Western Australian Consolidated Regulations Western Australian Consolidated Regulations (1) An infringement
notice under section 87 of the Act shall be in the form of Form 1 in the
schedule to these regulations.
(2) An embargo notice
under section 90B of the Act shall be in the form of Form 2 in the
schedule to these regulations.
Form 1
WESTERN AUSTRALIA
Police (Gaming) Regulations 1982
INFRINGEMENT NOTICE
DATE . . . . . . . . . . . . . .
M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . .
Surname (Block
letters) Other
names in full
ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .
Number
and Street
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Post Code . . . . . . . . . . .
Town and Suburb
* DATE OF BIRTH . . . . . . . . . . . . . . . . . . . . * AGE . . . . . . . .
. . . . . . .
* DRIVER’S LICENCE No. . . . . . . . . . . . . . . * EXPIRY DATE . . . .
. . .
It is alleged that on the . . . . . . . . . . . . . . . . day of . . . . . . .
. . . . . . . . . . . .
19 . . . . . at about . . . . . . . . . . . . hours, you were found committing
an offence
against section 87 (6) of the Police Act 1892 on premises situated
at . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
such premises being alleged to be a common gaming house. If you do not wish to
have a complaint of the alleged offence heard and determined in a court you
may complete the form attached to this notice and forward or deliver that form
together with the sum of $50 by way of modified penalty to a person named on
the back of this notice within . . . . . . . . . . . . . . [insert a time of
not less than 10 days] days from the date on which this notice is given,
whereupon you will not be liable to costs or further penalty in the matter.
You have a right to decline to proceed in the manner described above and if
you wish to contest the allegation or submit to the court matters in
extenuation of penalty or for any other reason to allow the matter to be
determined in a court hearing you need not reply or take any further action in
respect of this notice, in which case a complaint of the alleged offence may
be made against you in due course.
STATION . . . . . . . . . . . . . . . . POLICE OFFICER . . . . . . . . . . . .
. No. .
* If known.
Form 2
WESTERN AUSTRALIA
Police (Gaming) Regulations 1982
EMBARGO NOTICE
I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . [insert name
of the justice of the peace granting embargo notice] of . . . . . . . . . . .
. . . .
being a justice of the peace and being satisfied on the application of the
following * police officer/* constable . . . . . . . . . . . . . . . . .
[insert name and designation of applicant police officer or constable] that
there is reasonable cause to believe that . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
[insert description of things] may be required as evidence for the purposes of
proceedings under the Police Act 1892 or is liable to forfeiture under
that Act and cannot, or cannot readily, be seized and detained under that Act,
hereby grant to that * police officer/* constable an embargo notice in respect
of * that thing/* those things.
* Delete whichever is inapplicable.
Granted on . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
Signature of justice of the
peace
granting embargo notice
NOTE: The attention of the person on whom this embargo notice is served is
drawn to sections 90B and 90C of the Police Act 1892 , as amended.