Transcription of Form 5 - Application for extraordinary licence
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Form 5 - Application for extraordinary licence
MAGISTRATES COURTS of WESTERN AUSTRALIA Application FOR extraordinary licence Road Traffic (Authorisation to drive ) Act 2008 Magistrates Court (General) Rules 2005 Court number Magistrates court at Date lodged Applicant Full name Address Telephone no Occupation Date of birth Employment (tick one box) Self employed Not employed Employed by the employer below. Employer s name and address Details of disqualification from holding or obtaining a drivers licence Date disqualified Period disqualified Reason1 Application Under the Road Traffic (Authorisation to drive ) Act 2008 I apply for an order directing the CEO to grant an extraordinary licence that allows me to drive : Vehicles of class In these localities
MAGISTRATES COURTS of WESTERN AUSTRALIA APPLICATION FOR EXTRAORDINARY LICENCE Road Traffic (Authorisation to Drive) Act 2008 s.27 Magistrates Court (General) Rules 2005 – Form 5
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