Form 3	Information and summons
Magistrates Court Act 1930
(see s 25 (Informations) and s 38 (Form of summons)

In the *[Magistrates/Childrens] Court of the Australian Capital Territory
Criminal jurisdiction

No *[CC/CH]			of (year)		

Information

Details of *[informant/informant’s representative]
Name:
Address *[home/business]:

Information––description of people and property and of offences
The *[informant/informant’s representative] *[states/states on oath/solemnly affirms]––

	On (insert date) at (insert time) (insert name of alleged offender) committed or may have committed the following offence in the ACT*[against a person/relating to property/relating to a thing]:

	(description of offence and relevant legislation)
	(address of premises or place offence occurred)

This information is laid under the Magistrates Court Act 1930, section 25.

Signed:
(signature of informant/informant’s representative)

*[Sworn/Affirmed/Laid] before me by the *[informant/informant’s representative].

*[Magistrate/Registrar/Deputy Registrar]: 

Date:

Note	If a warrant is intended to be issued in the first instance against the person charged, the information must be in writing and on oath (see Magistrates Court Act 1930, s 30 (1) (Form of information)). 
If a summons instead of a warrant is intended to be issued in the first instance against the person charged, the information may be made orally and without oath (see Magistrates Court Act 1930, s 30 (3)).

*omit if, or whichever is, inapplicable

(do not complete the summons if a warrant for the arrest of the defendant is sought under the Magistrates Court Act, section 42)

*Summons to defendant on information

Details of the defendant
Name:
Address:

Direction
To the defendant:
On (insert date) at (insert time) you are required to appear before the Court at (insert address) to answer to the information stated on pages 1 and 2 and to be further dealt with according to law.

This summons is issued under the Magistrates Court Act 1930, section 38.

Date:
*[Magistrate/Registrar/Deputy Registrar]:

*omit if, or whichever is, inapplicable

Affidavit of service

On (insert date), I (insert full name of person making affidavit) of (insert home or business address) *[say on oath/solemnly affirm]––

	On (insert date), I served the defendant, (insert defendant’s name) with the summons by––
*(a)	giving a copy of the summons to the defendant; or
*(b)	leaving a copy of the summons at the last-known or usual *[home/business] address of the defendant with (insert name), a person who appeared to be at least 16 years old and *[living/employed] at the address.

Note	Service of a summons must be effected at least 72 hours before the time stated in the summons for the hearing of the information (see Magistrates Court Act 1930, s 41 (2) (Service of summons)). 

*[Sworn/Affirmed] by (full name): 
(signature of person making affidavit)

at (place) in the presence of: 

(signature of person before whom affidavit is made) 

(full name of person before whom affidavit is made) of (address)

*[Justice of the Peace/Barrister/Solicitor/(other)]
*omit if, or whichever is, inapplicable