Magistrates Court Act 1930—Form 40

Summary conviction on confession
Australian Capital Territory, 
                           to wit.	}	
BE it remembered that on the                            day of                         , 20    , at Canberra, in the Territory, AB being charged before the Magistrates Court, at Canberra, that [he or she] AB [etc stating the offence and the time and place when and where committed] and AB, pleading guilty to such charge [he or she] is thereupon convicted before the court of the offence, and AB is adjudged for [his or her] offence to be imprisoned in the gaol at
                                                , in the                                                   for the term of                                                      .
Given under my hand 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