Consent to prosecute under Section 114 (3) of the EP Act
Police Officer or Chief Executive Officer
Name
First name
Last name
Position
Location
Address
Street address
Street address line 2
City
State
Post code
Contact number
Email
example@example.com
Consent required to initiate a prosecution under
Please Select
49A (2)
49A (3)
81 (2)
82 (2)
83
93
Offence details
Offence location
Date and time
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Suspect name
First Name
Last Name
Suspect date of birth
-
Day
-
Month
Year
Date
Suspect address
Street address
Street address line 2
City
State
Post code
Alleged details and circumstances
Witness
Witness name
First Name
Last Name
Witness date of birth
-
Day
-
Month
Year
Date
Witness address
Street address
Street address line 2
City
State
Post code
Witness statement obtained
Yes
No
Witness evidence summary
Witness 2
Witness 2 name
First name
Last name
Witness 2 date of birth
-
Day
-
Month
Year
Date
Witness 2 address
Street address
Street address line 2
City
State
Post code
Witness 2 statement obtained
Yes
No
Witness 2 evidence summary
Witness 3
Witness 3 name
First name
Last name
Witness 3 date of birth
-
Day
-
Month
Year
Date
Witness 3 address
Street address
Street address line 2
City
State
Post code
Witness 3 statement obtained
Yes
No
Witness 3 evidence summary
Submit button
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