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TRESPASS NOTICE _ [iesaromis sob
> Section 7 and 8 Trespass Act PROMIS Person ID
DoB
being the lawful Occupier of/Member of the Police Force acting in relation to, the place located at
HEREBY ISSUE A DIRECTION to you under Section 7 of the Trespass Act that you are TO LEAVE
the above place.
AND as you are trespassing or have trespassed or | have reasonable cause to suspect you are likely to
‘trespass, | also ISSUE A WARNING to you under Section 8 of the Trespass Act that you are to STAY OFF
the above place. (Delete this section if MOPF issuing).
You are no longer permitted to enter the above place.
‘Place’ includes premises and land (including prohibited land and Crown Land).
Trespassing on this place after you have been given this notice may result in your arrest and prosecution
for the offence of trespass. Penalty: 20 Penalty Units.
Signature of the Occupier/MOPF BYR ined ned.
This notice is in effect for 1 year from date of service. Expire
ORIGINAL (white) delivered/sent to person being issued this notice.
DUPLICATE (pink) placed on Police Station file. Alert added to PROMIS
TRIPLICATE (yellow) to Occupier/ MOPF who has issued this notice.
Clothing and distinguishing feature
Licence/ ID documents sighted
Ethnicity... Hair colour
Eye colour
Height
Weight
Endorsement of Service
I served and explained the meaning of this notice on the above named person at:
Locatior
Date and time
Print name Rank ..
Number
Signature