Form 1—Form for the purposes of section Form 1—Form for the purposes of section 16BA

## Form 1—Form for the purposes of section 16BA (Front of Form) Commonwealth of Australia Crimes Act 1914 FORM FOR THE PURPOSES OF SECTION 16BA \*Branch Office of the Director of Public Prosecutions \*Regional Office of the Attorney‑General’s Department 1 2 TO: You are charged with the following federal \*offence/\*offences: (i) 3; (ii) 3; before the 4 . Information for Defendant 1. The list on the back of this document gives particulars of 5 other \*offence/\*offences which you are believed to have committed. 2. If you are convicted of \*the charge/\*any of the charges mentioned above and before sentence is passed, you may: (a) if: (i) the court decides; and (ii) the prosecution agrees; admit all or any of the offences specified on the back of this document; and (b) ask that any of those offences that you have admitted be taken into account by the court in passing sentence for the \*offence/\*offences of which you have been convicted. 3. If you are convicted and the court does take any of the offences that you have admitted into account, the maximum sentence that may be passed upon you for \*the offence/\*any offence of which you have been convicted will still be the maximum penalty that the court could have imposed on you for the offence if no other offence had been taken into account. 4. If the court takes an offence that you have admitted into account, the court may make such orders about reparation, restitution, compensation, costs and forfeiture as it could have made if you had been convicted before the court of the offence, but will not impose any other punishment for the offence. 5. No proceedings may be taken or continued against you for an offence taken into account by the court in respect of a conviction unless the conviction in respect of which the offence has been taken into account has been quashed or set aside. 6. If, in the circumstances mentioned in paragraph 5: (a) proceedings are taken or continued against you for an offence that you have admitted; or (b) if the court does not for any reason take anyone or more of the offences that you have admitted into account; your admission cannot be used as evidence against you in any proceedings taken or continued for the offence about which the admission was made or for any other offence listed on the back of this document. 6 7 \*Director of Public Prosecutions/\*A person authorised by the Director of Public Prosecutions under subsection 16BA (1) of the Crimes Act 1901/\*A person appointed under section 69 of the Judiciary Act 1903 8 Acknowledgment I, 2 , acknowledge receipt of a copy of this document. 9 8 CERTIFICATE This is to certify that in passing sentence on 2 for the \*offence/\*offences listed above of which 2 has been convicted, the court has taken into account the \*offence/\*offences admitted by 2 which are numbered 10 in the list on the back of this document. Dated 8 . 11 \*Judge of 4/\*Magistrate (Back of Form) Crimes Act 1914, section 16BA Federal offences which you are believed to have committed | Itemnumber | Place where offence was committed | Date ofoffence | Brief description of offence | | ---------- | --------------------------------- | -------------- | ---------------------------- | | | | | | 1 insert address 2 insert name of defendant 3 insert details of offences 4 insert name of court 5 insert number of offences listed 6 signature of the Director of Public Prosecutions, person authorised by the Director of Public Prosecutions under subsection 16BA (1) of the Crimes Act 1914 or person appointed under section 69 of the Judiciary Act 1903 7 insert full name of person authorised by the Director of Public Prosecutions under subsection 16BA (1) of the Crimes Act 1914 or of person appointed under section 69 of the Judiciary Act 1903 8 insert date 9 signature of defendant 10 insert the number of each offence taken into account 11 signature of judge or magistrate \* omit if inapplicable