Supreme Court Rules 1937—Form 4.3
(see o 80 r 3)
Certificate identifying exhibit
In the Supreme Court of the Australian Capital Territory
Criminal jurisdiction

No		of (year)

The Queen
and
(name of accused person)

This is the exhibit marked (initials of person and identifying number eg ABC 1) shown to me when (name of person making the affidavit) made *[his/her] affidavit on (date).

(signature of person before whom affidavit is taken)
*[Justice of the Peace/Barrister/Solicitor/(other)]

*(delete whichever is inapplicable)

Endnote
1	This form was originally in the Supreme Court Rules 1937. Under the Court Procedures Act 2004 A2004-59, pt 8, the form became a form approved under that Act. 

©  Australian Capital Territory 2005