Document ID: chunk:federal_register_of_legislation:F2021C00429:clause:1_5:p1
Version: federal_register_of_legislation:F2021C00429
Segment Type: clause
Provision Reference: sch 1 cl 5 (pt 1/6)
Character Range: 71532–74719

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Dated 6.
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Note If you are served with a summons under subsection 19AZ(2) of the Crimes Act 1914 and then fail to attend as required by the summons without a reasonable excuse, you may have committed an offence and may be liable, on conviction, to a fine not exceeding 10 penalty units.

   1 insert name and address of witness
   2 insert name of court
   3 insert address of court
   4 insert time and date
   5 insert details of documents or articles
   6 insert date
   7 signature of prescribed authority
   8 designation of prescribed authority
   * omit if inapplicable

Form 10—Order and recognisance where discharge without conviction

Commonwealth of Australia

Crimes Act 1914

ORDER AND RECOGNISANCE UNDER SECTION 19B

IN THE 1

AT 2

IN THE *STATE OF 3

BETWEEN:
4(*Informant/*Appellant)
‑and‑
5(*Defendant/*Respondent)

ORDER
THE COURT DISCHARGES the *defendant/*appellant under section 19B of the Crimes Act 1914 without proceeding to conviction upon the *defendant/*appellant giving security *with *surety/*sureties of $              6 by recognisance of $              7 to comply with the following conditions:
      (a) that the *defendant/*appellant is to be of good behaviour for  8 *months/*years;
      *(b) that the *defendant/*appellant is to *make reparation/*make restitution/*pay compensation of $              9 to              10 *by              11/ *by instalments of $               12;
      *(c) that the *defendant/*appellant is to pay costs of this prosecution for the *offence/*offences specified below of $              9 to              10 *by              11/ *by instalments of $              12;
      *(d) that the *defendant/*appellant is to comply with the following further conditions:
          (i)  13;
          (ii)  13.
This Order has been issued because:
      *(a) the appellant, 14 of 15, appealed to this court against the *sentence/*conviction and sentence imposed by the               2 Magistrates' Court on              16 in respect of the following federal *offence/*offences:
          (i)  17;
          (ii)  17; and
      *(a) the defendant, 14 of 15, was charged with the following federal *offence/*offences:
          (i)  17;
          (ii)  17; and
      (b) the court is satisfied that the *charge is/*charges are proved, but is of the opinion, having regard to:
          (i) the character, antecedents, age, health or mental condition of the person; or
          (ii) the extent to which the *offence is/*offences are of a trivial nature; or
          (iii) the extent to which the *offence was/*offences were committed under extenuating circumstances;
       that *it is inexpedient to inflict *any punishment/*any punishment other than a nominal punishment./*it is expedient to release the *defendant/*appellant on probation.
Dated 16.
18
*Judge of 1/*Magistrate/*Registrar of 1/ *Clerk of              1/*Justice of the Peace

RECOGNISANCE
I, 14, the *defendant/*appellant:
      (a) have had explained to me:
          (i) the purpose and effect of this Order; and
          (ii) the consequences that may follow if I fail, without reasonable cause or excuse, to comply with the conditions of