Application for Withdrawal of Infringement Notice

Important message

Changes to Library access and book drop

Construction of the new Civic Centre building will soon commence. The current Civic Centre carpark and nearby entrance will be closed from Monday 28 April and remain closed while works take place. The City Library will remain open and will be accessible from the Civic Centre Customer Services’ entry near Civic Park.

Please note that the City Library returns chute will be temporarily unavailable. A new Book Drop will be installed at the Cavenagh St side of the Civic Centre soon.

We kindly ask all customers to:

return items inside the Library during opening hours, or
use one of the 24/7 return chutes located at Casuarina, Nightcliff or Karama libraries.

For more information about the project, please go here.

We apologise for the inconvenience and thank you for your understanding.

Please note: A Statutory Declaration may be requested in addition to this form.

Applications can take up to 7 days for processing. Responses will be received via email/post advising you of the outcome.

Infringement Notice Number

Vehicle Registration

Full Name

Full name of the person submitting the declaration

Address

Contact

Full details of request

If you are at fault due to paying for a different number plate, your infringement will not be withdrawn.

(attach any additional pages, photographs or documents as necessary)

Attachment 1

One file only.
20 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, jpg, png, jpeg.

Attachment 2

One file only.
20 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, jpg, png, jpeg.

Privacy Statement

City of Darwin complies with Information Privacy Principles contained in the Northern Territory Information Act. These principles protect the privacy of personal information collected, used and stored. It also details how you can access your personal information. Council’s Privacy Statement is available from the City of Darwin, Harry Chan Avenue, Darwin or online.

I hereby certify that the above statements are true and correct to the best of my knowledge and understand that providing false and misleading information is an offence under the Local Government Act 2019 for which the maximum penalty is $74,000 or imprisonment for 2 years.

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