Schedule 4A

Community work hours

In force

regulation 14

Community Work Hours Ordered	Months to Complete
50 or less	3
51 – 125	6
126 – 300	12
301 – 375	18
376 – 480	24

Schedule 5

regulation 17

FORM 1

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Examination Summons – Individual

Fines and Penalties (Recovery) Act 2001

section 68(2)

regulation 17(3)(a)

Name:
Address:
Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:

You are required to attend before the Fines Recovery Unit to be orally examined as to your financial circumstances generally and your means and ability to satisfy the enforcement order(s) made against you.

You are required to produce the following documents to the Fines Recovery

Unit at the examination:

You

must attend at the Fines Recovery Unit at [place] for the hearing of the examination on __________________ at

_____________ a.m./p.m. or as soon afterwards as the business of the Unit allows.

Date issued: ____________________

_______________________

DIRECTOR

FINES RECOVERY UNIT

NOTE: If you do not attend at the Unit as directed by this summons, the

Director may issue a warrant for your arrest.

Do not ignore this summons. If you do not understand it or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _______

Fine

Defaulter: _________________________________________________

Type of Process Served: Examination Summons (Individual)

Name of Deponent: _____________________________________________

Date affidavit made: ______________________

I, (full name)

of (address)

say on oath that I did at _ _ : _ _ a.m./p.m.

on the _ _ / _ _ / _ _

serve

________________________________________________________, the fine defaulter, with this examination summons by delivering a true copy of the examination summons personally to the fine defaulter at

______________

______________________________________________________________

I identified the fine defaulter as follows:

______________________________________________________________

_____________________________________________________________.

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

FINANCIAL STATEMENT – INDIVIDUAL

Name:
Address:
Date of Birth:
Drivers Licence No.
Reference No.
Marital Status:

DEPENDANTS

Name	Age	Name	Age

DECLARATION

I do solemnly and sincerely declare that the following information and annexures (if any) are true and correct.

Declared at (place):

on (date):

Signed:

____________________________________________

NOTE:

A person knowingly making a false or misleading statement to the

Fines Recovery Unit is liable to a penalty of 200 penalty units, being the equivalent of $(monetary amount) or imprisonment for

12 months. See section 109A of the Act.

This document does not have to be witnessed.

Attach original or certified copies of documents in support of your income and expenditure.

FINANCIAL INFORMATION

AMOUNT AND SOURCE OF INCOME (Indicate weekly/fortnightly etc.)

1.1 Occupation:
1.2 If employed – name of employer:
1.3 Address of employer:
1.4 Wage before tax:
1.5 If not employed – type of benefit received:
1.6 Amount of benefit received:
1.7 Other income received: (eg. royalties, airfares)
1.8 TOTAL INCOME RECEIVED:

PROPERTY AND ASSETS

2.1 House and / or land – location:
2.2 Market value:
2.3 Amount of mortgage (if any):
2.4 Where mortgage held (bank, building society, credit union etc.):
2.5 Mortgage Account No.:
2.6 Motor Vehicle (model, make and year):
2.7 Value:
2.8 Amount owing under finance:
2.9 Finance Company:
2.10 Bank, building society, credit union etc. accounts (who with):
2.11 Account Number(s):
2.12 Branch:
2.13 Account Balance:
2.14 Shares or bonds held – value:
2.15 Type of shares (eg. Telstra):
2.16 Money owed to you – amount:
2.17 Who owes you money:
2.18 Furniture and household goods: List and value items:









2.19 Total Value of household goods:
2.20 Amount owing for household goods to finance company etc.:
2.21 Life Insurance Policies:
2.22 Policy details:
2.23 TOTAL PROPERTY & ASSETS

DEBTS

AND LIABILITIES (Indicate weekly/fortnightly etc.)

3.1 Income Tax:
3.2 Superannuation:
3.3 Rent / Mortgage / Board payment:
3.4 Local Government Rates:
3.5 Water Rates:
3.6 Child Care:
3.7 Child Support Payments:
3.8 Electricity / Gas:
3.9 Food:
3.10 Motor vehicle expenses:
3.11 Fares – Bus / Taxi:
3.12 Telephone:
3.13 School fees and expenses:
3.14 Clothing and shoes:
3.15 Medical / Chemist expenses:
3.16 Credit card repayments:
3.17 Personal loan repayments:
3.18 Other:
3.19 TOTAL DEBTS & LIABILITIES

OTHER

CIRCUMSTANCES

Identify each asset referred to in paragraph 2 that is owned jointly, and give the name of the other owner or owners:

__________________________________________________________________________________________________________________________________________________________________________________________

Identify each debt referred to in paragraph 3 that is due jointly, and give the name of the other debtor or debtors:

__________________________________________________________________________________________________________________________________________________________________________________________

Give particulars of any other circumstances that affect your financial situation:

__________________________________________________________________________________________________________________________________________________________________________________________

Do not ignore this notice. If you do not understand this notice or need help contact the Fines Recovery Unit on (08) 8924 3600.

FORM 2

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Examination Summons – Body Corporate

Fines and Penalties (Recovery) Act 2001

section 68(2)

regulation 17(3)(b)

Name:
Address:


Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:

You or an authorised representative of the fine defaulter corporation are required to attend before the Fines Recovery Unit to be orally examined as to the corporation's financial circumstances, means and ability to satisfy the enforcement order(s) made against the corporation.

You or the authorised representative are required to produce the following documents to the Fines Recovery Unit at the examination:

You or the authorised representative must attend at the Fines

[place] for the hearing of the examination on __________________ at

_____________ a.m./p.m. or as soon afterwards as the business of the Unit allows.

Date issued: ____________________

_______________________

DIRECTOR

FINES RECOVERY UNIT

NOTE: If you do not attend at the Unit as directed by this summons, the

Director may issue a warrant for your arrest.

Do not ignore this summons. If you do not understand it or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _______

Fine

Defaulter: ________________________________________________

Type of Process Served: Examination Summons (Body Corporate)

Name of Deponent: _____________________________________________

Date affidavit made: ______________________

I, (full name)

of (address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _

_ / _ _ / _ _

serve

________________________________________________________, an authorised representative of the fine defaulter corporation with this examination summons by delivering a true copy of the examination summons personally to the authorised representative at

____________________________

______________________________________________________________

I identified the person served as follows:

______________________________________________________________

_____________________________________________________________.

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

FORM 3

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Warrant of Apprehension

Fines and Penalties (Recovery) Act 2001

section 68(10)

regulation 17(4)

TO THE BAILIFF:

Name:
Address:
Date of Birth:



Amount Owing:


Costs of this Order:
TOTAL OWING:

The fine defaulter identified above has failed to attend before the Fines

Recovery Unit at the time and place appointed by the summons issued on _________________ to be examined in relation to the fine defaulter’s financial circumstances.

I authorise you to apprehend the fine defaulter and to bring him or her before the Director of the Fines Recovery Unit or a registrar of the Local Court.

Issued at Darwin in the Northern Territory

on the ____________________

_______________________

DIRECTOR

FINES RECOVERY UNIT

BAILIFF

RECORD

Fine defaulter apprehended on and taken to the Fines Recovery Unit.

Warrant returned on Fine defaulter not located/Paid In Full/Other:

Signed:

BAILIFF.

FORM 4

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Property Seizure Order

Fines and Penalties (Recovery) Act 2001

section 70

regulation 17(5)

THE BAILIFF:

YOU ARE AUTHORISED to enforce this order by seizing and selling personal property of the fine defaulter sufficient to pay the money owing to the Fines Recovery Unit in respect of the order.

Fine Defaulter Name:
Address:
Date of Birth
Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:

From the proceeds raised by the sale of the fine defaulter's property you must pay into the Fines Recovery Unit the money owing in respect of the order except the amount for your fees and expenses for executing this order.

If you attempt to execute under this order but are unable to do so, you must endorse on the order a statement of the dates, times, places and results of those attempts.

Immediately after you have performed all your obligations under this order you must endorse on the order a statement of the date, time and place you executed the order and the results of the execution, including how the proceeds of the sale are to be distributed.

Issued at Darwin in the Northern Territory

Date:

___________________

______________________

DIRECTOR

FINES RECOVERY UNIT

THIS ORDER IS VALID FOR A PERIOD OF 12 MONTHS FROM DATE OF ISSUE

BAILIFF FIELD REPORT

Bailiff:

_____________________ Date received by Bailiff: _______________

Order not executed – details of attempt(s).

Date	Time	Place	Result

Order executed

Date	Time	Place	Result	How Proceeds distributed

I certify that this is a true and accurate record of action taken on this order.

_________________________________ (Bailiff)

FORM 5

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Garnishee Order – Attachment of Debt

Fines and Penalties (Recovery) Act 2001

section 72(1)(a)

regulation 17(6)(a)

Name:
Address:
Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:

THE GARNISHEE:

At:

The Fines Recovery Unit has issued the above enforcement order(s) against the above fine defaulter. The fine defaulter has failed to comply with the order(s) and $_____________ remains outstanding.

THE FINES RECOVERY UNIT ORDERS THAT:

1. The Garnishee immediately pays to the Fines Recovery Unit –

(a)

the sum of $__________ from the debt(s) due from the garnishee to the fine defaulter; or

(b)

if the amount of the debt(s) due from the garnishee to the fine defaulter is not sufficient to satisfy the order in full – the whole amount that is due to the fine defaulter.

2. In default of payment action may be taken against the garnishee.

Issued at Darwin in the Northern Territory

On the __________________

_________________________________

DIRECTOR

FINES RECOVERY UNIT

Do not ignore this notice. If you do not understand this notice or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _____________

Fine

Defaulter: _________________________________________________

Type of process served: Garnishee Order (Debt due)

Name of Deponent:_____________________________________________

Date affidavit made: ______________________

I, (full name)

of (address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _ _ / _ _ / _ _

serve _________________________________________________________, the fine defaulter, with this garnishee order by delivering a true copy of the order personally to the fine defaulter at ___________________________________

______________________________________________________________

I identified the fine defaulter as follows:

_________________________________________________________

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _____________

Garnishee: ____________________________________________________

Type of process served: Garnishee Order (Debt due)

Name of Deponent: _____________________________________________

Date

Sworn/Affirmed: ______________________

I, (full name)

of (address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _ _ / _ _ / _ _

serve

________________________________________________________, the garnishee, with this garnishee order by delivering a true copy of the order *personally to the garnishee/to a person in the employ of the garnishee*/to the registered office of the garnishee* at

________________________________

______________________________________________________________

I identified the *garnishee/person in the employ of the garnishee* as follows:

_________________________________________________________

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

FORM 6

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Garnishee Order – Continuous Attachment of Wages or Salary

Fines and Penalties (Recovery) Act 2001

section 72(1)(b)

regulation 17(6)(b)

Name:
Address:
Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:

To the EMPLOYER:
At:

The

Fines Recovery Unit has issued the above enforcement order(s) against the above fine defaulter.

The fine defaulter is employed by you/your organisation and is a person to whom earnings are payable or are likely to become payable by you/your organisation.

THE

FINES RECOVERY UNIT ORDERS THAT:

1. The employer must, for the purpose of securing payment of the outstanding enforcement orders, while the fine defaulter is employed by that employer, or until this order ceases to have effect, make deductions out of the net earnings of the fine defaulter.

2. * The protected earnings are 80% of the net earnings in respect of each payday.

3. * The appropriate deduction is $________/_______% of the net earnings in respect of each payday.

4. Subject to paragraph 6, on each pay-day that the net earnings are in excess of the protected earnings specified in paragraph 2, the employer may first pay to himself or herself, out of that excess,

$(monetary amount) for the administrative costs of complying with this order.

5. Subject to paragraph 6, following payment of the administrative costs in accordance with paragraph 4, the employer must pay to the

Fines Recovery Unit, out of the remaining excess, the appropriate deduction specified in paragraph 3.

6. If on a pay-day the amount of net earnings in excess of the protected earnings is insufficient to allow for payment in full of the administrative costs or appropriate deduction, on that pay-day the employer may first pay as much as the excess allows towards the administrative costs, must then pay as much as the excess allows towards the appropriate deduction, and must pay the deficit in accordance with paragraph 7.

7. If on a pay-day, after payment of the administrative costs and appropriate deduction in full, the net earnings remain in excess of the protected earnings, the employer must pay from that excess as much of the total deficit from previous pay-days as the excess allows, first towards the outstanding administrative costs and then towards the outstanding appropriate deductions.

Issued at Darwin in the Northern Territory

On the __________________

_________________________________

DIRECTOR

FINES RECOVERY UNIT

Delete if inapplicable

NOTE:

A Garnishee order comes into force at the end of 7 days after the day on which the order is served on the employer.

NOTE:

If the employer wilfully fails to comply with the garnishee order, the Fines Recovery Unit may apply to the Local Court to have the order enforced against the employer.

Do not ignore this notice. If you do not understand this notice or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

NOTICE

TO EMPLOYER

The garnishee order served with this notice requires you to deduct from the net earnings payable to the fine defaulter as your employee, on each pay-day until the order is discharged or suspended, the amount referred to in the order as the appropriate deduction, and to pay that amount to the Fines Recovery Unit.

EARNINGS AND DEDUCTIONS

earnings means money payable to a fine defaulter by way of:

(a)

wages or salary, including fees, bonuses, commission, pay in lieu of leave or retirement benefit, overtime pay or other profits arising from the fine defaulter’s office or employment; or

(b)

a pension, including:

(i)

an annuity for past services whether or not the services were rendered to the person paying the annuity; and

(ii)

periodic payments of compensation for the loss, abolition or relinquishment of, or a reduction in profits arising from, an office or employment, but does not include a pension under the Social

Security Act 1991 of the Commonwealth or the Veterans'

Entitlements Act 1986 of the Commonwealth;

net earnings means the earnings payable to a fine defaulter on a pay-day after the deduction of:

(a)

tax instalments under the Income Tax Assessment Act 1936 of the Commonwealth; and

(b)

superannuation contributions under the Superannuation Act 1986 of the Commonwealth;

appropriate deduction means the amount that the Fines Recovery Unit considers to be:

(a)

a reasonable deduction from the net earnings; and

(b)

not more than is necessary to pay the amount owing within a reasonable time after an attachment of earnings order is made.

protected earnings means the amount of the net earnings below which the

Fines Recovery Unit considers it unreasonable for the earnings to be reduced by a payment to the Fines Recovery Unit, having regard to the resources and needs of the fine defaulter and of any other person for whom the fine defaulter provides or reasonably may provide.

NOTICE

TO EMPLOYER

You are required to give the fine defaulter a notice specifying particulars of the payments made by you under the garnishee order, including the payment for your administrative costs in respect of the order.

NOTICE

IF YOU ARE NOT THE EMPLOYER

You must promptly advise the Director of the Fines Recovery Unit:

(a)

if you are not the employer of the fine defaulter; or

(b)

if you are now the employer of the fine defaulter but later cease to employ the fine defaulter – after you cease to be the employer.

EMPLOYEE

NOT TO BE DISMISSED OR PREJUDICED

A person who dismisses an employee, injures an employee in his or her employment or alters an employee's position to his or her prejudice because a garnishee order has been made, or because the person is required to make payments under the order in relation to the employee, may be dealt with as for contempt of court.

Dated:

__________________________________

DIRECTOR

FINES RECOVERY UNIT

Do not ignore this notice. If you do not understand this notice or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _____________

Fine

Defaulter:_________________________________________________

Type of process served: Garnishee Order (Attachment of wages or salary)

Name of Deponent: ____________________________________________

Date affidavit made: ______________________

(full name)

(address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _ _ / _ _ / _ _

serve

________________________________________________________, the fine defaulter, with this garnishee order by delivering a true copy of the order personally to the fine defaulter at

__________________________________________________________________________________________________________________________________________________________________________________________

I identified the fine defaulter as follows:

__________________________________________________________________________________________________________________________________________________________________________________________

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _____________

Employer: ____________________________________________________

Type of process served: Garnishee Order (Attachment of wages or salary)

Name of Deponent: ____________________________________________

Date

Sworn/Affirmed: ______________________

(full name)

(address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _ _ / _ _ / _ _

serve ________________________________________________________, the employer, with this garnishee order by delivering a true copy of the order *personally to the employer/to a person in the employ of the employer*/to the registered office of the employer* at

_________________________________

__________________________________________________________________________________________________________________________________________________________________________________________

I identified the *employer/person in the employ of the employer* as follows:

__________________________________________________________________________________________________________________________________________________________________________________________

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

FORM 7

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Community Work Order

Fines and Penalties (Recovery) Act 2001

section 77

regulation 17(7)

Name:
Address:
Date of Birth:
Reference Number:
Date of Order:

Amount Owing:


Costs of this Order:
TOTAL OWING:
HOURS OF WORK TO BE PERFORMED:

The enforcement order referred to above, made in relation to you, has not been satisfied and I believe that enforcement action under

Division 8 of the Act will not be effective in satisfying the order.

I now order you to attend at

______________________________________, within 7 days of being served with this order to be assessed by the Commissioner of Correctional

Services as to your suitability to participate in an approved project to work off the outstanding amount. If you are assessed as suitable to participate, you will be provided with details of the work you are to perform and your obligations under this order.

Community work reduces the amount owing at the rate of the monetary value of 2 penalty units, being the equivalent of $(monetary value), for each 8 hours of work performed. You may choose to pay part of the amount owing at any stage and your work hours will be reduced accordingly. If you pay the outstanding amount in full, you will not be required to perform any community work.

If you fail to attend at the specified place, or fail to comply with your obligations under this order, the order will be revoked and a warrant may issue for your arrest. If you cannot pay the full amount outstanding, you will serve a day in custody for every $(monetary amount), being the equivalent of

2 penalty units, owed (or part thereof).

Date issued:

____________________

_______________________

DIRECTOR, FINES RECOVERY UNIT

Do not ignore this order. If you do not understand it or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

AFFIDAVIT OF SERVICE

Fines

Recovery Unit Reference Number: _____________

Fine

Defaulter: _________________________________________________

Type of Process Served: Community work order

Name of Deponent: _____________________________________________

Date affidavit made: ______________________

I, (full name)

of (address)

say on oath that I did at _ _ : _ _ a.m./p.m. on the _ _ / _ _ / _ _

serve the fine defaulter ______________________________________

with this community work order by delivering a true copy of the community work order personally to the fine defaulter at

__________________________

______________________________________________________________

I identified the fine defaulter as follows:

__________________________________________________________________________________________________________________________________________________________________________________________

(a)

confirmed the fine defaulter's name and date of birth/approximate age; and

(b)

explained/caused to be explained to the fine defaulter in

language where and when he/she must attend for assessment, and that if he/she fails to attend he/she may be arrested and taken into the custody of the Commissioner of Correctional Services,

and I am satisfied that he/she understood the explanations given.

Made at [place] on

[date]

________________

[signature of deponent]

Witnessed by

Signature

Justice of the peace / commissioner for oaths

Name

Address or phone no.

FORM 8

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Revocation of Community Work Order

Fines and Penalties (Recovery) Act 2001

section 85

regulation 17(8)

Name:
Address:
Date of Birth:
Reference Number:
Date of Community Work Order:

You are advised that the community work order made in relation to you on ________________ has been revoked. You must contact the

Fines Recovery Unit within 14 days of the date of this notice or a warrant may be issued for your arrest.

If you cannot pay the full amount outstanding, upon arrest you will serve a day in custody for every $(monetary amount), being the equivalent of 2 penalty units, owed (or part thereof).

Date issued: ____________________

_______________________

DIRECTOR

FINES RECOVERY UNIT

NOTE: If you do not contact the Fines Recovery Unit within 14 days of the date of issue of this notice, the Director may issue a warrant for your arrest.

Do not ignore this order. If you do not understand it or need help contact the Fines Recovery Unit, a legal practitioner or your local legal aid office.

FORM 9

NORTHERN TERRITORY OF AUSTRALIA

FINES RECOVERY UNIT

Warrant of Commitment

Fines and Penalties (Recovery) Act 2001

section 86

regulation 17(9)

TO: ALL NORTHERN TERRITORY POLICE OFFICERS and THE COMMISSIONER OF

CORRECTIONAL SERVICES

Name:
Address:
Date of Birth:
Enforcement Order:
Date of Order:

Amount Owing:


Costs of this Warrant:
TOTAL OWING:
PERIOD OF IMPRISONMENT:

The above fine defaulter having had a community work order revoked under

Part 5 of Division 9 of the Fines and Penalties

(Recovery) Act and the amount of $ _______________ being still outstanding –

Northern Territory Police Officers are ordered to convey the fine defaulter to the nearest custodial correctional facility and deliver the fine defaulter to the General Manager of the facility;

and

The Commissioner of Correctional Services must receive the fine defaulter into the Commissioner's custody and keep the fine defaulter for the period of _____________ days unless the relevant outstanding amount is sooner paid.

Issued at Darwin in the Northern Territory

On the: ____________________

_______________________

DIRECTOR, FINES RECOVERY UNIT

PAYMENT

ENDORSEMENT

Date of Payment: Amount: Receipt

No.: Signature:

Money to Fines Recovery Unit on:

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