Magistrates Court Act 1930—Form 34
(see s 92 (3))
Statement of the defendant
Australian Capital Territory, 
                           to wit.	}	
AB stands charged before the Magistrates Court, at Canberra, this
                               day of                             , 20     , that [he or she] [describe the offence as in a warrant of commitment], and the charge being read to AB and the witnesses for the prosecution, CD and EF, being severally examined AB is now addressed by the court as follows:
‘Do you wish to say anything in answer to the charge? You are not obliged to say anything unless you desire to do so; but whatever you say may be given in evidence against you on your trial.  You are clearly to understand that you have nothing to hope from any promise or favour, and nothing to fear from any threat that may have been held out to you to induce you to make any admission or confession of your guilt; but whatever you now say may be given in evidence against you on your trial, notwithstanding any such promise or threat.’
Whereupon AB says as follows: [Here state whatever the prisoner may say, and in his or her very words as nearly as possible; get him or her to sign it if he or she will.]
	[Signature]
	AB
Taken before the court at Canberra, in the Territory, the day and year first abovementioned.
	[Signature]
	Magistrate

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