For the purposes of sections 88(3) and 89A(7) of the Act, a withdrawal notice—
(a) must be served in accordance with section 93 of the Act; and
(b) must contain the following particulars—
(i) the name and address of the person on whom the traffic infringement notice was served; and
(ii) the number and date of issue of the traffic infringement notice; and
(iii) a statement that the traffic infringement notice has been withdrawn; and
(iv) if it is intended that proceedings in the Magistrates' Court be instituted against the person in respect of the alleged traffic infringement, a statement to that effect; and
(v) if a payment has been made in respect of the infringement penalty, a statement that the amount paid will be refunded.