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Regulation 2

SCHEDULEThe Tobacco Retailers Act (Northern Ireland) 2014

FIXED PENALTY NOTICE

[NAME OF DISTRICT COUNCIL]

[ADDRESS OF DISTRICT COUNCIL]

PART 1

RECIPIENT COPY

Penalty Notice Number:__________________________________________________________

Full name and address of alleged offender:__________________________________________

_______________________________________________________________________________

_________________________________________Postcode:_____________________________

Date of birth (if known):_____________________________________

I,_________________________________________(name), an authorised officer of the [name of District Council], have reason to believe that you committed the following offence under section/Article ______ of the Tobacco Retailers Act (Northern Ireland) 2014/the Health and Personal Social Services (Northern Ireland) Order 1978/the Children and Young Persons (Protection from Tobacco) (Northern Ireland) Order 1991. (Delete those statutes which do not apply.)

Alleged offence: The circumstances alleged to constitute the offence are that at__________________(time)

on __________________(date) you, at/on the following premises (where alleged offence took

place, including address, if any)_____________________________________________________

_______________________________________________________________________________

allegedly (details of offence):_______________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

This fixed penalty notice, “notice”, offers you the opportunity of discharging any liability for conviction for that offence by the payment of a fixed penalty, “penalty”, of______________ (insert the amount of fixed penalty in figures and words). No proceedings will be taken for this offence before the expiration of 28 days beginning______________________ (insert the date on which this notice is given). You will not be liable to conviction for the offence if you pay the penalty within that period. In this notice this period is referred to as the 28 day period.

You can pay a discounted amount of __________________ (insert the amount of the fixed penalty discounted by 25% in figures and words) if you pay within the period of 14 days beginning with ___________________. (Insert date on which this notice is given). If the 14th is not a working day, you may pay on the next working day. “Working day” means any day which is not Saturday, Sunday, Christmas Day, Good Friday or a day which is a bank holiday. In this Form this period is referred to as the 14 day period.

Information for the immediate attention of the person who has been issued with this notice is at Part 2. Details of how to pay this fixed penalty are at Part 3.

_______________________________________________________________________________

Signature                                                Date

If you have any questions or any representations about this notice, please contact [name of District Council and contact details].