Council’s name

Environmental Health

EXPIATION NOTICE

Expiation of Offences Act 1996

NAME
Address / NOTICE NUMBER / EPA
DATE OF ISSUE OF EXPIATION NOTICE
ISSUING OFFICER

It is alleged that you committed the following offence(s):

OFFENCE / Contravention of a mandatory provision under the Environment Protection (Water Quality) Policy-Section 17 (1) A person must not discharge or deposit a pollutant listed in Part 1 of Schedule 4 into any waters or onto land in a place from which it is reasonably likely to enter any waters (including by processes such as seepage or infiltration, or carriage by wind, rain, sea spray or storm water or by the rising of the water table.
DATE
TIME
LOCATION

The Offence(s) are expiable by payment of the following amount on or before the pay by date to the Council XXX

Amount Payable / Pay by date
Expiation Fee / $300
Reminder Fee / [cost 1]
TOTAL / [Infringement balance]
YOU MUST READ ALL THE INFORMATION ON THE OTHER SIDE OF THIS NOTICE
If you take no action on this notice, you may be automatically convicted of the offence(s).
EXPIATION NOTICE NUMBER / EXPIATION NOTICE NUMBER
Election to be Prosecuted / Payment Slip
I
of
Post Code
Elect to be prosecuted for the offence. r
I dispute the offence for the following reasons: r
(If insufficient space, attach further sheets).
¨  You may, before electing to be prosecuted, dispute the offence informally in writing
Signed
Date / I wish to expiate the offence.
To expiate an offence, you must pay the expiation fee and any applicable reminder notice fees. Payment can be made in person at the Council XXX office between 9.00am & 5pm, Mon – Fri OR by post with a cheque or money order (address) OR Credit Card (Visa, MasterCard) by completing the payment slip below and sending it to the postal address as indicated above OR Fax to XXX. Pay on-line at www.
PAYMENT IN FULL [Infringement balance] Date: _ _ _ _ _/_ _ _ _ _/_ _ _ _ _
Cheque o Money Ordero Credit Card o
PLEASE DEBIT MY: MasterCard o Visa o Amount: [Infringement balance]
Card Number______
Expiry Date______/______CVV ______
Name on Card ______
Signed ______
Date______. Contact Phone ______
Expiation Number [infringement number]
Pay in full by the due date using one of the payment options set out in the notice or contact the Fines Enforcement and Recovery Unit for application for more time to pay on the grounds of hardship call 1800 659 538. For more information about managing overdue fines: visit the unit’s website at www.fines.sa.gov.au

IT IS IMPORTANT THAT YOU READ ALL THE INFORMATION ON THIS PAGE

YOUR CHOICES :

For the alleged offence, you must, on or before the pay date make one of the following choices:

•  Pay the total amount due for the offence Payment may be by cash (cash must not be sent by mail), money order or cheque payable to Council XXX. On-line payments are available via the Council Web Site. Receipts are only issued on request. Complete the appropriate form on the front of this notice and post or deliver it as set out below OR

•  Enter into a payment arrangement with the Fines Enforcement and Recovery Officer which may include payment of the amount of the fee(s) in instalments, an extension of time in which to pay or other options by agreement with the Fines Enforcement and Recovery Officer. A fee will apply to enter into an arrangement; OR

•  if the offence is a parking or traffic offence and you were not driving at the time of the offence, or, if you had by the time of the offence transferred ownership of the vehicle, complete a statutory declaration stating the name and address of the driver or new owner and post or deliver it to the Council; OR

•  If you think the offence was trifling, apply to the Council for a review of the Expiation Notice (for special meaning of trifling see Section 4(2) Expiation of Offences Act 1996). Applications for review should be addressed to the Manager (Health and Public Safety); OR

•  Dispute the allegation that you committed the offence and elect to be prosecuted. If you elect to be prosecuted for an offence, you may get a summons. The summons will set out when and where to attend court. Complete the appropriate form on the front of this notice and post or deliver it as set out below. However, you may first dispute the offence informally in writing.

If no choice is made for an offence within the expiation period 1 reminder notice will be sent and a reminder fee will apply. After that, the outstanding amount may be referred to the Fines Enforcement and Recovery Officer who may take enforcement action against you which may involve entering into a payment arrangement or property that you own (including motor vehicles and land) being seized and sold. An additional amount will become payable if enforcement action is taken.

For further information: phone.
Payment details: In person at the Local Government Centre, address or Post to
postal address or Online at: www.

STATUTORY DECLARATION
Notice Number ______
I ______
of ______
______
Solemnly and sincerely declare that (reason for dispute)
______
______
______
______
______
______
______
______
______
______
______ / I make this solemn declaration conscientiously believing the same to be true and by virtue of the provisions of the Oaths Act 1936.
Signed: ______
Declared
at ______on______
Before me______
(Person before whom the declaration is made )
r Commissioner for taking affidavits
r Justice of the Peace
r Proclaimed Police Officer.
Note: In order to process this Statutory Declaration a Full Name and Address must be supplied.

Environmental Health Reminder Notice