Notice to withdraw infringement notice
Schedule 5 Notice to withdraw infringement notice
[r. 54(2)]
Food Act 2008 s. 126(7) and Food Regulations 2009 r. 54(2) Withdrawal of infringement notice | Notice No. | ||||
Alleged offender | Family name or | ||||
Other names | |||||
Address | No. | Street name | |||
Postcode | |||||
Infringement notice | Infringement notice No. | ||||
Date of issue | |||||
Alleged offence [*delete whichever | Description of offence ___________________________________ | ||||
*Food Act 2008 s. ________ *Food Regulations 2009 r. _________ | |||||
Designated officer withdrawing notice | Name and title of officer and | ||||
Signature | |||||
Date of notice | |||||
Withdrawal of infringement notice [*delete whichever | The above infringement notice issued against you has been withdrawn. If you have already paid the modified penalty for the alleged offence you are entitled to a refund. *Your refund is enclosed. or *If you have paid the modified penalty but a refund is not enclosed, to claim your refund sign this notice and post it to [details of relevant enforcement agency]. Signature | ||||
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