NORTHERN TERRITORY POLICE

WITNESS DETAILS COVER PAGE

Witness Personal Details
Title:
Family Name:
Given Names:
Date of Birth:
Place of Birth:
Country of Birth:
Gender:
Witness Home Details
Home Address:
(include city, state, postcode)
Home Telephone:
Mobile Telephone:
E-mail Address:
Witness Work Details
Occupation:
Work Address:
Work Telephone:
Auction Details
Type of Auction (eg. EBAY)
Your Auction user ID:
Auction Item number:
Auction Item description:
Seller’s Auction user ID:
Seller’s Bank Details:
Amount & date paid:
Method of payment
Other names used by Seller
Statement Details
Date Statement Taken:
In the matter of:
Statement Taken By:
Place Statement Taken:
BRIEF NARRATIVE OF INCIDENT:

- CONFIDENTIAL -

POLICE - PROTECTED

Continued statutory declaration of: <Name>

NORTHERN TERRITORY

OATHS ACT

STATUTORY DECLARATION

I, <Name>, of an address known to police, do solemnly and sincerely declare that:

  1. I am <age> years of age.
  1. I am (please state your occupation and any relevant background about yourself. This gives the Police and the defence some idea about you).
  1. I am a registered user of the online auction site My registered username is < your ebay user ID >. I have been using the site for approximately < number of months or years >. < Describe your level of familiarity with the rules and procedures of buying from the site. >
  1. I have conducted < numerous, some, a few > such transactions in the past where I have received the items that I paid for. < If you are a first time buyer delete this paragraph >
  1. Approximately < time, day and date that you first saw the item that you bidded on and won >. I was surfing the ebay website looking for < type of product, eg. mobile phone >, when I saw item number < ebay item number >. It was a < Brand and type of product > for < amount $ or which was subject to bidding >, plus postage of < amount $ >. A seller using the username < sellers ebay user ID > was auctioning the < Type of product >. I checked the seller’s previous feedback. They were positive and did not have any complainants or adverse comments. This made me believe that I was dealing with a genuine seller. Since this was a good price, I decided to bid for it. I entered a bid of < amount of your first bid $ >. I retained a copy of this item on my computer which I have printed.
  1. I am able to produce a printout of a copy of ebay item <number>. It is attached to this statutory declaration, marked as annexure 1.
  1. About < Time, day and state of notification that you had won >. I received an email from the ebay-automated service informing me that I had won the auction for the <product type>. It also informed me that I now had to < method of payment, ie money order, deposit into an account > of < amount of winning bid > into the seller’s nominated back account. Details of this account were: < Seller’s bank details: Bank name, BSB number and account number >.
  1. I am able to produce a copy of the email from dated <date on email> detailing the seller’s account details. It is attached to this statutory declaration, marked as annexure 2.
  1. About < Time, day and date when you made the payment> I went to < Type the name of bank and it’s location ie, Bondi Branch > and withdrew <$ amount of money from account number < your BSB number and account number>. I then went to < bank name and branch > and deposited <$ amount into the seller’s bank account number < Seller’s BSB and account number >.
  1. I am able to produce a copy of the <bank name and branch> deposit slip/butt for the above transaction, dated <date of deposit>. It is attached to this statutory declaration, marked as annexure 3.

Or if you made a payment by internet banking delete the above mentioned paragraph and annexure, then complete the below alternative for internet banking. DELETE THIS PARAGRAPH WHEN FINISHED AND READY TO PRINT.

  1. About < Time, day and date when you made payment > I accessed my < Bank name > account number <BSB number and account number > by accessing the bank’s website on the Internet and entering my secure log-on details. I then transferred <$ amount of money into < seller’s name account number < Seller’s BSB number and account number >. I then entered into the transfer description field the words < if you entered a description put here, otherwise delete this statement >. The transfer was confirmed by receipt number < receipt number from your bank > issued by my bank almost immediately after I completed the transaction.
  1. I am able to produce a copy of my bank statement for my account <type your BSB and account number> showing the transfer of money to the seller’s account <type seller’s BSB and account number> on <date of payment>. It is attached to this statutory declaration, marked as annexure 4.
  1. About < Time, day and date > I sent an email to the person that I know as the seller by the name of < seller’s ebay user ID > on email address < insert email address here > where I informed him/her > that I had transferred the money into < his/her > nominated bank account. I also provided < him/her > with my postal address of <insert the postal address you supplied>,where he could send me the product type won.
  1. I am able to produce a copy of the above email dated <date of the email>. It is attached to this statutory declaration, marked as annexure 5.

For each e-mail that you either received from the seller or sent to the seller complete a paragraph similar to the one below and with an annexure that will be a copy of the e-mail mentioned in the paragraph. Please complete each paragraph in chronological order with increasing annexure numbers. DELETE THIS PARAGRAPH WHEN FINISHED AND READY TO PRINT.

  1. About < Time, day and date >I received an e-mail from the seller, < seller’s ebay user ID > that had been sent at < Time > the < same/previous > day. In that e-mail, brief summary of the email eg. he/she >confirmed receiving my payment and thanked me for the same; or < he/she > acknowledged my postal address and informed me that the monitor would be shipped in the next couple of days, etc.. I have also retrieved the header / source details from that e-mail sent to me.
  1. I am able to produce a copy of the above email sent by < seller’s user ID >, < time and date > together with a copy of the header information for that email. It is attached to this statutory declaration, marked as annexure.
  1. < Describe the course of correspondence between you and the seller, including whether there was any point at which e-mails went unanswered. Also include details of any names used other than the seller’s ebay user id. Include every copy of e-mail correspondence between you and the seller as indicated below >.
  1. < If there were any phone calls between you and the seller describe each with reference to: Date, Time, number on which the calls were received or number which you called and the exact conversation to the best of your recollection > OR < I did not have any telephone conversations with the seller >.
  1. < include any information here about any inquiries you conducted to establish the seller’s real identity/contact address/phone number AND/OR any contact with other buyers if applicable, and the results of these inquiries >.
  1. When I transferred < amount paid > to < seller’s eBay user ID > bank account, I believed that I was paying a genuine seller who did have a < product type > for sale, and that on receiving of my money, < he/she > would post/freight the item to me. I would not have paid this money if I had known that I would not receive the < product name >. To date, I have not received either the < product type > or my money back.
  1. I < have/have not > been paid compensation by < ebay/Paypal > as a result of my report to them. This compensation was < AU$$ >. I < did/did not > leave feedback on the seller’s account at eBay. I wish to claim compensation in the amount of < amount paid>.

______

(Witness/Declarant’s signature)(Police Officer’s signature)

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Continued statutory declaration of: <Name>

And I further declare that I:

(A)Have attained the age of 18 years;

And

(B)I have read this statement before signing it;

And I make this solemn declaration by virtue of the Oaths Act, conscientiously believing the statements contained in this declaration to be true in every particular. I acknowledge that a person wilfully making a false statement in a statutory declaration is guilty of an offence and is liable to a penalty of 2,000 dollars or imprisonment for twelve months or both.

Declared at on <day>, <date> <month> <yr>

(Place Signed) (Day) (Month)(Year)

______

<Name of Witness/Declarant>

BEFORE ME______

<Name, Rank, Station of Police Officer>

TELEPHONE:

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