Sch 10Forms

Schedule 10 — Forms

[r. 167]

Form 1 — Infringement notice

• Biodiversity Conservation Act 2016Infringement notice Infringement notice no.
• Alleged offender Name: Family name
• Given names
• or Body corporate name _________________________
• Address _________________________________________ Postcode
• Alleged offence Description of offence ______________________________
• Biodiversity Conservation Act 2016 s. or Biodiversity Conservation Regulations 2018 r.
• Date / /20 Time am/pm
• Modified penalty $
• Officer issuing notice Name
• Signature
• Office
• Date Date of notice / /20
• Notice to alleged offender It is alleged that you have committed the above offence.If you do not want to be prosecuted in court for the offence, pay the modified penalty within 28 days after the date of this notice. How to pay****By post: Send a cheque or money order (payable to ‘Approved Officer — Biodiversity Conservation Act 2016’) to: Approved Officer — Biodiversity Conservation Act 2016Department of Biodiversity, Conservation and AttractionsLocked Bag 104 Bentley Delivery Centre WA 6983

In person: Pay the cashier at any office of the Department of Biodiversity, Conservation and Attractions, or pay over the telephone by credit card by calling the general telephone number of any office of the Department of Biodiversity, Conservation and Attractions.

• If you do not pay the modified penalty within 28 days, you may be prosecuted or enforcement action may be taken under the Fines, Penalties and Infringement Notices Enforcement Act 1994. Under that Act, some or all of the following action may be taken — your driver’s licence may be suspended, your vehicle licence may be suspended or cancelled, you may be disqualified from holding or obtaining a driver’s licence or vehicle licence, your vehicle may be immobilised or have its number plates removed, your details may be published on a website, your earnings or bank accounts may be garnished, and your property may be seized and sold.If you need more time to pay the modified penalty, you can apply for an extension of time by writing to the Approved Officer at the above postal address.