approved forms (magistrates court criminal rules 1992)
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South Australia
APPROVED FORMS
Approved Forms relating to Magistrates Court Criminal Rules 1992.
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INDEX OF FORMS
Form 01 Application for release on bail ....................................................................................................................... 6
Form 06 Application for review of bail by Magistrate ................................................................................................... 7
Form 07 Application to vary or revoke bail .................................................................................................................. 9
Form 7 Application to vary conditions of or revoke bail agreement ....................................................................... 11
Form 08 Application to vary terms of or revoke guarantee of bail ........................................................................... 13
Form 01 Complaint ..................................................................................................................................................... 15
Form 02 complaint and summons ............................................................................................................................. 16
Form 03 Complaint and summons with form for plea ............................................................................................... 19
Form 04 Information .................................................................................................................................................. 23
Form 05 Information and summons .......................................................................................................................... 25
Form 05A Summons ........................................................................................................................................................ 28
Form 5B Summons ..................................................................................................................................................... 31
Form 06 Warrant of apprehension .............................................................................................................................. 34
Form 07 Warrant of remand ...................................................................................................................................... 36
Form 08 Form of election ........................................................................................................................................... 38
Form 9A Admission and consent t sentence .............................................................................................................. 42
Form 10 Order of committal ...................................................................................................................................... 44
Form 11 Summons to witness .................................................................................................................................... 45
Form 12 Warrant to arrest witness ............................................................................................................................ 49
Form 13 Notice to produce person from custody ...................................................................................................... 53
Form 15 Notice in respect of drivers licence pursuant to section 27c(2) or section 27c(3) ...................................... 55
Form 15A Summons to person substantially affected ................................................................................................... 58
Form 16 Notice of order of forfeiture, destruction, compensation etc ..................................................................... 61
Form 17 Notice of previous convictions..................................................................................................................... 64
Form 18 Notice of penalty ......................................................................................................................................... 66
Form 19 Application for rehearing ............................................................................................................................... 67
Form 20 Notice of committal on written plea of guilty ............................................................................................. 69
Form 21A Important information for defendants committed for trial to the Supreme or District Court (State
Prosecutions) ........................................................................................................................................... 70
Form 21B Information for defendants committed for trial (Commonwealth Prosecutions) ........................................ 73
Form 22 Application to vary a community service order ........................................................................................... 76
Form 23 Application miscellaneous statutory jurisdiction section 10 rule 29 Magistrates Court Act ................ 78
Form 24 Warranty of commitment - contempt ......................................................................................................... 81
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Form 25 Request for registration of order ................................................................................................................. 83
Form 26 Warrant of distress against body corporate registered order .................................................................. 85
Form 27 Authority to enter and inspect section 22 Magistrates Court Act ............................................................ 88
Form 28 Application for intervention order ............................................................................................................... 89
Form 28A Complaint (paedophile restraining order) ...................................................................................................... 3
Form 28B Complaint (child protection restraining order) ............................................................................................... 4
Form 29 Interim intervention summons order ............................................................................................................ 6
Form 29A Summons (paedophile restraining order) ..................................................................................................... 10
Form 29B Summons (child protection restraining order) .............................................................................................. 13
Form 30 Intervention order ....................................................................................................................................... 16
Form 31 Application for variation or revocation of intervention order .................................................................... 20
Form 31A Restraining order (paedophile) and summons (s 99A and 99C) ................................................................... 21
Form 31B Restraining order (child protection) and summons ...................................................................................... 25
Form 31C Restraining order (Paedophile) ..................................................................................................................... 28
Form 31D Restraining order (child protection) .............................................................................................................. 29
Form 32 Application to revoke restraining order ...................................................................................................... 30
Form 33 Restraining order as varied .......................................................................................................................... 33
Form 34 Order revoking restraining order ................................................................................................................. 36
Form 35 Notice of not guilty hearing ......................................................................................................................... 37
Form 36 Problem gambling order .............................................................................................................................. 40
Form 37 Notice of problem gambling attachment order .......................................................................................... 41
Form 38 Notice of intention to assign tenancy .......................................................................................................... 42
Form 39 Tenancy Order ............................................................................................................................................. 44
Form 40 Application to vary or revoke a problem gambling order or tenancy order ................................................ 45
Form 41 Request to register foreign intervention order ........................................................................................... 46
Form 41 Request to register foreign intervention order ........................................................................................... 47
Form 42 Notice of registration of foreign intervention order ................................................................................... 48
Form 43 Multilingual notice ....................................................................................................................................... 49
Form 44 Application for extension of period of detention ........................................................................................ 52
Form 45 Affidavit (intervention order) ...................................................................................................................... 53
Form 46 Order for variation or revocation of intervention order ............................................................................. 55
Form 47 Application for a control order .................................................................................................................... 56
Form 48 Interim control order and summons ........................................................................................................... 57
Form 49 Control order ............................................................................................................................................... 59
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Form 50 Application for variation or revocation of control order or interim control order ............................................................................................................................ 61
Form 51 Order for variation or revocation of control order or interim control order .............................................. 63
Form 53 Application for warrant (Animal Welfare Act) ............................................................................................. 64
Form 53 Warrant (Animal Welfare Act s.31D) ........................................................................................................... 66
Form 54 Duplicate warrant (Animal Welfare Act s.31D)............................................................................................ 68
Form 55 Appeal of enforcement determination ........................................................................................................ 70
Form 56 Application for community service order .................................................................................................... 71
Form 57 Application to revoke community service order ........................................................................................... 72
Form 58 Application to oppose seizure and sale of assets ........................................................................................ 73
Form 59 Order to exclude property from sale or direct proceeds of sale ................................................................. 74
Form 60 Application to release a seized and clamped or impounded vehicle .......................................................... 75
Form 61 Order to release a seized and clamped or impounded vehicle ................................................................... 77
Form 62 Notice of community service order (pecuniary penalties) .......................................................................... 78
Form 63 Order for restoration of pecuniary .............................................................................................................. 79
Form 73 Order for detention mental incapacity provision CLCA ............................................................................ 80
Form 74 Warrant of apprehension for forensic procedure ....................................................................................... 81
Form 75 Fortification removal order .......................................................................................................................... 82
Form 77 Withdrawal notice 9Fortification Removal Order, SOA s.74BH) ................................................................. 86
Form 77 Withdrawal notice (fortification removal order, SOA s.74BH) .................................................................... 88
Form 78 Warrant of arrest (Criminal Law (Sentencing) Act, 1988, s.71(3)(a),71 (4)) ................................................ 90
Form 79 Application for review of licence disqualification/suspension (Road Traffic Act 1961 s47IAB) .................. 91
Form 80 Application for special arrangements (Evidence Act) .................................................................................. 92
Form 81 Notice of objection (Evidence Act) .............................................................................................................. 93
Form 82 Warrant of arrest fail community service (Criminal law (Sentencing) Act 1988, s71(3)(b)) ..................... 95
Form 83 Application for clamping, impounding and forfeiture of vehicles ............................................................... 97
Form 84 Order to extend clamping period or offer for impounding or forfeiture of motor vehicle ....................... 100
Form 85 Order for relief (Criminal law (Clamping, Impounding and Forfeiture of Vehicles) Act 2007 ........ s.12(1))
102
Form 86 Application for a warrant to seize a motor vehicle (Criminal Law (Clamping, Impounding and .. Forfeiture
of Vehicles) Act 2007 s.17(2)) ........................................................................................................................................ 104
Form 87 Warrant of seizure of motor vehicle (Criminal Law Clamping, Impounding and Forfeiture of Vehicles) Act
2007 s.17(2) ................................................................................................................................................................... 107
Form 88 Warrant of seizure of motor vehicle [telephone application] (Criminal Law (Clamping, ... Impounding and
Forfeiture of Vehicles) Act 2007 s.17(2)) ....................................................................................................................... 109
Form 89 Duplicate warrant of seizure of motor vehicle (Criminal Law (Clamping, Impounding and ..... Forfeiture of
Vehicles) Act 2007 s17(2)) ............................................................................................................................................. 111
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Form 90 Application for warrant to enter and search premises (Road Traffic Act 1961 s.40T and 341B) ............................................................................................................... 114
Form 91 Warrant to enter and search premises (Road Traffic Act 1961 s.40T and 41B) ........................................ 116
Form 92 Duplicate warrant to enter and search premises (Road Traffic (Miscellaneous) Regulations 1999, Reg 10)
118
Form 93 Application for search warrant (National Electricity Law s.21 or National Gas Law s.35) ......................... 120
Form 94 Search warrant (National Electricity Law s.21 or National Gas Law s.35) ................................................. 122
Form 95 Application for extension ........................................................................................................................... 124
Form 96 Application for search warrant (Rail Safety National Law (SA) Act 2012, par 150 of the .............. Schedule)
126
Form 97 Search Warrant (Rail Safety National Law (SA) Act 2012, par 150 of the Schedule) ................................. 128
Form 98 Duplicate warrant (Rail and Safety National Law (SA) Act 2012, par 150 of the Schedule) ...................... 130
Form 99 Firearms prohibition order ........................................................................................................................ 132
Form 100 Application for disclosure of operatives identity in proceedings ......................................................... 136
Form 101 Suppression order .................................................................................................................................. 138
Form 102A Notice of intention by the prosecution authority to adduce evidence of discreditable conduct ..................
........................................................................................................................................................... 139
Form 102B Notice of intention by a defendant to adduce evidence of discreditable conduct .................................. 141
Form 102C Notice of objection to proposed evidence of discreditable conduct ....................................................... 143
Form 103 Application for warrant (Correctional Services Act 1982 s 76 or 76A) .................................................. 144
Form 104 Warrant (Correctional Services Act 1982 s76 or 76A) ........................................................................... 146
Form 105 Order upon notification ......................................................................................................................... 147
Form 106 Interim non-association order and/or place-restriction order and summons ...................................... 148
Form 107 Non-association order and/or place-restriction order .......................................................................... 152
Form 108 Application for variation or revocation of non-association order and/or place-restriction order ..............
............................................................................................................................................................... 156
Form 109 Publication Order ................................................................................................................................... 158
Form 110 Application for spent conviction order and/or exemption order .......................................................... 160
Form 111 Spent conviction order and/or exemption order .................................................................................. 164
Form 112 Application for warrant (heavy Vehicle National Law (SA) Act 2013, Clause 506 of the ........... Schedule)
166
Form 113 Warrant (Heavy Vehicle National Law (SA) Act 2013, Clause 507 of the Schedule).............................. 168
Form 114 Duplicate warrant (Heavy Vehicle National Law (SA) Act 2013, Clause 508 of the Schedule .....................
............................................................................................................................................................... 170
Form 115 Affidavit .................................................................................................................................................. 172
Form 116 Application for enforcement warrant (Marine Safety (Domestic Commercial Vessel) Nation .......... Law
(Application) Act 2013, Schedule 1, Clause 135) ........................................................................................................... 174
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Form 117 Enforcement warrant (Marine Safety (Domestic Commercial Vessel) National Law ......................................... (Application) Act 2013, Schedule 1, Clause 135 176
Form 118 Duplicate warrant (Marine Safety (Domestic Commercial Vessel) National Law (Application) . Act 2013,
Schedule 1, Clause 136) ................................................................................................................................................. 178
Form 119 Application for warrant (Burial and Cremation Act 2013) ..................................................................... 180
Form 120 Warrant (Burial and Cremation Act 2013) ............................................................................................. 182
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Form 01 Application for release on bail
FORM 1 - BAIL ACT 1985 (section 8(1))
APPLICATION FOR RELEASE ON BAIL
I, (insert full name) (the applicant)
apply for bail.
Signature of Applicant:
Date of application:
Time of application: hours
DECISION OF BAIL AUTHORITY
Tick appropriate box
Bail refused (Form 2 Written record of reasons for refusal of bail
application must be completed except where the
authority refusing bail is a judge of the Supreme
Court or the District Court)
Bail granted (Form 3 Grant of bail must be completed)
Full name of bail authority:
Bail authoritys signature:
Date:
Time: hours
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Form 06 Application for review of bail by Magistrate
Bail Act 1985
(sections 14(2)(b) and 15)
Application for review of bail by Magistrate
NoteIf the Supreme Court is to review the decision of the bail authority, the appropriate application form under the rules of the
Supreme Court must be completed and not this form.
Part A: Application
(Insert full name of person applying for release on bail)
of (insert address)
is charged with / has been convicted of
I, (insert name of applicant)
of (insert address)
apply to (insert name of court)
at
to review a decision of a bail authority, namely
(insert name of bail authority and brief description of decision)
made at
on / /
Applicants signature:
Date:
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Part B: Review of bail by Magistrate by telephone under section 15
Name of magistrate contacted:
Date contact made:
Time of contact:
Result of review: Refused / Granted
Signature of member of police force
or justice who contacted the magistrate:
Note: Strike out Part B if the review of bail is to be heard in court.
Part C: Notice of Court hearing of review of bail
To
The person applying for release on bail
The police prosecutor at
The Director of Public Prosecutions
The guarantor of bail
The application for review of a bail authority, the details of which are set out in Part A, has been listed for hearing at
the Magistrates Court / Youth Court sitting at
on (insert day and date)
at am / pm
All parties to the application must attend the hearing.
Court officers signature:
Date:
Note: Strike out Part C if the review of the bail is to be heard by telephone.
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Form 07 Application to vary or revoke bail
FORM 7 BAIL ACT 1985 (Section 6(4))
APPLICATION TO VARY CONDITIONS OF BAIL AGREEMENT
APPLICATION TO REVOKE BAIL AGREEMENT
PART A: APPLICATION
(Insert full name of person released on bail)
of (insert address)
is charged with / has been convicted of
and was granted bail on / /
I, (insert name of applicant)
of (insert address)
apply to (insert name of court)
at
to - vary the conditions of the bail agreement
revoke the bail agreement
I make this application on the following grounds:
Applicants signature:
Date:
PART B: NOTICE OF HEARING
TO
The person on bail
The police prosecutor at
The Director of Public Prosecutions
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The guarantor of bail
The application to
vary the conditions of a bail agreement
revoke the bail agreement
the details of which are set out in Part A, has been listed for hearing at (insert name of court)
on (insert day and date)
at am / pm
All parties to the application must attend the hearing.
Court officers signature:
Date:
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Form 7 Application to vary conditions of or revoke bail agreement
FORM 7 BAIL ACT 1985 (Section 6(4))
APPLICATION TO VARY CONDITIONS OF BAIL AGREEMENT
APPLICATION TO REVOKE BAIL AGREEMENT
PART A: APPLICATION
(Insert full name of person released on bail)
of (insert address)
is charged with / has been convicted of
and was granted bail on / /
I, (insert name of applicant)
of (insert address)
apply to (insert name of court)
at
to - vary the conditions of the bail agreement
revoke the bail agreement
I make this application on the following grounds:
Applicants signature:
Date:
PART B: NOTICE OF HEARING
TO
The person on bail
The police prosecutor at
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The Director of Public Prosecutions
The guarantor of bail
The application to
vary the conditions of a bail agreement
revoke the bail agreement
the details of which are set out in Part A, has been listed for hearing at (insert name of court)
on (insert day and date)
at am / pm
All parties to the application must attend the hearing.
Court officers signature:
Date:
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Form 08 Application to vary terms of or revoke guarantee of bail
FORM 8 BAIL ACT 1985 (Section 7(4))
APPLICATION TO VARY TERMS OF GUARANTEE OF BAIL
APPLICATION TO REVOKE GUARANTEE OF BAIL
PART A: Application
(Insert full name of person released on bail)
of (insert address)
is charged with / has been convicted of
and was granted bail on / /
I, (insert name of guarantor)
of (insert address)
apply to (insert name of court)
at
to - vary the terms on my guarantee of bail
revoke my guarantee of bail
I make this application on the following grounds:
Guarantors signature:
Date:
PART B: NOTICE OF HEARING
TO
The guarantor
The person on bail
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The police prosecutor at
The Director of Public Prosecutions
The application to
vary the terms of a guarantee of bail
revoke a guarantee of bail,
the details of which are set out in Part A, has been listed for hearing at (insert name of court)
on (insert day and date)
at am / pm
All parties to the application must attend the hearing.
Court officers signature:
Date:
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Form 01 Complaint
Form 1
COMPLAINT Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 49
Court Use
date filed
Complainant
Name:.................................................... , .............................................. ...............................................
surname given name Complainants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
...............................................................................................................................................
city/town/suburb state postcode
Offence details
Other orders sought (forfeiture, compensation, additional penalty, destruction or the like Rule 15.03)
.............................. .......................................... ..........................................
Date Complainant
Witness (Registrar, Deputy Registrar or Justice of the Peace)
(Not required if Complainant is a Public Authority)
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Form 02 complaint and summons Form 2
COMPLAINT AND SUMMONS Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 49 and 57
Court Use
date filed
Complainant
Name:.................................................... , .............................................. ..........................................
surname given name Complainants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
...............................................................................................................................................
city/town/suburb state postcode
Offence details
Other orders sought (forfeiture, compensation, additional penalty, destruction or the like Rule 15.03)
.............................. ..........................................
.........................................................................................................................................................
Date Complainant
Witness
(Registrar, Deputy Registrar or Justice of the Peace)
(Not required if Complainant is a Public Authority)
Important notice to Defendant
If you fail to appear on the hearing date set out below or on any day to which this matter is adjourned the Court may:-
proceed in your absence or
issue a warrant for your arrest
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Hearing details Registry..................................................... Date....................................
Address..................................................... Time .................................am/pm
....................................... ................................................. ........................................
telephone facsimile e-mail address
. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing
there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less
than 16 years of age;
any other method permitted by the Rules specify
...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 03 Complaint and summons with form for plea Form 3
COMPLAINT AND SUMMONS
Magistrates Court of South Australia
www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 49 and 57
Court Use
date filed
Complainant
Name:.................................................... , .............................................. ..........................................
surname given name Complainants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Offence details
.............................. ..........................................
Date Complainant
Important notice to Defendant
If you fail to appear on the hearing date set out below or on any day to which this matter is adjourned the Court may:-
proceed in your absence or
issue a warrant for your arrest
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Hearing details Registry.................................................... Date....................................
Address.................................................... Time .................................am/pm
....................................... ................................................. ........................................
telephone facsimile e-mail address
. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
It is important that you read the information on the other side of this form.
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If you intend
pleading
guilty
attend at court either in person or through a solicitor.
fill out this form, have it witnessed by one of the listed people and send it to the court registry to which you were summonsed before the hearing date.
NOTE:- If you wish to apply to reduce the demerit points attracted by this offence you must attend at court to give evidence.
written
guilty plea
I am the defendant in this matter.
I wish to plead guilty to the charge(s)
I wish to say:- (attach sheet if insufficient space)
............................................ date
..........................................................................
signed by defendant or its authorised Manager or Managing Director
Details of witness
JP/Solicitor/Police Officer number ..........................................
..................................................... signed by witness
pleading not
guilty
Attend at court or have a solicitor attend for you and indicate a not guilty plea.
You will be expected to have discussed the issues in detail with the Complainant, or their representative prior to a trial date being set
If you do not attend court you may be convicted and fined in your absence.
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing there and
not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less than 16
years of age;
by sending 2 copies by prepaid post.
any other method permitted by the Rules specify
...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 04 Information Form 4
INFORMATION
Magistrates Court of South Australia
www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 101
Court Use
date filed
Informant
Name:.................................................... , .............................................. ..........................................
surname given name Informants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Offence details
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Other orders sought (forfeiture, compensation, additional penalty, destruction or the like Rule 15.03)
.............................. ..........................................
..........................................
Date Informant
Witness
(Registrar, Deputy Registrar or Justice of the Peace)
(Not required if Informant is a Public Authority)
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Form 05 Information and summons Form 5
INFORMATION AND SUMMONS Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 101 and 103
Court Use
date filed
Informant
Name:.................................................... , .............................................. ..........................................
surname given name Informants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Offence details
Other orders sought (forfeiture, compensation, additional penalty, destruction or the like Rule 15.03)
.............................. .......................................... ..........................................
Date Informant Witness
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(Registrar, Deputy Registrar or Justice of the Peace)
(Not required if Informant is a Public Authority)
Important notice to Defendant
If you fail to appear on the hearing date set out below or on any day to which this matter is adjourned the Court may:-
proceed in your absence or
issue a warrant for your arrest
Hearing details Registry..................................................... Date....................................
Address..................................................... Time .................................am/pm
....................................... ................................................. ........................................
telephone facsimile e-mail address
. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing
there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less
than 16 years of age;
any other method permitted by the Rules specify
...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 5A Summons
Form 5A
SUMMONS Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921
Sections 57 and 103
Court Use
date filed
Complainant/Informant
Name:.................................................... , .............................................. ..........................................
surname given name Complainant/Informants reference
Address .............................................. .............................................. ..................................
street telephone facsimile
................................................................................................. ..........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name dd/mmm/yy
Address ...................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Complaint/Information details
Date Complaint or Information made
............................................
Important notice to Defendant
If you fail to appear on the hearing date set out below or on any day to which this matter is adjourned the Court may:-
proceed in your absence or
issue a warrant for your arrest
Hearing details Registry..................................................... Date....................................
Address..................................................... Time .................................am/pm
-
....................................... ................................................. ........................................
telephone facsimile e-mail address
. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
-
PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing
there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less
than 16 years of age;
any other method permitted by the Rules specify
...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 5B Summons Form 5B
SUMMONS Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921
Section 57A
(Where written plea of guilty is permitted)
Court Use
date filed
Complainant
Name:.................................................... , .............................................. ...........................................
surname given name Complainant/Informants reference
Address .............................................. ............................................. .........................................
street telephone facsimile
................................................................................................. ...........................................
city/town/suburb state postcode e-mail address
Defendant
Name:..................................................... , ................................................ DOB..................................
surname given name dd/mmm/yy
Address .................................................................................................. ...........................................
street licence number
...............................................................................................................
city/town/suburb state postcode
Complaint
Date Complaint or Information made
............................................
Important notice to Defendant
If you fail to appear on the hearing date set out below or on any day to which this matter is adjourned the Court
may:-
proceed in your absence or
issue a warrant for your arrest
Hearing details Registry..................................................... Date....................................
Address..................................................... Time .................................am/pm
....................................... ................................................. ........................................
telephone facsimile e-mail address
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. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
It is important that you read the information on the other side of this form.
If you intend
pleading
guilty
attend at court either in person or through a solicitor.
fill out this form, have it witnessed by one of the listed people and send it to the court registry to which you were summonsed before the hearing date.
NOTE:- If you wish to apply to reduce the demerit points attracted by this offence you must attend at court to give evidence.
written
guilty plea
I am the defendant in this matter.
I wish to plead guilty to the charge(s)
I wish to say:- (attach sheet if insufficient space)
............................................ date
..........................................................................
signed by defendant or its authorised Manager or Managing Director
Details of witness
JP/Solicitor/Police Officer number ..........................................
..................................................... signed by witness
pleading not
guilty
Attend at court or have a solicitor attend for you and indicate a not guilty plea.
You will be expected to have discussed the issues in detail with the Complainant, or their representative prior to a trial date being set
If you do not attend court you may be convicted and fined in your absence.
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing
there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less
than 16 years of age;
any other method permitted by the Rules specify
...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day of .............................. 20...
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Form 06 Warrant of apprehension Form 6
WARRANT OF APPREHENSION Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921 - Section 58;
Bail Act 1985 - Section 18
Registry ............................................................. File No ............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Originating Document Type ..........................................................
Date Substantiated on Oath ..........................................................
Complainant/Informant ..........................................................
Defendant
Name:..................................................... , ................................................ DOB..................................
surname given name dd/mmm/yy
Address ..................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Particulars of Charge
Date of Offence .......................................................................
Offence Location .......................................................................
Offence .......................................................................
Section and Act .......................................................................
(And other charges)
Reason for Issue of Warrant ........................................................................
Date Warrant Issued ........................................................................
To the Commissioner of Police for the State of South Australia and each member of the Police Force for the State.
You are directed to apprehend the defendant and, subject to any endorsement below, bring the defendant as soon as practicable
before the Court to answer these charges and to be further dealt with according to law.
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. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
ENDORSEMENT Pursuant to section 5(2)(b) of the Bail Act 1985
Variable 1 The defendant may not be released on bail.
Variable 2 At the discretion of a member of the Police Force who is of, or above, the rank of Sergeant or who is in charge of a
police station, the defendant may be released on bail.
Variable 3 Person or class of persons authorised/required to release the defendant on bail following arrest
...............................................
............................................................
Registrar/Justice of the Peace
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Form 07 Warrant of remand
Form 7
WARRANT OF REMAND Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921 - Sections 59, 103 and 112;
Criminal Law (Sentencing) Act 1988 - Section 19(4)
Registry ............................................................. File No ............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Originating Document Type ..........................................................
Complainant/Informant ..........................................................
Defendant
Name:..................................................... , ................................................ DOB..................................
surname given name dd/mmm/yy
Address ..................................................................................................... ..................................
street licence number
..................................................................................................
city/town/suburb state postcode
Particulars of Charge
Date of Offence .......................................................................
Offence Location .......................................................................
Offence .......................................................................
Section and Act .......................................................................
(And other charges)
Particulars of Remand
Court Remanded to: ....................................................................
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TAKE NOTE
The requirements of s.19 of the Bail Act are such that if it becomes apparent that the defendant is not going to be
able to arrange bail in the terms certified above, then arrangements should be made for him/her to be brought back
before the court as soon as possible for the conditions to be reviewed.
In any event, if the defendant is not successful in arranging bail, then he/she must be brought back before the
court for the conditions to be reviewed within five days of the date of this warrant.
Prisoner movement arrangements should be made with the court on the day preceding the defendants court
appearance. If (after reviewing bail conditions) the court declines to vary the bail conditions certified on the warrant,
no further review is required.
Date and Time Remanded to: ....................................................................
Reason for Remand: ....................................................................
Correctional Institution: ....................................................................
Bail Conditions where Certified
The defendant who has not yet entered into a bail agreement, may be bailed by agreement upon the following
conditions:
Date Warrant Issued:
To the Sheriff, Commissioner of Police for the State of South Australia and each Member of the Police Force of the
said State and to the Executive Director of the Department of Correctional Services.
The Sheriff and the Commissioner of Police and Members of the Police Force, are directed to take the defendant to
the specified correctional institution. The Executive Director of the Department of Correctional Services, is directed
to receive the defendant unless he/she has been bailed in the meantime, detain the defendant until the day and time
specified, and on that day and at that time to have the defendant before the Court to which the defendant was
remanded to be further dealt with according to law, unless some other order is made in the meantime.
. . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
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Form 08 Form of election Form 8
ELECTION FORM Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921 - Section 103(2)
date filed
Registry ............................................................. File No ............................................
Address ...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Informant
surname given name Informants
reference
street telephone facsimile
city/town/suburb state postcode e-mail address
Defendant
surname given name dd/mmm/yy
street licence number
city/town/suburb state postcode
The information to which this form is attached contains minor indictable (*and summary) charges.
You have the right to choose how the charge(s) will be dealt with
* by a Magistrate; or
* by a Judge and Jury in the District Court
If you want the charge(s) dealt with in the District Court you MUST complete this form and return it to the
Magistrates Court.
Election
Defendants solicitor ....................................................
telephone facsimile e-mail
Defendants counsel ....................................................
telephone facsimile e-mail
Defendant to note: If you have changed your address, please supply details below:
.................................................................................
New address
..............................................................................
New telephone
-
IT IS ADVISABLE NOT TO COMPLETE THIS FORM UNLESS YOU HAVE HAD LEGAL ADVICE
N.B. (1) AN ELECTION DOES NOT TAKE EFFECT UNTIL THIS COMPLETED FORM IS FILED IN
THE COURT AT THE ABOVE ADDRESS. IT MUST BE LODGED -
(a) Where a summary of the evidence has been requested by the defence or directed by
the Court - within 14 days of the delivery of the summary;
(b) Where there is no request or direction for a summary - not later than 6 weeks after the
defendant's first appearance before the Court.
(2) A COPY OF THE INFORMATION TO WHICH THIS FORM RELATES MUST BE ATTACHED
WHEN IT IS FILED.
(3) YOU MAY NOT ELECT FOR TRIAL BEFORE A JUDGE SITTING WITHOUT A JURY {S.7(2)
JURIES ACT 1927}
* Delete as appropriate
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Form 09 Written plea admitting charge
Form 9
WRITTEN PLEA ADMITTING CHARGE
Magistrates Court of South Australia
www.courts.sa.gov.au
Summary Procedure Act, 1921 - Section 105(1)(a)
Court Use
date filed
Registry ............................................................. File No ............................................
Address ...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Informant
Name:.................................................... , .............................................. ..........................................
surname given name
Informants reference
Address .............................................. .............................................. ..................................
street telephone
facsimile
................................................................................................. ..........................................
city/town/suburb state postcode
e-mail address
Defendant
Name:..................................................... , ................................................ DOB ..................................
surname given name
dd/mmm/yy
Address ...................................................................................................... ..................................
street
licence number
..................................................................................................
city/town/suburb state postcode
I admit all charges in the attached Information and understand that I will be committed to a Superior Court for
sentence.
[If there is no major indictable charge you must first complete an ELECTION FORM before completing this
form.]
I certify that the defendant has had legal advice in
respect of this plea
.................................................
............................................
Defendant
-
solicitor
.
...........................................
date
Defendants solicitor ....................................................
.......................................... ............................................ .................................................
telephone facsimile e-
mail
Defendants counsel ....................................................
.......................................... ............................................ .................................................
telephone facsimile e-
mail
Defendant to note: If you have changed your address, please supply details below:
.....................................................................
New address
..................................................................
New telephone number
NOTE (1) If you complete this form, it must be lodged with the Court before the date set for your
appearance A copy of the INFORMATION to which this form relates must be attached
when it is filed. If you do that, you need not appear. You will be informed of the date and
time that you are to appear in the Superior Court.
(2) If there is NO MAJOR INDICTABLE charge and you want the Magistrates Court to
impose penalty on your plea of guilty, you must attend at the Magistrates Court hearing
in person.
You must do one or other, or a WARRANT for YOUR ARREST may be issued without further notice.
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Form 9A Admission and consent to sentence Form 9A
ADMISSION AND CONSENT TO SENTENCE
Magistrates Court of South Australia
www.courts.sa.gov.au
Summary Procedure Act 1921
Section 108
Court Use
Date Filed:
It is advisable not to complete this form unless you have had legal advice
Registry File No
Address
Street Telephone Facsimile
City/Town/Suburb State Postcode Email Address
Informant
Name
Surname Given name/s AP Number
Address
Street Telephone Facsimile
City/Town/Suburb State Postcode Email Address
Defendant
Full Name
Address
DOB
Street dd/mm/y
yyy
City/Town/Suburb State Postcode
The Information to which this form is attached contains major indictable charges.
You can admit the charge/s and consent to be sentenced by a Magistrate, rather than a Judge in the District
or Supreme Court. The Director of Public Prosecutions must also consent.
If you want to admit the charge/s and consent to be sentenced by a Magistrate you MUST complete this
form.
Admission and Consent
-
I admit the following major indictable charge/s and consent to being sentenced by the Magistrates Court:
............................................. ...............................................................
Date Defendant
I certify that the defendant has had legal advice in respect of this admission and consent.
............................................. ...............................................................
Date Defendants Solicitor
Solicitors Name
Telephone: Facsimile: Email:
............................................. ..............................................................
Date Defendants Counsel
Counsels Name
Telephone: Facsimile: Email:
On behalf of the Director of Public Prosecutions, I consent to the defendant being sentenced by the
Magistrates Court.
............................................. ..............................................................
Date Director of Public Prosecutions
Prosecutors Name
Telephone: Facsimile: Email:
IMPORTANT NOTICE
This form must be presented to the Court either at the time the defendant appears before the Court or at the
time the defendant returns a written plea of guilty.
A copy of the information to which this admission and consent relate must be attached.
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Form 10 Order of committal
Form 10
COMMITTAL FOR TRIAL/SENTENCE Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921 - Section 105 and 107
Registry .................................................... File No ............................................
Address ...............................................................
............................................
telephone
..................................
facsimile
............................................
e-mail address
Defendant
surname given name dd/mmm/yy
street licence number
city/town/suburb state postcode
Presiding Officer ..........................................................................
Nature of Committal trial sentence
Court Supreme Court District Court
Sitting place: ..........................
Charges:
An alibi notice has been given to the defendant.
* A copy of Section 69(3) of the Judiciary Act has been given to the defendant. (* delete if not applicable)
BAIL STATUS
on bail in custody, bail certified in custody, bail refused
Defendants solicitor ....................................................
telephone facsimile e-mail
Defendants counsel ....................................................
telephone facsimile e-mail
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Form 11 Summons to witness
Form 11
WITNESS SUMMONS Magistrates Court of South Australia www.courts.sa.gov.au
Magistrates Court Act, 1991, Section 20
Registry ............................................................. File No............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
........................................
....
e-mail address
Witness
Name: ..............................................................................................
Address: ..............................................................................................
Case details
surname given name
Offence .......................................................................
.......................................................................
Date of Offence .......................................................................
Offence Location .......................................................................
What you need to do: (for detailed explanation see attached sheet)
Attend Court to give evidence on the hearing date
Bring the Evidentiary Material listed below
Deliver the Evidentiary Material listed below to the Registrar before the hearing
Evidentiary Material:
-
The Seal of the Court is to be fixed to this form.
Hearing details
am/pm
telephone facsimile e-mail address
(delete as appropriate)
telephone facsimile e-mail address
Date:............................. . . . . . . . . . . . . . . .
. . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
-
Information about this summons.
Unless the summons has the Seal of the Magistrates Court on it, it has not been properly issued
and therefore doesnt need to be obeyed.
What is this document?
What do you have to do?
If the summons requires you to produce documents or things only, you may comply with it by delivering all of the documents or things to the Registrar of the Magistrates Court at the address given prior to the time and date on the summons.
If you do that, you do not have to attend on the day and at the time shown on the summons.You should only deliver documents or things to the Registrar if you have all of the documents or things requested and if you have no objection to producing them to the Court and to them being inspected by the parties to the case.
If you do deliver the documents or things to the Registrar, they should be securely packaged and have a copy of this summons attached.If you object to the parties seeing the documents or things, you must come to court on the day and at the time listed and tell the Magistrate why you object to producing them.
If the summons requires you to give evidence (whether or not it also requires you to bring documents or things), you must attend at the Registry on the day shown in sufficient time to be in the correct courtroom by the time listed unless you contact the person who had this summons issued and have arranged to come to court at some other time.
What about the cost of attending court? In addition to your reasonable expenses of attending at Court, you are also entitled to be paid by the party who had the summons issued this summons, your reasonable expenses incurred in complying with the summons, including an appropriate witness fee. If you need all or some of these expenses paid before you come to court, you should contact the party who had the summons issued.
If you do not understand what you must doThe Registrar of the court that issued the summons;
The person the applied to issue the summons; or A solicitor to obtain your own legal advice.
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less than 16 years of age;
any other method permitted by the Rules specify ...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 12 Warrant to arrest witness
Form 11
WITNESS SUMMONS
Magistrates Court of South Australia
www.courts.sa.gov.au
Magistrates Court Act, 1991, Section 20
Registry ............................................................. File No............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
........................................
....
e-mail address
Witness
Name: ..............................................................................................
Address: ..............................................................................................
Case details
surname given name
Offence .......................................................................
.......................................................................
Date of Offence .......................................................................
Offence Location .......................................................................
What you need to do: (for detailed explanation see attached sheet)
Attend Court to give evidence on the hearing date
Bring the Evidentiary Material listed below
Deliver the Evidentiary Material listed below to the Registrar before the hearing
Evidentiary Material:
-
Hearing details
am/pm
telephone facsimile e-mail address
(delete as appropriate)
telephone facsimile e-mail address
Date:............................. . . . . . . . . . . . . . . .
. . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
The Seal of the Court is to be fixed to this form.
-
Information about this summons.
Unless the summons has the Seal of the Magistrates Court on it, it has not been properly issued
and therefore doesnt need to be obeyed.
What is this document?
What do you have to do?
If the summons requires you to produce documents or things only, you may comply with it by delivering all of the documents or things to the Registrar of the Magistrates Court at the address given prior to the time and date on the summons. If you do that, you do not have to attend on the day and at the time shown on the summons.
You should only deliver documents or things to the Registrar if you have all of the documents or things requested and if you have no objection to producing them to the Court and to them being inspected by the parties to the case.
If you do deliver the documents or things to the Registrar, they should be securely packaged and have a copy of this summons attached.
If you object to the parties seeing the documents or things, you must come to court on the day and at the time listed and tell the Magistrate why you object to producing them.
If the summons requires you to give evidence (whether or not it also requires you to bring documents or things), you must attend at the Registry on the day shown in sufficient time to be in the correct courtroom by the time listed unless you contact the person who had this summons issued and have arranged to come to court at some other time.
What about the cost of attending court? In addition to your reasonable expenses of attending at Court, you are also entitled to be paid by the party who had the summons issued this summons, your reasonable expenses incurred in complying with the summons, including an appropriate witness fee. If you need all or some of these expenses paid before you come to court, you should contact the party who had the summons issued.
If you do not understand what you must doThe Registrar of the court that issued the summons;
The person the applied to issue the summons; or A solicitor to obtain your own legal advice.
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PROOF OF SERVICE
Name of deponent:.....................................................................
Address of deponent:...................................................................
Name of person served:..............................................................
Address at which service effected:..............................................
Date service effected:..................................................................
Time of day: Between ............ am/pm and ..............am/pm
Method of service (tick box)
personally;
by leaving a copy at the last (or most usual) place of abode with a person apparently residing there and not less than 16 years of age;
by leaving a copy at the place of business with a person apparently employed there and not less than 16 years of age;
any other method permitted by the Rules specify ...........................................................................................
I certify that I served the attached document in the manner described.
Certified this....... day ) ..............................................
of ................. 200... )
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Form 13 Notice to produce person from custody
Form 13
NOTICE TO PRODUCE PERSON IN CUSTODY Magistrates Court of South Australia www.courts.sa.gov.au
Magistrates Court Act, 1991 - Section 23 &
Correctional Services Act, 1982 Section 28
Registry ............................................................. File No ............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Details of person to be brought before the Court
surname given name dd/mmm/yy
Institution .....................................................................................................
Capacity in which person is required to attend:-
Particulars of Case
Complainant/Informant
surname given name Complainants
reference
street telephone facsimile
city/town/suburb state postcode e-mail address
Person Charged ..........................................................................................................
To the Manager of the Institution at which the person is in custody.
The person mentioned is required to attend before the Court in this matter.
You are required to produce the person at.
Registry ............................................................. Date........................................
Time
Date
MAGISTRATE
Registrar/Justice of the Peace
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Form 14 Warrant to bring person from institution to a court (Magistrates Court Act 1991, s.23)
Form 14
WARRANT TO BRING PERSON IN CUSTODY Magistrates Court of South Australia www.courts.sa.gov.au
Magistrates Court Act, 1991 - Section 23
Registry ............................................................. File No ............................................
Address ...............................................................
...............................................................
............................................
telephone
............................................
facsimile
............................................
e-mail address
Details of person to be brought before the Court
surname given name dd/mmm/yy
Institution .....................................................................................................
Particulars of Case
Complainant/Informant
surname given name Complainants
reference
street telephone facsimile
city/town/suburb state postcode e-mail address
Person Charged ..........................................................................................................
To the Sheriff, the Commissioner of Police and any member of the South Australian Police Force. The person mentioned is required to attend before the Court as a witness in this matter. You are required to produce the person as follows.
Registry ............................................................. Date ..................
Time ..
......................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . date MAGISTRATES COURT Registrar/Justice of the Peace
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Form 15 Notice in respect of drivers licence pursuant to section 27c(2) or section 27c(3)
Form 15
NOTICE TO DEFENDANT AS TO PENALTY Magistrates Court of South Australia www.courts.sa.gov.au
Summary Procedure Act, 1921 - Section 27C(3), Section 62C(2), Rule 15.01
Registry ........................................................... File No ............................................
Defendant
surname given name dd/mmm/yy
street licence number
city/town/suburb state postcode
You have been convicted in your absence of the following offence(s)
drivers licenceYou should attend Court or have a solicitor attend for you.
If you fail to attend a warrant may be issued for your arrest.
Next hearing
am/pm
telephone facsimile e-mail address
date . . . . . . . . . . . . . . . . . . . . . . . . . . .
MAGISTRATES COURT
Registrar/Justice of the Peace
IF YOU WISH TO DISPUTE THESE CHARGES YOU SHOULD READ THE INFORMATION ON THE BACK
OF THIS FORM
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NOTICE TO DEFENDANT
RE-HEARING
Section 76a of the Summary Procedure Act provides that the Court may, on its own initiative or on the application
of any party, set aside a conviction or order provided that:
(a) the parties consent to have it set aside
(b) the conviction or order was made in error
(c) it is in the interes
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