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e said State, Other'orders sought (forfeiture, compensation, additional penalty, destruction or the like — Rule 15.03) Date Complainant Witness (Registrar, Deputy Registrar or Justice of the Peace) (Not required if Complainant is a Public Authority) EFTA00265390 Re-FeR TO PH-cfroc ROPH I C Cul c)eiN
ruction or the like — Rule 15.03) Date Complainant Witness (Registrar, Deputy Registrar or Justice of the Peace) (Not required if Complainant is a Public Authority) EFTA00265390 Re-FeR TO PH-cfroc ROPH I C Cul c)eiNac-E f meD \c-PL- Rec-CRD5 POIIcc BRUTALITY — 1 t•), CRIc5.5 SOST14 I NE.,-E) EKTREM E I PD11
rfeiture, compensation, additional penalty, destruction or the like — Rule 15.03) EFTA00266575 ck_ ck tS - Date ~~~• IC ,e< P Want Witness (Registrar, Deputy Registrar ct Justine of the Peace) (Not required if Complainant is a Public Authority) EFTA00266576 SUBJECT ROAD TRAFFIC ACT - ALCO TEST
A00266575 ck_ ck tS - Date ~~~• IC ,e< P Want Witness (Registrar, Deputy Registrar ct Justine of the Peace) (Not required if Complainant is a Public Authority) EFTA00266576 SUBJECT ROAD TRAFFIC ACT - ALCO TEST FOR ALCOHOL ORAL ADVICE ON REFUSAL OR FAILURE TO COMPLY Pursuant to Section 7E(4Xab) of th R
mmary offence Other orders sought (forfeiture, compensation, additional penalty, destruction or the like — Rule 15.03) Date Complainant Witness (Registrar. Deputy Registrar or Justice of the Peace) (Not required if Complainant is a Public Authority) EFTA00266621 4( IM\lk)ftke:E) 1 SNooLOCRS sOS-TA t
ruction or the like — Rule 15.03) Date Complainant Witness (Registrar. Deputy Registrar or Justice of the Peace) (Not required if Complainant is a Public Authority) EFTA00266621 4( IM\lk)ftke:E) 1 SNooLOCRS sOS-TA t NE 0 - A REST' 461 kisse)s NOT P.Rel,-sear s- WrrEt) s r11-14. It-) piancccr office iN
Entities connected to both Registrar and a Public Authority
Leon Black
PERSONKadina
ORGANIZATIONPort Pirie
LOCATIONthe State of South Australia
LOCATIONCourtney Wild
PERSONSouth Australia
LOCATIONConstable of Police
ORGANIZATIONDeponent's Signature
ORGANIZATIONthe Police Force
ORGANIZATIONJacqueline
PERSON
Justice of the Peace
ORGANIZATION
Paul Gardner
PERSONthe John Pirie Island
LOCATIONthe Jetty area
LOCATIONCarol PEARCE
PERSONErnie POLLEY
PERSONthe Port Pixie Police Station
ORGANIZATIONMITSUBISHI Magna
ORGANIZATION