.

DETAILS OF CHILD

Surname:                     Other Names:

Date of Birth:

Address:                                

Suburb:                         Postcode:

DETAILS OF INFRINGEMENT NOTICE

Description of offence:                                

*Act/*Statutory Rule/*Local Law/*Subordinate Instrument/ *Commonwealth Act or any Act of another State or Territory or any subordinate instrument under such an Act that applies as a law of Victoria/*Code:        

Infringement Notice No.:

Time of offence:                     Date of offence:    

Place of offence:                     Date of Issue of Infringement
    Notice:

VEHICLE DETAILS (if relevant)

Registration Number:     State of Issue (Registration):

*Licence/*Permit Number:                    

State of Issue (*Licence/*Permit):

Vehicle Class:

ENFORCEMENT AGENCY DETAILS

Informant's Name:    

Agency:                                    

Address:                                    

PENALTY/INSTALMENT DETAILS

The original infringement amount was: [ insert amount ]

The amount that has been paid is: [insert amount]

The amount to be registered (including $ [insert amount] costs) is: [insert amount]

(The amount to be registered consists of the original infringement amount minus any amount previously paid to the Agency (whether or not pursuant to a payment plan), plus any prescribed costs.)

*delete if not applicable.

NOTES:    
•         this form can be replicated for each additional penalty/instalment.

__________________".