To:
[defendant’s full name or (if not a natural person) full legal name, and defendant’s postal address]
Enforcement authority: [name and postal address of authority]
Infringement notice number:
Date of birth: [if a natural person]
This notice is to remind you that an infringement notice under section 56B of the Health and Safety in Employment Act 1992 has been issued to you.
The infringement fee payable is: [state amount from infringement notice].
The last date of payment is now 28 days after date of issue of this notice. The due date is: [date].
For your information, full details of the alleged infringement offence and the infringement notice are set out below.
The infringement notice was issued by [name of inspector], being a health and safety inspector appointed under section 29(1) of the Health and Safety in Employment Act 1992.
The infringement notice was issued in relation to an alleged infringement offence
For a breach of: [state provision of the Act or regulations that has allegedly been breached] |
In that you: [describe nature of alleged breach] |
This alleged infringement offence took place at: |
Location: [details of location] | Date: [date of alleged offence] |
| Time: [time of alleged offence] |
You have received prior warning for the same or a similar matter, being: [eg, details of hazard or prohibition notice]. |
Infringement fees may be paid [insert details of where to pay and method of payment].
Note: Payment must be made in full. Part payment will not be accepted.
IMPORTANT: Please read the summary of rights printed on the following pages.
Details of service
[To be provided for filing in court.]
Infringement notice: Served by personal service*/postal service* on [date of service].
Reminder notice: Served by personal service*/postal service* at [address**] on [date of service].
*Delete which does not apply. |
**Full address at which the reminder notice was served. |
REMITTANCE ADVICE The remittance advice must accompany all payments. | | Infringement notice number: Client number: Due date: |
Name and address: [name and address of defendant] | | Infringement fee payable: [amount] |
Summary of rights
Payments
1
If you pay the infringement fee for the alleged infringement offence within 28 days after being served with this notice, no further enforcement action will be taken against you for the offence.
Further action
2
You may—
raise any matter relating to the circumstances of the alleged infringement offence with the enforcement authority; or
deny liability for the offence and request a court hearing; or
admit liability for the offence, but have a court consider written submissions as to penalty or otherwise.
For more details, read paragraphs 3 to 6 below.
3
To raise any matter relating to the circumstances of the alleged infringement offence, write to the enforcement authority at the address on the front page of this notice. You should raise these matters with the enforcement authority at the earliest opportunity.
4
If you deny liability and wish to request a hearing in the District Court in respect of the alleged infringement offence, you must, before or within 28 days after service on you of this reminder notice, write to the enforcement authority at the address on the front of this notice requesting a court hearing in respect of the alleged offence. You must sign your request. If you are a body corporate, a person authorised to act on your behalf must sign the request. The enforcement authority will, unless it decides not 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.
Note:
If the court finds you guilty of the offence, costs will be imposed in addition to any penalty.
5
If you admit liability for the offence, but want the court to consider your submissions as to penalty or otherwise, you must, before or within 28 days after service on you of this reminder notice,—
write to the enforcement authority at the address shown on the front of this notice; and
set out the written submissions you wish to be considered by the court; and
sign your request. If you are a body corporate, a person authorised to act on your behalf must sign the request.
The enforcement authority will then file your letter with the court (unless it decides not to commence court proceedings in respect of the alleged offence). There is no provision for an oral hearing before the court if you follow this course of action.
Note:
Costs will be imposed in addition to any penalty.
6
The infringement notice may be withdrawn by an inspector at any time before—
the infringement fee is paid; or
an order for payment of a fine is made or deemed to be made by a court under section 21 of the Summary Proceedings Act 1957.
If the infringement notice is withdrawn, written notice will be given to the person who received the infringement notice.
Further details about correspondence or payment of infringement fee
7
When writing or making payment of an infringement fee, please indicate—
the infringement notice number; and
the date of the alleged infringement offence; and
your address for reply (if you are not paying the infringement fee for the alleged offence).
Non-payment of infringement fee
8
If you do not pay the infringement fee and do not request a hearing in respect of the alleged offence within 28 days after being served with this notice, you will be liable to pay costs in addition to the infringement fee (unless the enforcement authority decides not to commence proceedings against you).
Defence
9
You have a defence in proceedings for an alleged infringement offence if the infringement fee for that offence has been paid to the enforcement authority at the address shown on the front page of this notice before or within 28 days after service on you of this reminder notice. Late payment or payment made to any other address will not constitute a defence.
Note:
All queries and correspondence regarding the alleged infringement offence must be directed to the enforcement authority named in this notice at the address shown on the front page of this notice.
Schedule form 4: amended, on 10 October 2006, by regulation 4(1) of the Health and Safety in Employment (Prescribed Matters) Amendment Regulations 2006 (SR 2006/262).
Schedule form 4: amended, on 10 October 2006, by regulation 4(2)(a) of the Health and Safety in Employment (Prescribed Matters) Amendment Regulations 2006 (SR 2006/262).
Schedule form 4: amended, on 10 October 2006, by regulation 4(2)(b) of the Health and Safety in Employment (Prescribed Matters) Amendment Regulations 2006 (SR 2006/262).
Schedule form 4: amended, on 10 October 2006, by regulation 4(2)(c) of the Health and Safety in Employment (Prescribed Matters) Amendment Regulations 2006 (SR 2006/262).