Magistrates Court Act 1930—Form 42
(see s 143)
Certificate of dismissal
Australian Capital Territory, 
                           to wit.	}	
I, the undersigned, a magistrate of the Territory, hereby certify that on 
the                          day of                       , 20    ,
at                                              , in the Territory, AB was charged before the Magistrates Court, at Canberra, AB, [etc stating the offences and the time and place when and where alleged to have been committed] and that the court thereupon dismissed the information.
Given under my hand, at Canberra, in the Territory, this                          day of                           , 20    .
	[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