Road Traffic (Infringements) Amendment Regulations 2009 (WA)

13 November 2009 GOVERNMENT GAZETTE, WA 4539

TRANSPORT

TR301*

Road Traffic Act 1974

Road Traffic (Infringements) Amendment

Regulations 2009

Made by the Governor in Executive Council.

1.             Citation

These regulations are the Road Traffic (Infringements)
Amendment Regulations 2009.

2.             Commencement

These regulations come into operation as follows —

(a)	regulations 1 and 2 — on the day on which these regulations are published in the Gazette;
(b)	the rest of the regulations — on the day after that day.

3.             Regulations amended

These regulations amend the Road Traffic (Infringements)
Regulations 1975.

4.             Schedule 2 Form 4 replaced

Delete Schedule 2 Form 4 and insert:

Form 4

MOTOR VEHICLE OFFENCE — NOTICE REQUESTING INFORMATION

Road Traffic Act 1974 s. 102C, 102D

Notice No. [Notice No.] Vehicle No. [Vehicle No.]

[Name and address of responsible person]

Date of issue [Issue date]

Compliance date [Compliance date]

REQUEST FOR INFORMATION

Under the Road Traffic Act 1974 you are a responsible person for the vehicle referred to above.
It is alleged that the offence described in Part A was committed involving that vehicle. As a responsible person you are required to give
to the WA Police the name and address of the driver or person in charge of the vehicle at the time of the alleged offence.

To do this fill in Part B and return this form by the compliance date.

Failing to provide the information as requested is an offence. There is more information about this overleaf.

Issuing officer	PD No.
PART A	DETAILS OF OFFENCE
Offence Location

4540 GOVERNMENT GAZETTE, WA 13 November 2009

Date and time ________ / _______ / _______ _____________ hours

These images identify the vehicle involved in the alleged offence and may assist you to identify the driver.

[Photographs of vehicle]

PART B INFORMATION TO BE PROVIDED

If you know who was driving or in charge of the vehicle at the time of the alleged offence, fill in Division 1.

If the vehicle had been stolen or unlawfully taken or used, fill in Division 2.

If you do not know who was driving at the time, you may make a statutory declaration to that effect as described in Division 3.

Division 1 Driver or person in charge known	T Driver	or	T Person in charge of vehicle
Surname No. and street	Given names

Suburb Postcode

Phone No. Driver’s licence No. State

Division 2 Vehicle stolen or unlawfully taken or used	T Stolen or unlawfully taken or used
Reported to police	T Yes Report No.

Division 3 Driver or person in charge not known
If you do not know and cannot reasonably ascertain the name and address of the driver or person in charge of the vehicle at the time
of the alleged offence you may give a statutory declaration to that effect. The statutory declaration must be returned with this form.
A statutory declaration must be made in accordance with the Oaths, Affidavits and Statutory Declarations Act 2005.

It must be signed before an authorised witness. An example statutory declaration is available at [www. Police website ].

Making a false statutory declaration is an offence for which you may be imprisoned for 5 years.

SIGN AND RETURN FORM

Surname No. and street	Given names
Suburb Postcode
Phone No.	Position
Signature	Date

Return	By post	[Postal address]
form	In person	[Street address]

Reverse of Form 4

If you have filled in Part B on the front of the form, DO NOT FILL IN THIS SIDE OF THE FORM

FAILING TO PROVIDE REQUESTED INFORMATION IS AN OFFENCE

If you do not complete Part B and return this form by the compliance date set out on the front of this form you commit an offence —
called the “failing to comply offence”.

This notice then has effect as an infringement notice about the failing to comply offence. Infringement No. [Notice No.]

If you do not want to be prosecuted for the failing to comply offence, you can pay the	Modified penalty [Modified penalty]
modified penalty. To do this you must pay the modified penalty by the payment date.
The options for how to pay are set out in Part D below.	Payment date [Payment date]

If you do not do pay the modified penalty you may be prosecuted for committing the failing to comply offence. offence described in Part A. You may also be ordered to pay costs.

If you want the offence dealt with by a court, fill in Part C and return this form by the payment date.

PART C	FAILING TO COMPLY OFFENCE – ELECTION TO GO TO COURT
T	I elect to have the failing to comply offence described above dealt with by a court.
Surname No. and street	Given names
Suburb Postcode
Phone No.	Position
Signature	Date

By post [Postal address]

Return form

In person [Street address]

PART D FAILING TO COMPLY OFFENCE – PAYMENT OPTIONS

[Details of how to pay:

• in person

• by post

• by any available electronic or other methods.]

By Command of the Governor,

PETER CONRAN, Clerk of the Executive Council.