Issuing officer: [name or number]
Address for correspondence and queries:
Alleged infringement offence details
Details of premises or specific location where alleged infringement offence committed:
Act or omission that you are alleged to have committed:
Payment of infringement fee
Infringement fee/Amount of the infringement fee* remaining unpaid: $[amount]
You must pay the infringement fee within 28 days after the service of this notice. The last date for payment is [date].
[Specify method(s) of payment and address for payment.]
(To be provided for filing in court)
The infringement notice was served by personal service/prepaid post*.
The reminder notice was served by personal service/prepaid post* at [full address at which reminder notice was served].
If there is anything in these notes you do not understand, you should consult a lawyer.
Note: The type of infringement offence that you are alleged to have committed appears in this form.
If you pay the infringement fee or the amount of the infringement fee remaining unpaid within 28 days after the service of this notice, no further enforcement action will be taken against you.
You will have a complete defence against proceedings relating to the alleged offence if you can show that the infringement fee or the amount of the infringement fee remaining unpaid has been paid to the enforcement authority and received at the address specified for payment within 28 days after the service of this notice.
Late payment, or payment made to any other address, will not constitute a defence to proceedings in respect of the alleged offence.
You must write to the enforcement authority at the address specified for correspondence and queries if you wish to do any of the following things:
raise a matter concerning the circumstances of the alleged offence for consideration by the enforcement authority:
deny liability for the alleged offence and request a court hearing:
admit liability for the offence, but have the court consider submissions as to penalty or otherwise. In your letter, you must request a hearing, admit liability in respect of the offence, and set out the submissions that you would like the court to consider.
You must ensure that your request is received on or before the last day for payment.
If you deny liability and request a court hearing, the enforcement authority will, if it decides to commence court proceedings in respect of the alleged offence, serve you with a notice of hearing setting out the place and time at which the matter will be heard by the court.
If you admit liability but wish to have the court consider submissions, the enforcement authority will then, if it decides to commence court proceedings in respect of the offence, file your letter with the court. You are not entitled to make oral submissions to the court.
If the court finds you guilty or if you admit liability and make submissions, costs will be imposed in addition to any penalty.
If you do not request a hearing and you do not pay the infringement fee or the amount of the infringement fee remaining unpaid within 28 days after the service of this notice, you will become liable to pay a fine and court costs.
Note: All payments, queries, and correspondence regarding this notice must be directed to the enforcement authority at the relevant address shown in this notice. When writing, please include the date of the alleged infringement offence, the reminder notice number (shown above), the full legal name of the notice recipient, and your address for replies.