Form 19Y APPLICATION FOR REHEARING Youth Court of South Australia Criminal Procedure Act 1921 Section 76A Registry at which conviction or order made: Registry File No Street Telephone Facsimile Address City/Town/Suburb State Postcode Email Address Details of original file: Defendant DOB Name Surname Given name/s dd/mm/yyyy Street Licence No. Address City/Town/Suburb State Postcode Informant Name Surname Given name/s Informant’s Reference Street Telephone Facsimile Address City/Town/Suburb State Postcode Email Address Charges: I now apply to have the conviction or order set aside. My reason(s) for wanting to set it aside is/are: Applicant’s signature State whether Applicant is Informant Defendant Registrar Registry Date Hearing details Address Time am/pm Telephone Facsimile Email Address Date YOUTH COURT IMPORTANT NOTICE TO APPLICANT An application to set aside a conviction or order must be made within 14 days after the applicant receives notice of the conviction or order.
Form 19Y APPLICATION FOR REHEARING Youth Court of South Australia Criminal Procedure Act 1921 Section 76A Registry at which conviction or order made: Registry File No Address Street Telephone Facsimile City/Town/Suburb State Postcode Email Address Details of original file: Defendant Name DOB Surname Given name/s dd/mm/yyyy Address Street Licence No. City/Town/Suburb State Postcode Informant Name Surname Given name/s Informant’s Reference Address Street Telephone Facsimile City/Town/Suburb State Postcode Email Address Charges: I now apply to have the conviction or order set aside. My reason(s) for wanting to set it aside is/are: Applicant’s signature State whether Applicant is Informant Defendant Registrar Hearing details Registry Date Address Time am/pm Telephone Facsimile Email Address Date YOUTH COURT IMPORTANT NOTICE TO APPLICANT An application to set aside a conviction or order must be made within 14 days after the applicant receives notice of the conviction or order.
Form%2019Y%20-%20Application%20for%20Rehearing.docx