Forms
Schedule 2 Forms
regulation
75
FORM
1
regulation
75(1)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
CHARGE
I,
, of ,
with the consent of , an authorised officer,
charge that [name, sex and date of birth of youth],
of
[address]
committed the following offence(s): [specify details of offence(s), including date and place of offence(s)]
[Signed]
*Signed/*made on oath before me
[Signed]
Justice of the peace
Date:
*Delete if not applicable
FORM
2
regulation
75(2)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
SUMMONS
TO YOUTH
To:
[name, sex and date of birth of youth]
of [address]
You have been charged by [name]
of that you committed the following offence(s): [specify details of offence(s), including date and place of offence(s)]
You are summoned to appear before the Youth Justice Court at [place]
on [date] at [time] to answer the charge and be dealt with according to law.
[Signed]
Justice of the peace
Date:
Note
If you fail to appear in response to this summons, a warrant may be issued for your arrest.
FORM
3
regulation
75(3)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
APPLICATION
FOR APPROVAL TO CARRY OUT
FORENSIC PROCEDURE ON YOUTH
I, *a police officer/ *an authorised officer/*officer in charge of
police station, apply to *the Court/*[senior police officer]
for approval to carry out:
*an intimate procedure
*a non-intimate procedure
*an identifying procedure
on
[name, sex and date of birth of youth]
of
[address]
*who is in lawful custody in respect of an offence
*who has been charged with an offence
*against whom proceedings have been instituted by summons
*against whom proceedings by summons have been consented to by an authorised officer.
[Signed]
Applicant
Date:
______________________________________________________________
*This application will be dealt with by the Youth Justice Court at [place]
on
[date] at [time] .
[Signed]
Registrar
Date:
*Delete if not applicable
FORM
4
regulation
75(4)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
SUMMONS
TO RESPONSIBLE ADULT
To:
[name of adult]
of
[address]
You are summoned to attend the Youth Justice Court at [place]
on [date] at
[time] in respect of the following charge(s) against [name of youth]
in respect of whom you are a responsible adult within the meaning of the
Youth Justice Act 2005: [details of charge(s)]
[Signed]
Justice of the peace
Date:
Notes
1. If you fail to attend in response to this summons, a warrant may be issued for your arrest.
2. If there are circumstances that make it unreasonable to require your attendance in response to this summons, you should contact [details].
FORM
5
regulation
75(5)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
WARRANT
To all police officers in the Northern Territory:
You are authorised to apprehend or arrest [name, sex and date of birth of person]
of
[address] ,
*who, in respect of proceedings against [name of youth] :
*failed to attend the Youth Justice Court;
*failed to remain in attendance during the proceedings;
*failed to answer a summons to attend the Youth Justice Court;
*who I am satisfied:
is in breach of an order of the Youth Justice Court; and
may not appear in Court for a hearing in relation to the breach;
*who failed to attend the Youth Justice Court:
*for a hearing in relation to a breach of an order of the Court;
*for a hearing of an application for a review of a sentence in relation to him or her;
and bring him or her before the Court.
[Signed]
Justice of the peace
Date:
*Delete if not applicable
FORM
6
regulation
75(6)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
REMAND
WARRANT
To:
all police officers in the Northern Territory and to *the
Superintendent of
detention centre/*officer in charge of
custodial correctional facility:
The
Youth Justice Court at [place] on [date] remanded
[name, sex and date of birth of youth]
of
[address]
in custody in relation to the following charge(s):
You are ordered to:
apprehend the youth if necessary;
take the youth to the nearest *detention centre/*custodial correctional facility;
deliver the youth to the *Superintendent/*officer in charge;
take the youth into custody and keep him or her (unless bailed in the meantime);
produce the youth before the Court at [place] at [time] on [date] .
[Signed]
Justice of the peace
Date:
*Delete if not applicable
Note
This warrant supersedes any previous warrant issued in this case for the youth.
FORM
7
regulation 75(7)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address]
On
[date] , the Youth Justice Court at [place]
, orders as follows:
[Signed]
Registrar
Date:
FORM
8
regulation
75(8)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
GOOD
BEHAVIOUR ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address] .
On
[date] ,
[name of youth] was *found guilty/*convicted by the Youth Justice Court at [place] of the following offence(s):
Case No. |
Offence No. |
Offence |
|
|
|
|
|
|
|
|
|
The
Court orders under section 83(1)(f) of the Youth Justice Act
2005 the youth be released immediately on giving security of $
[security amount] to:
appear before the Court if called on to do so during the period of
[not exceeding 2 years] ;be of good behaviour during the period of this order;
observe the following conditions imposed by the Court:
*Delete if not applicable
[Signed]
Registrar
Date:
I,
[name of youth]
fully understand the terms of this Good Behaviour Order. I accept those terms and will comply with the order.
[Signed]
Signed at [place] on [date] in the presence of
Justice of the peace
Notes
1. If you fail to comply with any of the conditions of this order, you may be ordered to pay part or all of the security amount.
2. A copy of this order must be given to the youth and to any responsible adult who attended Court. A copy must also be sent to the
Chief Executive Officer if the order entails supervision.
3. You may be arrested immediately if you breach this order.
4. You may apply to the Court to review this order.
FORM
9
regulation 75(9)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
COMMUNITY
WORK ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address] .
On
[date] ,
[name of youth] was *found guilty/*convicted by the Youth Justice Court at [place] of the following offence(s):
Case No. |
Offence No. |
Offence |
Hours |
|
|
|
|
|
|
|
|
|
|
|
|
The
Court orders under section 83(1)(h) of the Youth Justice Act
2005 as follows:
[name of youth] must:
(a) participate in work at an approved project;
the total number of hours to be worked is the total number of hours indicated above [not exceeding 480 hours]
the work under the order must be completed by [date]
(b) present
*himself/*herself
*at the place, to the person and within the time and by the means as directed by the Chief Executive Officer in writing
*as follows
[Signed]
Registrar
Date:
*Delete if not applicable
I,
[name of youth] fully understand the terms of this
Community Work Order and have consented to the making of the order and to the terms of the order. I accept those terms and will comply with the order.
[Signed]
Signed at [place] on [date] in the presence of
Justice of the peace
Notes
1. A copy of this order must be given to the youth and to any responsible adult who attended Court. A copy must also be sent to the
Chief Executive Officer.
2. You may be arrested immediately if you breach this order, including if you change your residential address and do not notify a community youth justice officer within 48 hours.
3. You may apply to the Court to review this order.
IMPORTANT
INFORMATION ABOUT YOUR COMMUNITY WORK ORDER
DUTIES
IN CARRYING OUT YOUR COMMUNITY WORK ORDER
Youth
Justice Act 2005 – section 95 refers
Under your Community Work Order, you must:
participate, for the number of hours specified in the order, in an approved project as directed by a community youth justice officer; and
participate in the project to the satisfaction of a community youth justice officer or project supervisor; and
while participating in the project – comply with any reasonable direction of a community youth justice officer or project supervisor; and
inform a community youth justice officer of any change in your residential address within 48 hours after the change; and
not commit an offence while the order is in force.
Unless you consent, you are not required to participate in an approved project under your community work order for more than 8 hours in any one day.
BREACH
OF YOUR COMMUNITY WORK ORDER
Youth
Justice Act 2005 – sections 96 and 121 refer
You will breach your Community Work Order if you:
fail to comply with a term or condition of the order; or
fail to carry out your obligations under section 95 of the Act (printed above); or
disturb or interfere with any other person participating in or doing anything under a Community Work Order; or
assault, threaten, insult or use abusive language to a probation and parole officer or project supervisor; or
change your address to avoid your obligations; or
fail to comply with the Youth Justice Regulations 2006 relating to Community Work Orders; or
commit an offence against a law in force in the Territory or elsewhere during the term of this order.
FORM
10
regulation
75(10)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
ORDER
TO SUSPEND SENTENCE OF DETENTION
OR
IMPRISONMENT
In the matter of: [name, sex and date of birth of youth]
of
[address]
On
[date] ,
[name of youth] was *found guilty/*convicted by the Youth Justice Court at [place] of the following offence(s):
Case No. |
Offence No. |
Offence |
Length of detention or imprisonment |
|
|
|
|
|
|
|
|
The
Court orders under section 83(1)(i) of the Youth Justice Act
2005 as follows:
*the whole of the period of detention or imprisonment be suspended and the youth be released immediately;
*the period of detention or imprisonment be partially suspended and the youth be released after the youth has served [period to be served]
*the period of *detention/*imprisonment is to begin on [date]
the *total period/*balance of the period of *detention/*imprisonment be suspended for a period of [period, not exceeding 2 years] from *the date of this order/*[other date]
*The
Court orders the total effective period of *detention/*imprisonment is [period]
*The
Court also imposed the following conditions:
[Signed]
*Registrar/*Youth
Judge
Date:
*Delete if not applicable
I,
[name of youth]
fully understand the terms of this order. I accept those terms and will comply with the order.
[Signed]
Signed at [place] on [date] in the presence of
Justice of the peace
Notes
1. You may be arrested immediately if you fail to comply with this order.
2. You may apply to the Court to review this order.
FORM
11
regulation 75(11)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
ALTERNATIVE
DETENTION ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address]
On
[date] ,
[name of youth] was *found guilty/*convicted by the Youth Justice Court at [place] of the following offence(s):
Case No. |
Offence No. |
Offence |
Length of detention or imprisonment |
|
|
|
|
|
|
|
|
The
Court orders under section 83(1)(j) of the Youth Justice Act 2005
as follows:
the sentence is suspended on the youth entering into this alternative detention order; and
the youth must *reside/*remain at [address of premises or place] for a period of [not exceeding 12 months]
This order is subject to the following conditions:
the youth must not leave the premises or place specified above during the period the order remains in force, except as permitted by the Chief Executive Officer or a community youth justice officer; and
the youth must obey all reasonable directions of the Chief Executive Officer or a community youth justice officer; and
in accordance with the directions of the Chief Executive Officer, the youth must wear or have attached a monitoring device and allow the placing, or installation in, and retrieval from, the premises or place specified in this order of a machine, equipment or device necessary for the efficient operation of the monitoring device; and
*[other conditions imposed by the Court]
*Delete if not applicable
This alternative detention order remains in force for the period commencing on [date] and ending on [date] unless it is discharged, revoked or varied by the Court.
[Signed]
Registrar
Date:
I,
[name of youth]
fully understand the terms of this Alternative Detention Order and have consented to the making of the order and to the terms of the order.
I accept those terms and will comply with the order.
[Signed]
Signed at [place] on [date] in the presence of
Justice of the peace
Notes
1. A copy of this order must be given to the youth and to any responsible adult who attended Court. A copy must also be sent to the Chief
Executive Officer.
2. You may be arrested immediately if you fail to comply with this order.
3. You may apply to the Court to review this order.
INFORMATION
ABOUT YOUR ALTERNATIVE DETENTION ORDER
Youth
Justice Act 2005 – sections 110 and 121 (Breach of Alternative
Detention Order refer).
You will breach your alternative detention order if you:
fail to reside in or remain at the premises or place specified in the order;
fail to comply with a term or condition of the order;
wilfully destroy, damage or remove, or attempt to destroy, damage or remove, any part of a monitoring device or any associated machine, equipment or device;
fail to comply with a lawful request of a community youth justice officer or police officer to undergo a breath test or breath analysis or provide a blood or urine sample;
disturb or interfere with any other person residing in the premises or place specified in the order;
assault, threaten, insult or use abusive language to a probation and parole officer; or
fail to comply with the Youth Justice Regulations 2006 relating to alternative detention orders; or
commit an offence against a law in force in the Territory or elsewhere during the term of this order.
FORM
12
regulation 75(12)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
PERIODIC
DETENTION ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address]
On
[date] ,
[name of youth] was *found guilty/*convicted by the Youth
Justice Court at [place] of the following offence(s):
Case No. |
Offence No. |
Offence |
Length of detention or imprisonment |
|
|
|
|
|
|
|
|
The
Court orders under section 83(1)(k) of the Youth Justice Act
2005 as follows:
the youth must serve [number] periods of *detention/*imprisonment;
each period of *detention/*imprisonment is [number of days] ;
the *detention/*imprisonment must be served at [name of *detention centre/*custodial correctional facility] ;
the youth must first report to the *detention centre/*custodial correctional facility on [day and date] at [time] ;
the youth must subsequently report on each following [day of week]
at [time] .
*The
Court orders the total effective period of *detention/*imprisonment is [period]
*The
Court also imposed the following conditions:
[Signed]
*Registrar/*Youth
Judge
Date:
*Delete if not applicable
I,
[name of youth] fully understand the terms of this
Periodic Detention Order and have consented to the making of the order and to the terms of the order. I accept those terms and will comply with the order.
[Signed]
Signed at [place] on [date] in the presence of
Justice of the peace
Notes
1. A copy of this order must be given to the youth and to any responsible adult who attended Court. A copy must also be sent to the
*Commissioner/*Chief Executive Officer.
2. You may be arrested immediately if you breach this order. You will breach this order if you fail to report at an appropriate time to serve a period of detention. You will also breach this order if you report for a period of detention in an unfit state.
IMPORTANT
INFORMATION ABOUT YOUR PERIODIC DETENTION ORDER
CONDITIONS
APPLYING TO YOUR PERIODIC DETENTION ORDER
Youth
Justice Act 2005 – section 114 refers
Under your Periodic Detention Order, you must:
report to the specified detention centre or custodial correctional facility at the time and on the date specified for the first period of detention or imprisonment; and
report to the detention centre or custodial correctional facility at the time and on the day of the week specified for subsequent periods of detention or imprisonment until the specified number of periods have been served; and
notify the superintendent of the detention centre or officer in charge of the custodial correctional facility within 48 hours after being charged with an offence, in the Territory or elsewhere, while the order is in force; and
notify the superintendent of the detention centre or officer in charge of the custodial correctional facility of any change in your address, within 48 hours after the change, while the order is in force; and
obey all lawful instructions and directions of the *Commissioner of Correctional Services/*Chief Executive Officer and the superintendent of the detention centre or officer in charge of the custodial correctional facility, as the case may be, while the order is in force; and
comply with any conditions the Court has imposed.
FORM
13
regulation
75(13)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
WARRANT
OF COMMITMENT – PERIODIC DETENTION
To:
*Superintendent of detention centre/ *officer in charge of custodial correctional facility:
The
Youth Justice Court at [place] on [date]
sentenced
[name, sex and date of birth of youth]
of
[address]
to a period of *detention/*imprisonment as follows:
Case No. |
Offence No. |
Offence |
Length of detention or imprisonment |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The youth must report to the *detention centre/*custodial correctional facility on the dates and at the times, and must be released on the dates and times, following:
Report |
Release |
||
Date |
Time |
Date |
Time |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
You are ordered to take the youth in custody and keep him or her for the periods specified and any further periods in accordance with section 119 of the Youth Justice Act 2005.
[Signed]
Registrar
Date:
*Delete if not applicable
FORM
14
regulation
75(14)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
WARRANT
OF COMMITMENT – DETENTION OR IMPRISONMENT
To:
all police officers in the Northern Territory and to the
*Superintendent of
detention centre/*officer in charge of
custodial correctional facility:
The
Youth Justice Court at [place] on [date]
sentenced
[name, sex and date of birth of youth]
of
[address]
to a period of *detention/*imprisonment as follows:
Case No. |
Offence No. |
Offence |
Length of detention or imprisonment |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
*Total effective period of detention/*imprisonment ordered is
*Sentence to commence on [date]
*Youth to be released, and the balance of the period of *detention/ *imprisonment to be suspended, after serving [period to be served]
You are ordered to:
apprehend or arrest the youth if necessary;
take the youth to the nearest *detention centre/*custodial correctional facility;
deliver the youth to the *Superintendent/*officer in charge;
take the youth into custody and keep him or her for the period specified.
[Signed]
*Registrar/*Youth
Judge
Date:
*Delete if not applicable
FORM
15
regulation
75(15)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
APPLICATION
FOR ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address]
I,
[name of applicant]
of
[address]
*the *youth/*responsible adult named in the order
*on behalf of the youth named in the order
*the Commissioner of Correctional Services/*Chief Executive Officer
*a prosecutor
apply to the Youth Justice Court at [place] for an order as follows:
[particulars of the order sought or, if breach of order alleged, particulars of order and breach]
[Signed]
Applicant
Date:
______________________________________________________________
This application will be heard by the Youth Justice Court at [place]
on
[date] at [time]
[Signed]
Registrar
Date:
*Delete if not applicable.
Note
If you (the youth) fail to appear for the hearing of this application, a warrant may be issued for your arrest.
FORM
15A
regulation
75(15A)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
APPLICATION
FOR INQUIRY INTO FAMILY CIRCUMSTANCES
In the matter of: [name of youth]
of
[address]
I,
[name of applicant]
of
[address]
*on behalf of [name of appropriate
Agency]
*a police officer
apply to the Youth Justice Court at [place] for an inquiry into the family circumstances of [name of youth] on the following basis:
*a parent, or the parents, of the youth have entered into a family responsibility agreement but the youth has continued to exhibit behavioural problems.
*a parent or the parents of the youth have been invited to enter into a family responsibility agreement but have not done so.
*a parent or the parents of the youth have entered into a family responsibility agreement but have not complied with its terms.
*the youth has been charged with an offence or has breached a condition of bail.
[Signed]
Applicant
Date:
*Delete if not applicable.
FORM
16
regulation
75(16)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
APPLICATION
FOR RECONSIDERATION OF SENTENCE
In the matter of: [name, sex and date of birth of youth]
of
[address]
I,
[name of applicant]
of
[address]
*the *youth/*responsible adult named in an order made on [date] at [place]
*on behalf of the youth named in an order made on [date] at [place]
apply to the Youth Justice Court at [place] for a reconsideration under section 141 of the Youth Justice
Act 2005 of the order, particulars of which are as follows:
[particulars of order]
The grounds for reconsideration are as follows: [particulars of grounds]
[Signed]
Applicant
Date:
______________________________________________________________
This application will be heard by the Youth Justice Court at [place]
on
[date] at [time]
[Signed]
Registrar
Date:
*Delete if not applicable.
Note
If you (the youth) fail to appear for the hearing of this application, a warrant may be issued for your arrest.
FORM
17
regulation
75(17)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
APPLICATION
FOR REVIEW OF SENTENCING ORDER
In the matter of: [name, sex and date of birth of youth]
of
[address]
I,
[name of applicant]
of
[address]
*the youth named in the order mentioned below
*on behalf of the youth named in the order mentioned below
*the Commissioner of Correctional Services/*Chief Executive Officer
*a prosecutor
apply to the Youth Justice Court at [place] for a review under section 142 of the Youth Justice Act 2005 of an order made on [date] at [place] , particulars of which are as follows: [particulars of the order]
The grounds for review are as follows [particulars of grounds]
[Signed]
Applicant
Date:
______________________________________________________________
This application will be heard by the Youth Justice Court at [place]
on
[date] at [time]
[Signed]
Registrar
Date:
*Delete if not applicable.
Note
If you (the youth) fail to appear for the hearing of this application, a warrant may be issued for your arrest.
FORM
18
regulation
75(18)
NORTHERN
TERRITORY OF AUSTRALIA
Youth
Justice Act 2005
AFFIDAVIT
OF SERVICE
I,
,
of
,
*make oath and say/*affirm as follows:
at [place] on [date] at [time] I served [name of person served] with the following documents: [description of documents]
the method of service was as follows: [how served]
copies of the documents served are attached and marked with the letter "A".
Made at [place]
________________________on [date]
________________
By
[signature of deponent]
Witnessed by
Signature
____________________________________________________
Justice of the peace / commissioner for oaths
Name
_______________________________________________________
Address or phone no.
*Delete if not applicable
The statute text is free to read above. View Pro plans to unlock the case-law research tools for each provision.