FORM 81A-L
rule 81A.41(5)
File No: [file number]
COMMUNITY WORK ORDER
[Offender's name in full]
of [address] 
came before this Honourable Supreme Court of the Northern Territory of Australia at [Darwin / Alice Springs] for the offences shown below and on [date] it imposed the hours of community work shown below:

CASE & OFFENCE NOS	
OFFENCE	HOURS ORDERED	
File number	[No]	[offence]	[hours]	

You must participate in one or more approved projects for a total of [period ordered].
You must present yourself to [name of person to whom offender must report] at [place to which offender must report] within [period ordered].
You must present yourself to a person at a place and at a time specified by the Director of Correctional Services. 
Date: [date]
[SHERIFF / DEPUTY SHERIFF]
I hereby confirm that I have consented to the making of this order and to its terms and conditions and I will comply with all of its requirements.
Date: [date]

Signature of offender

A copy of this order must be given to the offender and to the Director of Correctional Services

IMPORTANT INFORMATION ABOUT YOUR ORDER
SENTENCING ACT 1995 – section 37 – Duties in carrying out your community work order
1. 	Under this community work order you:
(a)	must participate, for the number of hours specified in the order, in the approved project that a probation officer directs you to participate in;
(b)	must participate in the project in a satisfactory manner;
(c)	must, while participating in the project, comply with any reasonable direction of a probation officer or supervising officer; and
(d)	must inform a probation officer of a change in your residential address not later than 48 hours after the change.
2.	Except where you consent, you shall not be required to participate in an approved project under your community work order for more than 8 hours (exclusive of time allowed for meals) in any one day.
SENTENCING ACT 1995 – section 39 – Breach of your community work order
	You will breach your community work order if you:
(a)	fail to comply with a term or condition of the order;
(b)	fail to carry out your obligations under section 37(1) (printed above);
(c)	disturb or interfere with any other person participating in or doing anything under a community work order;
(d)	assault, threaten, insult or use abusive language to a probation officer or supervising officer;
(e)	change your address for the purposes of evading the execution of the Sentencing Act 1995;
(f)	commit a breach of the Regulations; or 
(g)	commit an offence against a law in force in the Territory during a time when you are participating in an approved project under the order.