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Get red statutory declaration 2018-2024

RF1442 SPEED / RED LIGHT STATUTORY DECLARATION WARNING The Oaths Act 1936 provides a maximum penalty of 4 years imprisonment for any person who knowingly makes a Statutory Declaration which is untrue in any regard. Under s79B 6a of the Road Traffic Act 1961 SA Police must provide your name to the person you have nominated on this statutory declaration. SA Police must not provide your address. Declared and subscribed at in the State of Signature person making declaration Justice of the Peace Declared before Name ID Signature Proclaimed Police Officer Date FOR OFFICE USE ONLY Revised 10/03/2016 Page 1. SEND COMPLETED DECLARATION to the Manager Expiation Notice Branch GPO Box 2029 Adelaide SA 5001 or facsimile number 08 7322 3559 DO NOT SEND OR MAKE PAYMENT A NEW NOTICE WILL BE ISSUED TO THE NOMINATED DRIVER This Declaration must be completed by the person the notice is issued to It must be witnessed by a Justice of the Peace or a person proclaimed under Part V of the Oaths Act 1936 e.g. legal practitioner a proclaimed police officer Responsibility for payment will remain with the owner if this Declaration is not properly completed and submitted to the Commissioner of the South Australia Police on or before the due date for payment of the notice. The enquiries I have made to identify the driver are attach an additional page if necessary must be sighted and witnessed Full Residential Address Postal Address if same as above write AS ABOVE Drivers Licence No. Date Vehicle Sold State of Issue / Date of Hire from Date of Birth to and I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths Act 1936. However the nominated person might later obtain a copy of your statutory declaration. If this Statutory Declaration is not accepted by the issuing authority at any time responsibility may return to you and an enforcement warning notice may be issued to you additional fees apply. I Daytime Phone No. Full Name of Address Email authorised to speak for Company Name if applicable do solemnly and sincerely declare that at the time of the offence referred to in Expiation Notice No. issued to Motor Vehicle Registration Number State The vehicle was 7 Cross applicable driven by another person whose details are listed below or sold to the person / company whose details are listed below or hired to the person / company whose details are listed below. I am unable to ascertain the identity of the driver of the vehicle at the time of the alleged offence. .

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