Magistrates Court Act 1930—Form 5
(see s 38)
Summonses
Summons to the defendant on information
In the Magistrates Court at Canberra.
To AB, of                                             , in the Australian Capital Territory.
WHEREAS an information has this day been laid before the undersigned (a magistrate of or registrar of the Magistrates Court of the Territory), that you, on the                              day of                            20    ,
at                                                                                  [here state shortly the matter of the information].  These are therefore to command you, in the Sovereign’s name, to appear at                                at                                  in the Territory, on the                                  day of                                 20    , at                                                                       before the court, to answer the information, and to be further dealt with according to law.
Given under my hand, at                                                in the Territory, this
                             day of                                 20    .
	[Signature]
	Magistrate or Registrar of Magistrates Court

Affidavit of service [to be endorsed on summons].
AB                            of                              being duly sworn saith as follows:
I am a                                           of police stationed at                                   
On the                             day of                                   20    , I personally served the withinnamed CD with the within summons by delivering a copy of it to him or her personally and at the same time showing him or her the original summons.
Sworn before me [etc as in information].

Endnotes
1	This form was originally in the Magistrates Court Act 1930 (the authorising Act), schedule 1.  Under amendments made by the Legislation (Consequential Amendments) Act 2001, the form was omitted from the authorising Act and became a form approved under section 256 of that Act (see amdts 1.2764 and 1.2769). 
2	Under the Court Procedures Act 2004 A2004-58, pt 8, this form became a form approved under that Act.
3	This republication includes amendments made under the Legislation Act, part 11.3 (Editorial changes).

©  Australian Capital Territory 2005