Form 4.14	Magistrates Court—claim for expenses by witness
Court Procedures Rules 2006
(see r 4330 (Magistrates Court witness—informant may request attendance))
In the Magistrates Court of the Australian Capital Territory
Criminal jurisdiction

No MC		of (year)

*[The Queen/(name of informant)]
and
(name of accused person)

I, (name of witness), of (address) claim the following expenses incurred in attending the hearing of this matter in the Magistrates Court on (set out dates witness attended the hearing):

(set out expenses claimed in accordance with the Court Procedures Rules, schedule 4 (Scale of costs).  Attach receipts if available)

Date:
(signature of witness)

Receipt

I have received $ (amount) in payment of expenses incurred in attending the hearing of this matter.

Date:
(signature of witness)