Magistrates Court (Civil Proceedings) Amendment Rules 2017 (WA)
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WESTERN 2991 AUSTRALIAN GOVERNMENT
ISSN 1448-949X (print) ISSN 2204-4264 (online)
| PRINT POST APPROVED PP665002/00041 |
PERTH, TUESDAY, 20 JUNE 2017 No. 117 SPECIAL PUBLISHED BY AUTHORITY KEVIN J. McRAE, GOVERNMENT PRINTER AT 12.30 PM
© STATE OF WESTERN AUSTRALIA
Magistrates Court (Civil Proceedings) Act 2004
Magistrates Court (Civil Proceedings)
Amendment Rules 2017
Made by the Magistrates Court in accordance with the Magistrates Court
Act 2004 section 39.1. Citation
These rules are the Magistrates Court (Civil Proceedings)
Amendment Rules 2017.
2. Commencement
These rules come into operation as follows —
(a) rules 1 and 2 — on the day on which these rules are published in the Gazette; (b) the rest of the rules — on 1 July 2017.
3. Rules amended
These rules amend the Magistrates Court (Civil Proceedings)
Rules 2005.
4. Rule 131D inserted
At the end of Part 21 Division 1 insert:
131D. Forms under Restraining Orders Act 1997
(1) For the purposes of the Restraining Orders Act 1997,
the forms set out in Schedule 1 are prescribed in
relation to the matters specified in those forms.
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(2) Where a form is in parts, then only those parts of the
form that are relevant, taking into account the part
heading, need be used for a particular copy of the form,
or for a particular purpose.
5. Schedule 1 inserted
After rule 138 insert:
Schedule 1 — Forms prescribed for Restraining Orders
Act 1997
[r. 131D]
Table of forms
Forms about family violence restraining orders
Form Provisions of Act
1 Application for family violence restraining order Section 24A 2 Part A — Family violence restraining order Sections 29, 32, 43, Part B — Information to be on the copy of order given to the 49 and 63 person who is bound by the order
Part C — Information to be on the respondent’s endorsed copy
Part D — Information to be on the copy of the order given to
the person protected by the order
Part E — Information to be on the proof of service copy
Part F — Details of family order
3 Conduct agreement order Sections 10H, 43 Part A — Conduct agreement order
Part B — Information to be on the copy of order given to theperson who is bound by the order
Part C — Information to be on the copy of the order given to
the person protected by the order
Part D — Information to be on the proof of service copy
Part E — Details of family order
4 Section 63A family violence restraining order Section 63A Part A — Section 63A family violence restraining order
Part B — Information to be on the copy of the order given tothe person who is bound by the order
Part C — Information to be on the copy of the order given to
the person protected by the order
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Forms about violence restraining orders
Form Provisions of Act
5 Application for violence restraining order Section 25 6 Part A — Violence restraining order Sections 29, 32, 43, Part B — Information to be on the copy of order given to the 49 and 63 person who is bound by the order
Part C — Information to be on the respondent’s endorsed copy
Part D — Information to be on the copy of the order given to
the person protected by the order
Part E — Information to be on the proof of service copy
Part F — Details of family order
7 Part A — Section 63A violence restraining order Section 63A Part B — Information to be on the copy of the order given to the person who is bound by the order
Part C — Information to be on the copy of the order given to
the person protected by the order
Forms about misconduct restraining orders
Form Provisions of Act
8 Application for misconduct restraining order Section 38 9 Part A — Misconduct restraining order Part 4 Divisions 1 Part B — Information to be on the copy of the order given to and 2, sections 49
the person who is bound by the order and 63
Part C — Information to be on the copy of the order given to
the person protected by the order
Part D — Information to be on the proof of service copy
Forms about telephone orders
Form Provisions of Act
10 Part A — Telephone order Section 23 Part B — Court copy of telephone order
Part C — Information to be on the copy of the order given tothe person who is bound by the order
Part D — Information to be on the respondent’s endorsed copy
Part E — Information to be on the copy of the order given to
the person protected by the order
Part F — Information to be on the proof of service copy
11 Restraining order record of telephone application Section 21(4) Forms about variation and cancellation of orders
Form Provisions of Act
12 Part A — Application to vary or cancel a restraining order Section 45 Part B — Information to be on the copy of the application given to the applicant
13 Part A — Summons to vary or cancel restraining order Section 47 Part B — Information to be on the proof of service copy
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Other forms
Form Provisions of Act
14 Restraining order made during other proceedings — Record of Section 63 proceedings 15 Part A — Interstate restraining order — Application to register Section 75(2) Part B — Information to be on the copy of the application given to the applicant
Part C — Information to be on the copy of the application
given to the Commissioner of Police
Part D — Information to be on the copy of the application
given to the interstate court where the interstate order
was made
16 Part A — Restraining order — Summons Sections 26(3) Part B — Information to be on the proof of service copy and 39 17 Application to have final order under section 32(2) of the Act Section 32(5) set aside 18 Application to have decision under section 42 of the Act set Section 43A aside 20 June 2017 GOVERNMENT GAZETTE, WA 2995 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 1 — Application for family violence restraining order
Number: Jurisdiction:
Restraining Orders Act 1997 s. 24A
Family violence restraining order
Location:
Application
Applicant Family name: Date of birth: [If not the Other names: person seeking Address: street: to be protected]
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: seeking to be Other names: protected Address: street:
suburb: postcode: Phone nos.:
work: home: mobile: Respondent Family name: Date of birth: [Fill in as many Other names: details as you Home street: can] address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Grounds for Give details of the respondent’s behaviour. application Family orders
Are there any current family orders relating to the respondent’s Yes No Unknown [If yes, see the rights in relation to children who may be affected by a Details of family restraining order? order Annexure]
Are there any current Family Court proceedings in which such Yes No Unknown orders are being sought? Firearms
Does the respondent have a firearm or firearms licence? Yes No Unknown Does the respondent have access to a firearm at work? Yes No Unknown First hearing
Do you want the respondent to be present at the first hearing? Yes No Applicant
Signature: Date: [Not essential if
applicant is a
police officer]Hearing
Court: Date: Time: [To be filled Signature of registrar: in by the court] Notification I certify that on __ __/__ __/__ __ __ __ at _______ am/pm at ________________________ [To be filled I notified the applicant of the hearing date. in by the Signature of registrar: court]
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Form 2 — Family violence restraining order Part A — Family violence restraining order
Restraining Orders Act 1997 Number: s. 29, 32, 43, 49 and 63 Jurisdiction: Family violence Location: restraining order
Person who Family name: Date of birth: is bound by Other names: this order Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Applicant Family name: Date of birth: for the order [If not the Other names: person to be protected] Person Family name: Date of birth: protected Other names:
Type of The order is for 72 hours or less an interim order a final order order Terms of this order
Information In addition to the terms of this order, the court informs you that the following about behaviour and activities are unlawful: unlawful behaviour and
activities Order made
Date order made: Time order made: Registrar Date:
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Form 2 — Family violence restraining order
Part B — Information to be on the copy of order given to the
person who is bound by the order
IMPORTANT INFORMATION
FOR PERSON BOUND BY THIS ORDER
If the order is for 72 hours or less
A family violence restraining order has been made against you for 72 hours or less on the terms set out on arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both. If you breach the order in the presence of a child with whom you are in a family relationship (e.g. your child, your partner’s child or a child who ordinarily resides with you) the court sentencing you will consider this
the front of this order. This order came into force when it was served on you, or at a later time, if this is
specified on the front of this order. You must comply with this order until the end of the period specified
in the order.
an aggravating factor.Counselling, support and/or legal services may be of assistance to you.
If the order is an interim order
An interim family violence restraining order has been made against you on the terms set out on the front of of the other copy of this order and return it to the court within 21 days from the date this order was served on you. You will then not need to attend a final order hearing and the order will automatically become a final order which remains in force for the period specified in the order, or —
this order. This order came into force when it was served on you, or at a later time, if this is specified on
the front of this order, and it will remain in force until a final order is made or a court decides not to make
a final order. You must comply with this order at all times while it is in force.
You have an opportunity to object to the order before it becomes a final order.
If you want to object to this order being made final you must fill in the “Objection” section on the back
of the other copy of this order and return it to the court within 21 days from the date this order was served
on you. The court will then arrange a final order hearing at which it will consider anything you want to say
before deciding whether to make a final family violence restraining order. The court will let you know
where and when the final order hearing will be held.
(a)
if no period is specified and you are not a child, for 2 years from the date this interim order was served on you; or
(b)
if no period is specified and you are a child, for 6 months from the date this interim order was served on you.
If you were in prison at the time the court received your “Consent” form, the order will stay in force while
you are in prison and will expire 2 years after the date on which you are released from prison (or longer if
specified in the order).
If you do nothing and do not fill in and return the other copy of this order within 21 days the court will
assume that you do not object and the interim order will automatically become a final order.
Penalty: It is an offence to breach a family violence restraining order. If you breach this order you may be
arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Counselling, support and/or legal services may be of assistance to you.
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If the order is a final order
A final family violence restraining order has been made against you on the terms set out on the front of this order, and it will remain in force until it expires or is varied or cancelled by a court. You must comply with this order at all times while it is in force.
this order.
If there is a duration specified in the order, the order expires at the end of the specified period.If there is no duration specified in the order, the order expires —
• if it was made at a final order hearing and —
(a) you are not a child, 2 years after this final order comes into force; or (b) you are a child, 6 months after this final order comes into force; or
• if it was a telephone order which became a final order because you did not object, 3 months, or any shorter period specified in the order, after the telephone order was served on you. If you were in prison at the time this order was made, the order expires —
• in the case of an order made at a final order hearing or an interim order which became the final order, 2 years after the date on which you are released from prison (or longer if specified in the order); • in the case of a telephone order which became the final order because you did not object, 3 months after the date on which you are released from prison (or shorter if specified in the order). If, in the future, you want the order varied or cancelled you may apply to the court. If you would like more
information about doing this you should consult your lawyer or the registrar of the court.
Penalty: It is an offence to breach a family violence restraining order. If you breach this order you may be
arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.Counselling, support and/or legal services may be of assistance to you.
Additional information about conviction for breaching the order
Note 1: If you are convicted of breaching this order, the fact that the person protected by the order aided
you in the breach is not a mitigating factor for the purposes of your sentencing (see the
Restraining Orders Act 1997 section 61B(2)).Note 2: If you are convicted of breaching this order and you have been convicted of at least 2 other
offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years
before your conviction for breaching this order, you will face a penalty that is or includes
imprisonment (or, if you are a child, detention) unless the court decides under section 61A(6) of
the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person protected by this order, request a copy of any affidavit received in evidence in relation
to this order the registrar of the court where the application for the order was made is to provide a copy of theaffidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF YOU WERE
PRESENT IN COURT WHEN IT WAS MADE
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Form 2 — Family violence restraining order
Part C — Information to be on the respondent’s endorsed copy of
the order
IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
For interim orders only
If you want to object to this order being made final you must fill in the
“Objection” section below and return it to the court within 21 days from the date this
order was served on you. The court will then arrange a final order hearing at which it
will consider anything you want to say before deciding whether to make a final
family violence restraining order. The court will let you know where and when the
final order hearing will be held.If you do not object to this order being made final you must fill in the “Consent” section below and return this copy of the order to the court within 21 days of the date it was served on you.
If you do nothing and do not fill in and return this copy of the order to the court within 21 days this interim order will automatically become a final order.
Objection
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode:
Will you be represented by a lawyer at the final order hearing? Yes No
If yes: lawyer’s name: lawyer’s firm: How many witnesses (including yourself) do you intend to call? _________________
Does this interim order prevent you from —
• going to where you normally live? Yes No • having contact with your children? Yes No • going to where you work or otherwise prevent you from doing your job? Yes No • being in possession of a firearm which is essential for your job? Yes No
Signature: Date:
OR
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Consent
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode: I do not object to a final order being made on the same terms as this interim order. will automatically become a final order which will stay in force for —
(a) the period specified in the order; or (b)
if no period is specified and I am not a child, for 2 years from the date on which this order was served on me; or
(c)
if no period is specified and I am a child, for 6 months from the date on which this order was served on me.
If I am in prison when the court receives this form, the order will stay in force while I am in
prison and for a further 2 years from the date on which I am released from prison (or longer if
specified in the order).
Signature: Date:
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Form 2 — Family violence restraining order
Part D — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON PROTECTED BY THIS ORDER
If the order is for 72 hours or less
A family violence restraining order has been made to protect you for 72 hours or less on the terms set out on the front of this order. This order will come into force when it is served on the person who is bound by this order, or at a later time, if this is specified on the front of this order. The person who is bound by this order must comply with this order until the end of the period specified in the order.
Penalty: It is an offence to breach a family violence restraining order. If the person bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Counselling, support and/or legal services may be of assistance to you.
If the order is an interim order
An interim family violence restraining order has been made to protect you on the terms set out on the front final order.
of this order. This order will come into force when it is served on the person bound by this order, or at a
later time, if this is specified on the front of this order, and it will remain in force until a final order is
made or a court decides not to make a final order. The person who is bound by this order must comply
with this order at all times while it is in force.If the person who is bound by this order does object you will need to attend a final order hearing. At that hearing the court will consider anything you and the person who is bound by this order want to say before deciding whether to make a final restraining order. The court will let you know if a final order
hearing is to be held and where and when you need to attend. Even if the person who is bound by this
order does object, this interim order will remain in force until the final order hearing.If the person who is bound by this order does not object this order will automatically become a final order which remains in force for the period specified in the order or —
(a)
if no period is specified and the person is not a child, for 2 years from the date on which this order was served on the person; or
(b)
if no period is specified and the person is a child, for 6 months from the date on which this order was served on the person.
If the person was in prison at the time the court received the person’s “Consent” form, the order will stay
in force while the person is in prison and will expire 2 years after the date on which the person is released breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
from prison (or longer if specified in the order).
You will then not need to attend a final order hearing.
Counselling, support and/or legal services may be of assistance to you.
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If the order is a final order
A final family violence restraining order has been made to protect you on the terms set out on the front of this order.
This order will come into force when it is served on the person who is bound by this order, or at a later time, if this is specified on the front of this order, and it will remain in force until it expires or is varied or cancelled by a court. The person who is bound by this order must comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.
If there is no duration specified in the order, the order expires —
• if it was made at a final order hearing and —
(a) the person is not a child, 2 years after this final order comes into force; or (b) the person is a child, 6 months after this final order comes into force; or
• if it was a telephone order which became a final order because the person did not object, 3 months, or any shorter period specified in the order, after the telephone order was served on the person. If the person was in prison at the time this order was made, the order expires —
• in the case of an order made at a final order hearing or an interim order which became the final order, 2 years after the date on which the person is released from prison (or longer if specified in the order); • in the case of a telephone order which became the final order because the person did not object, 3 months after the date on which the person is released from prison (or shorter if specified in the order). If, in the future, you want the order varied or cancelled you may apply to the court. The person who is bound by this order may also apply to have the order varied or cancelled. If you would like more information about doing this you should consult your lawyer or the registrar of the court.
Penalty: It is an offence to breach a family violence restraining order. If the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Counselling, support and/or legal services may be of assistance to you.
Additional information about breaching the order
Note 1: If the person bound by this order breaches it and you aid the person in that breach, you will not
commit an offence however the court might decide to vary or cancel the order (see the
Restraining Orders Act 1997 section 61B(3) and (4)).Note 2:
If the person who is bound by this order is convicted of breaching the order and the person has been convicted of at least 2 other offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years before the conviction for breaching this order, the person will face a penalty that is or includes imprisonment (or, if the person is a child, detention) unless the court decides under section 61A(6) of the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person bound by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS
BOUND BY THE ORDER WAS PRESENT IN COURT WHEN IT WAS MADE
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Form 2 — Family violence restraining order
Part E — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving order: serving
I am the registrar of the court
order a police officer Rank, number and station: ___________________ a prison officer Prison: ___________________________________ a person authorised by the registrar Date of authorisation: _________
Service Method of service: personal oral by post substituted service Place where order served:
Date of service: Time of service:
Person Name: served Date of birth: [Person who is bound by the order] Signature: …………………………………...................
(If possible to obtain)
Certificate I certify that on the day and at the time and place set out above — I personally served this order on the person who is bound by the order
I orally served this order on the person who is bound by this order
I posted this order to the person who is bound by this order
I took the steps directed by the court to effect substituted service of this
order on the person who is bound by this order in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
In the case of oral service, I also certify that I —
• gave the person who is bound by this order the information required by the Restraining Orders Act 1997 section 55(5) and that the person appeared to understand what was said; or • arranged for someone else over the age of 16 years to give the information to the person in accordance with the Restraining Orders Act 1997 section 55(5A). Signature: Date:
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Form 2 — Family violence restraining order
Part F — Details of family order
Restraining Orders Act 1997 s. 66 Number: Details of family order Jurisdiction: Annexure to application Location:
Parties to Name: the family Address: street:
order or suburb: postcode:
proceedings Name:
Address: street:
suburb: postcode:
Children Names:
1.
2.
3.
4.
Address: street:
suburb: postcode:
Current Date order was made: Family Court matter no.:
family order Court by which order was made:
Terms of family order which relate to the respondent’s rights in relationto children: [If the person seeking to be protected by the restraining order is a party to the family order, attach a copy of the family order. If not, fill in the details as far as you (or the person seeking to be protected) are aware of them.]
Current
Court: Family Court matter no.: proceedings Terms of family order being sought which relate to the respondent’s rights in for family relation to children: order
Are these terms of the order being opposed? Yes No Unknown Applicant
Signature: Date:
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Form 3 — Conduct agreement order Part A — Conduct agreement order
Restraining Orders Act 1997 Number:
s. 10H and 43 Jurisdiction:
Conduct agreement order Location:
Person who Family name: Date of birth: has agreed Other names: to be bound Home street: by this order address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: protected Other names: Type of This a final order. order
Terms of
this order
Information In addition to the terms of this order, the court informs you that the following about behaviour and activities are unlawful: unlawful behaviour and
activities Order made
Date order made: Time order made: Registrar Date:
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Form 3 — Conduct agreement order
Part B — Information to be on the copy of order given to the
person who is bound by the order
IMPORTANT INFORMATION
FOR PERSON BOUND BY THIS ORDER
Terms of conduct agreement order
Although you do not admit that you have committed family violence, you have agreed to be bound by a
conduct agreement order on the terms set out on the front of this order.
This order came into force when it was served on you, or at a later time, if this is specified on the front of
this order, and it will remain in force until it expires or is varied or cancelled by a court. You must comply
with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.If there is no duration specified in the order, the order expires —
• if you are not a child, 2 years after this order comes into force; or • if you are a child, 6 months after this order comes into force. If you were in prison at the time this order was made, the order will stay in force while you are in prison and will expire 2 years after the date on which you are released from prison (or longer if specified in the order).
If, in the future, you want the order varied or cancelled you may apply to the court. If you would like more
information about doing this you should consult your lawyer or the registrar of the court.
Penalty: It is an offence to breach a conduct agreement order. If you breach this order you may be arrested
and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.Counselling, support and/or legal services may be of assistance to you.
Additional information about conviction for breaching the order
Note 1: If you are convicted of breaching this order, the fact that the person protected by the order aided
you in the breach is not a mitigating factor for the purposes of your sentencing (see the
Restraining Orders Act 1997 section 61B(2)).Note 2: If you are convicted of breaching this order and you have been convicted of at least 2 other
offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years
before your conviction for breaching this order, you will face a penalty that is or includes
imprisonment (or, if you are a child, detention) unless the court decides under section 61A(6) of
the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person protected by this order, request a copy of any affidavit received in evidence in relation
to this order the registrar of the court where the application for the order was made is to provide a copy of theaffidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF YOU WERE
PRESENT IN COURT WHEN IT WAS MADE
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Form 3 — Conduct agreement order
Part C — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON PROTECTED BY THIS ORDER
Terms of conduct agreement order
Although the respondent does not admit to having committed family violence, the respondent has agreed
to be bound by a conduct agreement order on the terms set out on the front of this order.
This order will come into force when it is served on the person who is bound by this order, or at a later
time, if this is specified on the front of this order, and it will remain in force until it expires or is varied or
cancelled by a court. The person who is bound by this order must comply with this order at all times while
it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.If there is no duration specified in the order, the order expires —
• if the person bound by this order is not a child, 2 years after this order comes into force; or • if the person bound by this order is a child, 6 months after this order comes into force. If the person bound by this order was in prison at the time this order was made, the order will stay in force
while the person is in prison and will expire 2 years after the date on which the person is released from
prison (or longer if specified in the order).
If, in the future, you want the order varied or cancelled you may apply to the court. The person who is
bound by this order may also apply to have the order varied or cancelled. If you would like more
information about doing this you should consult your lawyer or the registrar of the court.
Penalty: It is an offence to breach a conduct agreement order. If the person who is bound by this order
breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or
imprisonment for 2 years, or both.Counselling, support and/or legal services may be of assistance to you.
Additional information about breaching the order
Note 1: If the person bound by this order breaches it and you aid the person in that breach, you will not
commit an offence however the court might decide to vary or cancel the order (see the
Restraining Orders Act 1997 section 61B(3) and (4)).Note 2:
If the person who is bound by this order is convicted of breaching the order and the person has been convicted of at least 2 other offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years before the conviction for breaching this order, the person will face a penalty that is or includes imprisonment (or, if the person is a child, detention) unless the court decides under section 61A(6) of the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person bound by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS
BOUND BY THE ORDER WAS PRESENT IN COURT WHEN IT WAS MADE
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Form 3 — Conduct agreement order
Part D — Information to be on the proof of service copy
Certificate of service
Conduct agreement order no.:
Court of issue:
Person Name of person serving order: serving I am: order the registrar of the court a police officer Rank, number and station: ___________________ a prison officer Prison: __________________________________
a person authorised by the registrar Date of authorisation: _________
Service Method of service: personal oral by post substituted service Place where order served:
Date of service: Time of service:
Person Name: served Date of birth: [Person who is bound by the order] Signature: …………………………………...................
(If possible to obtain)
Certificate I certify that on the day and at the time and place set out above — I personally served this order on the person who is bound by the order
I orally served this order on the person who is bound by this order
I posted this order to the person who is bound by this order
I took the steps directed by the court to effect substituted service of this
order on the person who is bound by this order in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
In the case of oral service, I also certify that I —
• gave the person who is bound by this order the information required by the Restraining Orders Act 1997 section 55(5) and that the person appeared to understand what was said; or • arranged for someone else over the age of 16 to give the information to the person in accordance with the Restraining Orders Act 1997 section 55(5A). Signature: Date:
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Form 3 — Conduct agreement order
Part E — Details of family order
Restraining Orders Act 1997 s. 66 Number: Details of family order Jurisdiction: Annexure to application Location:
Parties to Name: the family Address: street:
order or suburb: postcode:
proceedings Name:
Address: street:
suburb: postcode:
Children Names:
1.
2.
3.
4.
Address: street:
suburb: postcode:
Current Date order was made: Family Court matter no.:
family order Court by which order was made:
Terms of family order which relate to the respondent’s rights in relation to children:[If the person seeking to be protected by the conduct agreement order is a party to the family order, attach a copy of the family order. If not, fill in the details as far as you (or the person seeking to be protected) are aware of them.]
Current
Court: Family Court matter no.: proceedings Terms of family order being sought which relate to the respondent’s rights in for family relation to children: order
Are these terms of the order being opposed? Yes No Unknown Applicant
Signature: Date:
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Form 4 — Section 63A family violence restraining order Part A — Section 63A family violence restraining order
Restraining Orders Act 1997 s. 63A Number: Section 63A family violence Jurisdiction: restraining order Location:
Person Family name: Date of birth: who is Other names: bound by Home street: this order address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: protected Other names:
Lifelong This order remains in force for the period of the life of the person who is order bound by this order. Terms of this order
Order
Date order made: Time order made: made
RegistrarDate:
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Form 4 — Section 63A family violence restraining order
Part B — Information to be on the copy of the order given to the
person who is bound by the order IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
Section 63A family violence restraining order
A family violence restraining order has been made against you under the Restraining
Orders Act 1997 section 63A. The order is in the terms set out on the front of this
order. This order came into force when it was served on you, or at a later time, if this
is specified on the front of this order. You must comply with this order for the rest of
your life.
Penalty: It is an offence to breach a family violence restraining order. If you breach
this order you may be arrested and on conviction will face a penalty of up to $6 000
or imprisonment for 2 years, or both. If you breach the order in the presence of a childwith whom you are in a family relationship (e.g. your child, your partner’s child or a
child who ordinarily resides with you) the court sentencing you will consider this an
aggravating factor.
Note 1: If you are convicted of breaching this order, the fact that the person
protected by the order aided you in the breach is not a mitigating factor for
the purposes of your sentencing (see the Restraining Orders Act 1997
section 61B(2)).Note 2: If you are convicted of breaching this order and you have been convicted of
at least 2 other offences under the Restraining Orders Act 1997 section 61(1)
or (2a) within the period of 2 years before your conviction for breaching this
order, you will face a penalty that is or includes imprisonment (or, if you are
a child, detention) unless the court decides under section 61A(6) of the Act
not to impose such a penalty.Counselling, support and/or legal services may be of assistance to you.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS BOUND BY THE ORDER WAS PRESENT IN
COURT WHEN IT WAS MADE
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Form 4 — Section 63A family violence restraining order
Part C — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON WHO IS PROTECTED BY THIS ORDER
Section 63A family violence restraining order
A family violence restraining order has been made to protect you under the Restraining Orders Act 1997 section 63A. The order is in the terms set out on the front of this order. This order came into force when it was served on the person who is bound by the order, or at a later time if this is specified on the front of this order. The person who is bound by this order must comply with this order for the rest of the person’s life.
Penalty: It is an offence to breach a family violence restraining order. If the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both. Note 1: If the person bound by this order breaches it and you aid the person in that
breach, you will not commit an offence however the court might decide to
vary or cancel the order (see the Restraining Orders Act 1997section 61B(3) and (4)).
Note 2: If the person who is bound by this order is convicted of breaching this order
and the person has been convicted of at least 2 other offences under the
Restraining Orders Act 1997 section 61(1) or (2a) within the period of
2 years before the conviction for breaching this order, the person will face a
penalty that is or includes imprisonment (or, if the person is a child,
detention) unless the court decides under section 61A(6) of the Act not to
impose such a penalty.Counselling, support and/or legal services may be of assistance to you.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS BOUND BY THE ORDER WAS PRESENT IN
COURT WHEN IT WAS MADE
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Form 5 — Application for violence restraining order
Number:
Restraining Orders Act 1997 s. 25
Violence restraining order Jurisdiction: Location: Application
Applicant Family name: Date of birth: [If not the Other names: person seeking to be protected] Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: seeking to be Other names: protected Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Respondent Family name: Date of birth: [Fill in as many Other names: details as you Home street: can] address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Grounds for Give details of the respondent’s behaviour. application Firearms
Does the respondent have a firearm or firearms licence? Yes No Unknown Does the respondent have access to a firearm at work? Yes No Unknown First hearing
Do you want the respondent to be present at the first hearing? Yes No Applicant
Signature: Date: [Not essential if
applicant is a
police officer]Hearing
Court: Date: Time: [To be filled in
by the court]Signature of registrar:
Notification I certify that on __ __/__ __/__ __ at _______ am/pm at _______________________________ [To be filled in I notified the applicant of the hearing date. by the court] Signature of registrar:
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Form 6 — Violence restraining order Part A — Violence restraining order
Restraining Orders Act 1997 Number: s. 29, 32, 43, 49 and 63 Jurisdiction:
Location:Violence restraining order
Person who Family name: Date of birth: is bound by Other names: this order Home street:
address: suburb: postcode: Work street: address: suburb: postcode:
Phone nos.: work: home: mobile:
Applicant Family name: Date of birth: for the order [If not the Other names: person to be
protected]Person Family name: Date of birth: protected Other names:
Type of The order is for 72 hours or less an interim order a final order order Terms of this order
Information In addition to the terms of this order, the court informs you that the following about behaviour and activities are unlawful — unlawful behaviour and
activities Order made
Date order made: Time order made: Registrar Date:
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Form 6 — Violence restraining order
Part B — Information to be on the copy of order given to the
person who is bound by the order IMPORTANT INFORMATION
FOR PERSON BOUND BY THIS ORDER
If the order is for 72 hours or less
A violence restraining order has been made against you for 72 hours or less on the terms set out on the arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both. If you breach the order in the presence of a child with whom you are in a family relationship (e.g. your child, your partner’s child or a child who ordinarily resides with you) the court sentencing you will consider this
front of this order. This order came into force when it was served on you, or at a later time, if this is
specified on the front of this order. You must comply with this order until the end of the period specified
in the order.an aggravating factor.
Counselling, support and/or legal services may be of assistance to you.
If the order is an interim order
An interim violence restraining order has been made against you on the terms set out on the front of this order. This order came into force when it was served on you, or at a later time, if this is specified on the front of this order, and it will remain in force until a final order is made or a court decides not to make a final order. You must comply with this order at all times while it is in force.
You have an opportunity to object to the order before it becomes a final order. of the other copy of this order and return it to the court within 21 days from the date this order was served on you. You will then not need to attend a final order hearing and the order will automatically become a final order which remains in force for the period specified in the order or —
If you want to object to this order being made final you must fill in the “Objection” section on the back
of the other copy of this order and return it to the court within 21 days from the date this order was served
on you. The court will then arrange a final order hearing at which it will consider anything you want to say
before deciding whether to make a final violence restraining order. The court will let you know where and
when the final order hearing will be held.
(a)
if no period is specified and you are not a child, for 2 years from the date this interim order was served on you; or
(b)
if no period is specified and you are a child, for 6 months from the date this interim order was served on you.
If you do nothing
and do not fill in and return the other copy of this order within 21 days the court will arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
assume that you do not object and the interim order will automatically become a final order.
Counselling, support and/or legal services may be of assistance to you.
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If the order is a final order
A final violence restraining order has been made against you on the terms set out on the front of this order. This order came into force when it was served on you, or at a later time, if this is specified on the front of this order, and it will remain in force until it expires or is varied or cancelled by a court. You must comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.
If there is no duration specified in the order, the order expires —
• if it was made at a final order hearing and —
(a) you are not a child, 2 years after this final order comes into force; or (b) you are a child, 6 months after this final order comes into force; or
• if it was a telephone order which became a final order because you did not object, 3 months, or any shorter period specified in the order, after the telephone order was served on you. If, in the future, you want the order varied or cancelled you may apply to the court. If you would like more arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
information about doing this you should consult your lawyer or the registrar of the court.
Counselling, support and/or legal services may be of assistance to you.
Additional information about conviction for breaching the order
Note 1: If you are convicted of breaching this order, the fact that the person protected by the order aided
you in the breach is not a mitigating factor for the purposes of your sentencing (see the
Restraining Orders Act 1997 section 61B(2)).Note 2: If you are convicted of breaching this order and you have been convicted of at least 2 other
offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years
before your conviction for breaching this order, you will face a penalty that is or includes
imprisonment (or, if you are a child, detention) unless the court decides under section 61A(6) of
the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person protected by this order, request a copy of any affidavit received in evidence in relation
to this order the registrar of the court where the application for the order was made is to provide a copy of theaffidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF YOU WERE
PRESENT IN COURT WHEN IT WAS MADE
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Form 6 — Violence restraining order
Part C — Information to be on the respondent’s endorsed copy of
the order
IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
For interim orders only
If you want to object to this order being made final you must fill in the
“Objection” section below and return it to the court within 21 days from the date this
order was served on you. The court will then arrange a final order hearing at which it
will consider anything you want to say before deciding whether to make a final
violence restraining order. The court will let you know where and when the final
order hearing will be held.If you do not object to this order being made final you must fill in the “Consent” section below and return this copy of the order to the court within 21 days of the date it was served on you.
If you do nothing and do not fill in and return this copy of the order to the
court within 21 days, this interim order will automatically become a final order.
Objection
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode:
Will you be represented by a lawyer at the final order hearing? Yes No If yes: lawyer’s name: lawyer’s firm:
How many witnesses (including yourself) do you intend to call? _________________
Does this interim order prevent you from —
• going to where you normally live? Yes No • going to where you work or otherwise prevent you from doing your job? Yes No • being in possession of a firearm which is essential for your job? Yes No
Signature: Date:
OR
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Consent
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode: I do not object to a final order being made on the same terms as this interim order. will automatically become a final order which will stay in force for the period specified in the order or —
(a)
if no period is specified and I am not a child, for 2 years from the date on which this interim order was served on me; or
(b)
if no period is specified and I am a child, for 6 months from the date on which this interim order was served on me.
Signature: Date:
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Form 6 — Violence restraining order
Part D — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON PROTECTED BY THIS ORDER
If the order is for 72 hours or less
A violence restraining order has been made to protect you for 72 hours or less on the terms set order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
out on the front of this order. This order will come into force when it is served on the person
who is bound by this order, or at a later time, if this is specified on the front of this order. The
person who is bound by this order must comply with this order until the end of the period
specified in the order.Counselling, support and/or legal services may be of assistance to you.
If the order is an interim order
An interim violence restraining order has been made to protect you on the terms set out on the become a final order which remains in force for the period specified in the order or —
front of this order. This order will come into force when it is served on the person bound by
this order, or at a later time, if this is specified on the front of this order, and it will remain in
force until a final order is made or a court decides not to make a final order. The person who is
bound by this order must comply with this order at all times while it is in force. The person
who is bound by this order has 21 days within which to object to the order before it becomes a
final order.
If the person who is bound by this order does object you will need to attend a final order
hearing. At that hearing the court will consider anything you and the person who is bound by
this order want to say before deciding whether to make a final restraining order. The court will
let you know if a final order hearing is to be held and where and when you need to attend.
Even if the person who is bound by this order does object, this interim order will remain in
force until the final order hearing.
(a) if no period is specified and the person bound by the order is not a child, for 2 years from the date this interim order was served on the person bound by this order. You will then not need to attend a final order hearing; or (b) if no period is specified and the person bound by the order is a child, for 6 months from the date this interim order was served on the person bound by this order. You will then not need to attend a final order hearing. Penalty: It is an offence to breach a violence restraining order. If the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Counselling, support and/or legal services may be of assistance to you.
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If the order is a final order
A final violence restraining order has been made to protect you on the terms set out on the
front of this order.
This order will come into force when it is served on the person who is bound by this order, or
at a later time, if this is specified on the front of this order, and it will remain in force until it
expires or is varied or cancelled by a court. The person who is bound by this order must
comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.If there is no duration specified in the order, the order expires —
• if it was made at a final order hearing and —
(a) you are not a child, 2 years after this final order comes into force; or (b) you are a child, 6 months after this final order comes into force; or
• if it was a telephone order which became a final order because the person who is bound by the order did not object, 3 months (or any shorter time specified in the order) after the telephone order was served on the person who is bound by the order. If, in the future, you want the order varied or cancelled you may apply to the court. The person who is bound by this order may also apply to have the order varied or cancelled. If you would like more information about doing this you should consult your lawyer or the registrar of the court.
Penalty: It is an offence to breach a violence restraining order. If the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Counselling, support and/or legal services may be of assistance to you.
Additional information about breaching the order
Note 1: If the person bound by this order breaches it and you aid the person in that breach,
you will not commit an offence however the court might decide to vary or cancel the
order (see the Restraining Orders Act 1997 section 61B(3) and (4)).Note 2: If the person who is bound by this order is convicted of breaching the order and the person has been convicted of at least 2 other offences under the Restraining Orders Act 1997 section 61(1) or (2a) within the period of 2 years before the conviction for breaching this order, the person will face a penalty that is or includes imprisonment (or, if the person is a child, detention) unless the court decides under section 61A(6) of the Act not to impose such a penalty.
Affidavit evidence may be provided on request
If you, or the person bound by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS
BOUND BY THE ORDER WAS PRESENT IN COURT WHEN IT WAS MADE
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Form 6 — Violence restraining order
Part E — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving order: serving I am: order the registrar of the court
a police officer Rank, number and station: ___________________ a prison officer Prison: ___________________________________
a person authorised by the registrar Date of authorisation: _________
Service Method of service: personal oral by post substituted service Place where order served:
Date of service: Time of service:
Person Name: served Date of birth: [Person who is bound by Signature: …………………………………................... the order] (If possible to obtain) Certificate I certify that on the day and at the time and place set out above: I personally served this order on the person who is bound by the order
I orally served this order on the person who is bound by this order
I posted this order to the person who is bound by this order
I took the steps directed by the court to effect substituted service of this
order on the person who is bound by this order in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
In the case of oral service, I also certify that I —
• gave the person who is bound by this order the information required by the Restraining Orders Act 1997 section 55(5) and that the person appeared to understand what was said; or • arranged for someone else over the age of 16 years to give the information to the person in accordance with the Restraining Orders Act 1997 section 55(5A). Signature: Date:
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Form 7 — Section 63A violence restraining order Part A — Section 63A violence restraining order
Restraining Orders Act 1997 s. 63A Number:
Section 63A violence Jurisdiction: restraining order Location:
Person who Family name: Date of birth: is bound by Other names: this order
Home street: address: suburb: postcode: Work street: address: suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: protected Other names:
Lifelong This order remains in force for the period of the life of the person who is bound by order this order. Terms of this order
Order made
Date order made: Time order made: Registrar Date:
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Form 7 — Section 63A violence restraining order
Part B — Information to be on the copy of the order given to the
person who is bound by the order IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
Section 63A violence restraining order
A violence restraining order has been made against you under the Restraining Orders Act 1997 section 63A. The order is in the terms set out on the front of this order. This order came into force when it was served on you, or at a later time, if this is specified on the front of this order. You must comply with this order for the rest of your life.
Penalty: It is an offence to breach a violence restraining order. If you breach this order you may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both. If you breach the order in the presence of a child with whom you are in a family relationship (e.g. your child, your partner’s child or a
child who ordinarily resides with you) the court sentencing you will consider this anaggravating factor.
Note 1: If you are convicted of breaching this order, the fact that the person
protected by the order aided you in the breach is not a mitigating factor for
the purposes of your sentencing (see the Restraining Orders Act 1997
section 61B(2)).Note 2: If you are convicted of breaching this order and you have been convicted of
at least 2 other offences under the Restraining Orders Act 1997 section 61(1)
or (2a) within the period of 2 years before your conviction for breaching this
order, you will face a penalty that is or includes imprisonment (or, if you are
a child, detention) unless the court decides under section 61A(6) of the Act
not to impose such a penalty.Counselling, support and/or legal services may be of assistance to you.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF YOU WERE
PRESENT IN COURT WHEN IT WAS MADE
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Form 7 — Section 63A violence restraining order
Part C — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON WHO IS PROTECTED BY THIS ORDER
Section 63A violence restraining order
A violence restraining order has been made to protect you under the Restraining Orders Act 1997 section 63A. The order is in the terms set out on the front of this order. This order came into force when it was served on the person who is bound by
the order, or at a later time, if this is specified on the front of this order. The person who is bound by this order must comply with this order for the rest of the person’s life.
Penalty: It is an offence to breach a violence restraining order. If the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
Note 1:
If the person bound by this order breaches it and you aid the person in that breach, you will not commit an offence however the court might decide to vary or cancel the order (see the Restraining Orders Act 1997
section 61B(3) and (4)). Note 2: If the person who is bound by this order is convicted of breaching this order
and the person has been convicted of at least 2 other offences under the
Restraining Orders Act 1997 section 61(1) or (2a) within the period of
2 years before the conviction for breaching this order, the person will face a
penalty that is or includes imprisonment (or, if the person is a child,
detention) unless the court decides under section 61A(6) of the Act not to
impose such a penalty.Counselling, support and/or legal services may be of assistance to you.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS BOUND BY THE ORDER WAS PRESENT IN
COURT WHEN IT WAS MADE
20 June 2017 GOVERNMENT GAZETTE, WA 3025 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 8 — Application for misconduct restraining order
Restraining Orders Act 1997 s. 38(2) Number: Misconduct restraining order Jurisdiction:
Application Location:
Applicant Family name: Date of birth: [If not the Other names: person seeking to be Address: street:
suburb: postcode:
protected]
Phone nos.: work: home: mobile:
Person Family name: Date of birth: seeking to Other names: be protected Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Respondent Family name: Date of birth: [Fill in as Other names: many Home street: details as you address:
suburb: postcode: can] Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Grounds for Give details of the respondent’s behaviour. application
Firearms
Does the respondent have a firearm or firearms licence? Yes No Unknown Does the respondent have access to a firearm at work? Yes No Unknown
Applicant
Signature: Date: Hearing
Court: Date: Time: [To be filled in by the court] Registrar: Notification I certify that on __ __/__ __/__ __ at _______ am/pm at _______________________ [To be filled I notified the applicant of the hearing date. in by the court] Registrar:
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Form 9 — Misconduct restraining order Part A — Misconduct restraining order
Restraining Orders Act 1997 Number:
s. 43, 49 and 63 Jurisdiction:
Misconduct restraining order Location:
Person who Family name: Date of birth: is bound by Other names: this order Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Applicant Family name: Date of birth: for order [If not the Other names: person to be
protected]Person Family name: Date of birth: protected Other names: Terms of the order Order made Date order made: Time order made:
Registrar Date:
20 June 2017 GOVERNMENT GAZETTE, WA 3027 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 9 — Misconduct restraining order
Part B — Information to be on the copy of the order given to the
person who is bound by the order IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
Misconduct Restraining Order
A misconduct restraining order has been made against you on the terms set out on the front of this order. This order comes into force when it was served on you, or at a later time, if this is specified on the front of this order, and it will remain in force until it expires or is varied or
cancelled by a court. You must comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.
If there is no duration specified in the order, the order expires 12 months after it comes into
force.
If, in the future, you want the order varied or cancelled you may apply to the court. If you would
like more information about doing this you should consult your lawyer or the registrar of the
court.
Penalty: It is an offence to breach a misconduct restraining order. If you breach this order you
may be arrested and on conviction will face a penalty of up to $1 000.
Note: If you are convicted of breaching this order, the fact that the person protected by the order
aided you in the breach is not a mitigating factor for the purposes of your sentencing (see the
Restraining Orders Act 1997 section 61B(2)).Counselling, support and/or legal services may be of assistance to you.
Affidavit evidence may be provided on request
If you, or the person protected by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF YOU WERE
PRESENT IN COURT WHEN IT WAS MADE
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Form 9 — Misconduct restraining order
Part C — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR THE PERSON PROTECTED BY THE ORDER
Misconduct Restraining Order
A misconduct restraining order has been made to protect you on the terms set out on the front of this order. This order comes into force when it is served on the person who is bound by this order, or at a later time, if this is specified on the front of this order, and it will remain in force until it expires or is varied or cancelled by a court. The person who is bound by this order must comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period.
If there is no duration specified in the order, the order expires 12 months after it comes into
force.
If, in the future, you want the order varied or cancelled you may apply to the court. The person
who is bound by this order may also apply to have the order varied or cancelled. If you would
like more information about doing this you should consult your lawyer or the registrar of the
court.
Penalty: It is an offence to breach a misconduct restraining order. If the person bound by this
order breaches this order the person may be arrested and on conviction will face a penalty of up
to $1 000.
Note: If the person bound by this order breaches it and you aid the person in that breach, you
will not commit an offence however the court might decide to vary or cancel the order (see theRestraining Orders Act 1997 section 61B(3) and (4)).
Counselling, support and/or legal services may be of assistance to you.
Affidavit evidence may be provided on request
If you, or the person bound by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
THIS ORDER COMES INTO FORCE IMMEDIATELY IF THE PERSON WHO IS
BOUND BY THE ORDER WAS PRESENT IN COURT WHEN IT WAS MADE
20 June 2017 GOVERNMENT GAZETTE, WA 3029 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 9 — Misconduct restraining order
Part D — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving order: serving I am: order the registrar of the court
a police officer Rank, number and station: ___________________ a prison officer Prison: ___________________________________
a person authorised by the registrar Date of authorisation: _________
Service Method of service: personal oral by post substituted service Place where order served:
Date of service: Time of service:
Person Name: served Date of birth: [Person who is bound by the order] Signature: …………………………………...................
(If possible to obtain)
Certificate I certify that on the day and at the time and place set out above: I personally served this order on the person who is bound by the order
I orally served this order on the person who is bound by this order
I posted this order to the person who is bound by this order
I took the steps directed by the court to effect substituted service of this
order on the person who is bound by this order in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
In the case of oral service, I also certify that I —
• gave the person who is bound by this order the information required by the Restraining Orders Act 1997 section 55(5) and that the person appeared to understand what was said; or • arranged for someone else over the age of 16 years to give the information to the person in accordance with the Restraining Orders Act 1997 section 55(5A). Signature: Date:
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Form 10 — Telephone order
Part A — Court copy of telephone order
Restraining Orders Act 1997 s. 23 Number: Telephone family violence Jurisdiction: restraining order / Violence Location: restraining order
Person who is Family name: Date of birth: bound by this Other names: order Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Protected Family name: Date of birth: person Other names: Type of order The order is a Family Violence Restraining Order a Violence Restraining Order for 72 hours or less an interim order Terms of the
orderOrder made Date order made: Time order made: Authorised Name: person Rank and number/identification:
Signature: Date:
Confirmation This order is correct is not correct and is to be amended as shown by Magistrate above
Signature: Date:
20 June 2017 GOVERNMENT GAZETTE, WA 3031 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 10 — Telephone order
Part B — Copy of the order given to the person who is bound by
the order
Restraining Orders Act 1997 s. 23 Number: Telephone family violence Jurisdiction: restraining order / Violence Location: restraining order
Person who Family name: Date of birth: is bound by Other names: this order Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: protected Other names: Type of The order is a Family Violence Restraining Order order a Violence Restraining Order for 72 hours or less an interim order Terms of the order Order made Date order made: Time order made: Authorised Name: person Rank and number/identification:
Signature: Date:
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Form 10 — Telephone order
Part C — Information to be on the copy of the order to be given to
the person who is bound by the order
IMPORTANT INFORMATION
FOR PERSON WHO IS BOUND BY THIS ORDER
If the order is for 72 hours or less
A family violence restraining order / violence restraining order has been made against you for 72 hours or less on the terms set out on the front of this order. This order came into force when it was served on you, or at a later time, if this is specified on the front of this order. You must comply with this order until the end of the period specified in the order.
Penalty: It is an offence to breach a family violence restraining order / violence restraining order. If you breach this order you may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both. If you breach the order in the presence of a child with whom you are in a family relationship (e.g. your child, your partner’s child or a child who ordinarily resides with you) the
court sentencing you will consider this an aggravating factor.
Counselling, support and/or legal services may be of assistance to you.
If the order is an interim order
An interim family violence restraining order / violence restraining order has been made against you on the terms set out on the front of this order. This order came into force when it was served on you, or at a later time, if this is specified on the front of this order, and it will remain in force until a final order is made or a court decides not to make a final order. You must comply with this order at all times while it is in force.
If you object to this order being made final
you must fill in the “Objection” section on the back of the of the other copy of this order and return it to the court within 21 days from the date this order was served on you. You will then not need to attend a final order hearing and the order will automatically become a final order which will stay in force for the period specified in the order or —
other copy of this order and return it to the court within 21 days from the date this order was served on
you. The court will then arrange a final order hearing at which it will consider anything you want to say
before deciding whether to make a final family violence restraining order / violence restraining order. The
court will let you know where and when the final order hearing will be held.
(a) if no period is specified and you are not a child, for 2 years from the date on which this order was served on you; or (b) if no period is specified and you are a child, for 6 months from the date on which this order was served on you.
If the order is a family violence restraining order and you were in prison at the time the court received your “Consent” form, the order will stay in force while you are in prison and for a further 3 months from
the date on which you are released from prison (or shorter if specified in the order). arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
If you do nothing and do not fill in and return the other copy of this order within 21 days the court will
assume that you do not object and the interim order will automatically become a final order.
Counselling, support and/or legal services may be of assistance to you.
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Additional information about conviction for breaching the order
If you are convicted of breaching this order, the fact that the person protected by the order aided you in the breach is not a mitigating factor for the purposes of your sentencing (see the Restraining Orders Act 1997 section 61B(2)).
Affidavit evidence may be provided on request
If you, or the person protected by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
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Form 10 — Telephone order
Part D — Information to be on the respondent’s endorsed copy
IMPORTANT INFORMATION
FOR THE PERSON WHO IS BOUND BY THIS ORDER
For interim orders only
If you object to this interim order being made final you must fill in the
“Objection” section below and return this copy of the order to the court within
21 days of the date it was served on you.
If you do not object to this order being made final you must fill in the “Consent” section below and return this copy of the order to the court within 21 days of the date it was served on you.
If you do nothing and do not fill in and return this copy of the order to the court within 21 days this interim order will automatically become a final order.
Objection
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode:
Will you be represented by a lawyer at the final order hearing? Yes No
If yes: lawyer’s name: lawyer’s firm: How many witnesses (including yourself) do you intend to call? _________________
Does this interim order prevent you from —
• going to where you normally live? Yes No • having contact with your children? Yes No • going to where you work or otherwise prevent you from doing your job? Yes No • being in possession of a firearm which is essential for your job? Yes No
Signature: Date:
OR
20 June 2017 GOVERNMENT GAZETTE, WA 3035 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Consent
Order Restraining order no.: Court of issue:
Family name: Date of birth: Other names: Address: street:
suburb: postcode: I do not object to a final order being made on the same terms as this interim order. will automatically become a final order which will stay in force for —
(a) the period specified in the order; or (b) if no period is specified and I am not a child, for 2 years from the date on which this order was served on me; or (c) if no period is specified and I am a child, for 6 months from the date on which this order was served on me. If the order is a family violence restraining order and I am in prison when the court receives this form, the order will stay in force while I am in prison and for a further 3 months from the date on which I am released from prison (or shorter if specified in the order).
Signature: Date:
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Form 10 — Telephone order
Part E — Information to be on the copy of the order given to the
person protected by the order
IMPORTANT INFORMATION
FOR PERSON PROTECTED BY THIS ORDER
If the order is for 72 hours or less
A family violence restraining order / violence restraining order has been made to protect you for 72 hours or less on the terms set out on the front of this order. This order will come into force when it is served on the person who is bound by this order, or at a later time, if this is specified on the front of this order. The person who is bound by this order must comply with this order until the end of the period specified in the order.
Penalty: It is an offence to breach a family violence restraining order / violence restraining order. If the person bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
If the order is an interim order
An interim family violence restraining order / violence restraining order has been made to protect you on the terms set out on the front of this order. This order will come into force when it is served on the person bound by this order, or at a later time, if this is specified on the front of this order, and it will remain in
force until a final order is made or a court decides not to make a final order. The person who is bound by order which will stay in force for —
this order must comply with this order at all times while it is in force. The person who is bound by this
order has 21 days within which to object to the order before it becomes a final order.
If the person who is bound by this order does object you will need to attend a final order hearing. At
that hearing the court will consider anything you and the person who is bound by this order want to say
before deciding whether to make a final restraining order. The court will let you know if a final order
hearing is to be held and where and when you need to attend. Even if the person who is bound by this
order does object, this interim order will remain in force until the final order hearing.
(a) the period specified in the order; or (b) if no period is specified and the person is not a child, for 2 years from the date on which this order was served on the person; or (c) if no period is specified and the person is a child, for 6 months from the date on which this order was served on the person. If the order is a family violence restraining order and the person was in prison at the time the Court received the person’s “Consent” form, the order will stay in force while the person is in prison and for a
further 3 months from the date on which the person is released from prison (or shorter if specified in the person who is bound by this order breaches this order the person may be arrested and on conviction will face a penalty of up to $6 000 or imprisonment for 2 years, or both.
order).
You will then not need to attend a final order hearing.
Counselling, support and/or legal services may be of assistance to you.
20 June 2017 GOVERNMENT GAZETTE, WA 3037 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Additional information about breaching the order
If the person bound by this order breaches it and you aid the person in that breach, you will not commit an offence however the court might decide to vary or cancel the order (see the Restraining Orders Act 1997 section 61B(3) and (4)).
Affidavit evidence may be provided on request
If you, or the person bound by this order, request a copy of any affidavit received in evidence in relation to this order the registrar of the court where the application for the order was made is to provide a copy of the affidavit to the person who made the request.
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Form 10 — Telephone order
Part F — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving order: serving I am: order the registrar of the court
a police officer Rank, number and station: ___________________ a prison officer Prison: ___________________________________
a person authorised by the registrar Date of authorisation: _________
Service Method of service: personal oral by post substituted service Place where order served:
Date of service: Time of service:
Person Name: served Date of birth: [Person who is bound by the order] Signature: …………………………………...................
(If possible to obtain)
Certificate I certify that on the day and at the time and place set out above — I personally served this order on the person who is bound by the order
I orally served this order on the person who is bound by this order
I posted this order to the person who is bound by this order
I took the steps directed by the court to effect substituted service of this
order on the person who is bound by this order in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
In the case of oral service, I also certify that I —
• gave the person who is bound by this order the information required by the Restraining Orders Act 1997 section 55(5) and that the person appeared to understand what was said; or • arranged for someone else over the age of 16 to give the information to the person in accordance with the Restraining Orders Act 1997 section 55(5A). Signature: Date:
20 June 2017 GOVERNMENT GAZETTE, WA 3039 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 11 — Restraining order record of telephone application
Restraining Orders Act 1997 s. 21(4) Number: Restraining order Jurisdiction: Record of telephone Location: application
Authorised Name: person Rank and number/identification:
Contact phone no.: Date of application:
Type of Family violence restraining order
order sought Violence restraining order
Reason for I am am not satisfied that the matter is sufficiently urgent to justify a
applying by telephone application. telephone Applicant The applicant is: [If not the
person person seeking to be protected parent or guardian of a child who is seeking to be protected seeking to be a child welfare officer on behalf of a child who is seeking to be protected protected] authorised person
legal guardian of the person who is seeking to be protected
Family name: Date of birth: Other names:
Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth: seeking to Other names: be protected Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Respondent Family name: Date of birth: Other names:
Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
The respondent is is not present
is is not being detained by a police officer
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Family Are there any current family orders relating to the respondent’s rights orders in relation to children who may be affected by a restraining order?
Yes No Unknown Are there any current Family Court proceedings in which such orders are being sought?
Yes No Unknown Details of family order or proceedings Firearms Does the respondent have a firearm or a firearms licence?
Yes No Unknown Does the respondent have access to a firearm at work?
Yes No Unknown Witnesses Applicant: and summary of evidence Respondent: Authorised person: Other people: Other notes Decision
I am am not satisfied that a telephone order should be made. and order The terms of the order are: Magistrate Name:
Court where Magistrate is based:
Magistrate’s location when hearing application:
Signature: Date: Time:
20 June 2017 GOVERNMENT GAZETTE, WA 3041 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 12 — Application to vary or cancel a restraining order
Part A — Application to vary or cancel a restraining order
Number:
Restraining Orders Act 1997 s. 45
Restraining order Jurisdiction: Location: Application to vary or cancel
Person Family name: applying to Other names: vary or cancel
Address: street:
suburb: postcode:
Phone nos.: work: home: mobile: Are you: the person protected by the order
the parent or guardian of a child protected by the order a police officer
the legal guardian of the person protected by the order the person bound by the order
Restraining Type of order: order Family Violence Restraining Order Violence Restraining Order Misconduct Restraining Order
Date order was made: Restraining order no.: Person who is bound by the order:
Person who is protected by the order:
Grounds for If you are the person bound by the restraining order, on what grounds do you seek leave to leave to continue the application? continue this
application[Only fill this in
if the
application is
being made by
the person
bound by the
order]
Variation or Do you want the order to be cancelled and a replacement order to be made? Yes cancellation
[Please tick one Duration of order: An order made under this option will remain in force for a box only.] period of 2 years from the date of service of the replacement order if no other period is specified.
Do you want an additional order, to be read with the original order, which Yes states the variation? Duration of order: Unless specified, an order made under this option will not vary the duration of the original order.
Do you want the order to be cancelled without any further order being made? Yes Duration of order: An order cancelled under this option ceases to be in force at the conclusion of the hearing at which it is cancelled.
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Variation What are the specific changes you are seeking? sought
Grounds for Why do you want the restraining order varied or cancelled? variation or cancellation
If you are the Do you want this application to cancel the restraining order Yes person heard in the absence of the person bound by the order? protected No Signature Signature of applicant:
Hearing Court: Date: Time:
Notification I certify that on __ __/__ __/__ __ at _____ am/pm at Signature of Registrar: [To be filled in by the court] ___________________________________________
I notified the person applying to vary or cancel the hearing
date.20 June 2017 GOVERNMENT GAZETTE, WA 3043 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 12 — Application to vary or cancel a restraining order
Part B — Information to be on the copy of the application to be
given to the applicant
IMPORTANT INFORMATION
FOR THE APPLICANT
Application by the person protected by the restraining order
If you are the person protected by the restraining order (or someone acting on behalf of that person) and you have applied to vary or cancel the order, you must attend a hearing on the date set out on the front of this application. The court will summons the person who is bound by the order who should also attend. At that hearing the court will decide whether or not to vary or cancel the restraining order.
If you do not attend the hearing, your application may be dismissed.
Application by the person who is bound by the restraining order
If you are the person who is bound by the restraining order and you have applied to vary or cancel a restraining order, you must attend a hearing on the date set out on the front of this application. The person protected by the restraining order will not attend this hearing. At this
hearing you will have the opportunity to satisfy the court that you should be granted leave to
continue the application. To do this you will need to satisfy the court that one of the followingapplies —
(a) you had a reasonable cause not to attend a prior hearing where the restraining order was made (this does not apply in respect of a hearing where you were not present because the person protected by the order chose to have the matter heard in your absence under the Restraining Orders Act 1997 section 26);
(b) there is evidence to support a claim that a person protected by the order has persistently invited or encouraged you to breach the order, or by the person’s actions has persistently attempted to cause you to breach the order;
(c)
there has been a substantial change in the relevant circumstances since the order was made;
(d)
if this application is made to vary or cancel an interim order, there is evidence to support a claim that the restraints imposed by the order are causing you unnecessary hardship.
If you do not may be dismissed
attend the hearing, your application . set a date for a further hearing and will summons the person protected by the order to attend. At that hearing the court will decide whether or not to vary or cancel the restraining order.
Your application to vary or cancel the restraining order will be dismissed if you do not satisfy
the court that one of the grounds set out above applies.
If you do not attend the hearing, your application may be dismissed.
Application to extend duration of order
If this application is to vary the restraining order by extending the duration of the order, then, copy of this application.
despite anything else in the Restraining Orders Act 1997, THE ORDER WILL NOT
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Form 13 — Summons to vary or cancel restraining order
Part A — Summons to vary or cancel restraining order
Number:
Restraining Orders Act 1997 s. 47
Restraining order Jurisdiction:
Location:Summons to vary or cancel
An application has been made to vary or cancel the restraining order to which you (or a person of whom you are a parent or guardian) are a party. The details of the application are set out below. You are required to attend a court hearing on this matter at the place and time set out below.
Person Person protected by the order summonsed Parent or guardian of a child protected by the order Person bound by the order Legal guardian of a person protected by the order Child Welfare Officer on behalf of a child protected by the order
Family name: Date of birth: Other names: Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Restraining Family Violence Restraining Order Date order made:
order Violence Restraining Order Date order served:
Misconduct Restraining Order Person bound by the order:
Person protected by the order:
Application An application has been made for the restraining order to be: cancelled varied The variations sought to the order are as follows: Grounds for application
Hearing Court: Date: Time: [To be filled in by the court] Registrar: If you do not attend the court hearing the restraining order may be varied or cancelled in your absence.
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Form 13 — Summons to vary or cancel restraining order Part B — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving summons: serving I am: summons the registrar of the court
a police officer a prison officer
Rank, number and station: ________________________
Prison: _______________________________________
a person authorised by the registrar Date of authorisation: _____________
Service Method of service: personal by post substituted service Place where summons served:
Date of service: Time of service:
Person Name: served Date of birth: [Person bound, or person protected by the Signature: ……………………………………………. order] (If possible to obtain) Certificate I certify that on the day and at the time and place set out above:
I personally served this summons on the person to be summonsed I posted this summons to the person to be summonsed I took the steps directed by the court to effect substituted service of this
summons on the person to be summonsed in accordance with the
Restraining Orders Act 1997 Part 6 Division 2.
Signature: Date:
OR
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Summons Name of person attempting to serve summons: not served I am:
the registrar of the court
a police officer a prison officer
Rank, number and station: _______________________
Prison: ______________________________________
a person authorised by the registrar Date of authorisation: ____________ Attempted method of service: personal by post substituted service Steps taken to attempt service: I was unable to serve this summons because:
the person to be summonsed does not appear to live or work at the addresses
given and cannot be found elsewhere
the person to be summonsed appears to be deliberately avoiding being served
with this summons other [give details] Signature: Date:
Please return this proof of service copy of the summons to the court before the hearing date, even if you have been unable to serve it.
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Form 14 — Restraining order made during other proceedings —
record of proceedings
Proceedings in which order made:
Restraining Orders Act 1997 s. 63
Jurisdiction:
Restraining order made
Location:
during other proceedings
Record of proceedings
Application Type of order:
Family Violence Restraining Order Violence Restraining Order Order made:
by court of its own motion on an application or request by Charges to which order relates: ______________________________________________
Person Family name: Date of birth: protected by Other names: the order Address: street:
suburb: postcode:
Phone nos.: work: home: mobile: Role in proceeding in which restraining order was made:
applicant/prosecutor victim respondent/accused other witness other ____________________________________
Person who Family name: Date of birth:
is bound by Other names: the
Home street: restraining
address: suburb: postcode: order
Work street:
address: suburb: postcode:
Phone nos.: work: home: mobile: Role in proceeding in which restraining order was made:
respondent/accused other witness other _____________________________________
Grounds on For FVROs: conviction for a violent personal offence listed in section 63(4AA) which order family member wants to be protected by FVRO applied for or For VROs: [specify grounds]
considered
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Family Are there any current family orders relating to the person who is orders bound by the restraining order’s rights in relation to children who
may be affected by a restraining order? Yes No Are there any current Family Court proceedings in which such
orders are being sought? Yes No Details of family order or proceedings: Firearms Does the person who is bound by the restraining order have a firearm or a firearms licence?
Yes No Does the person who is bound by the restraining order have access to a firearm at work?
Yes No Witness and Person protected by the restraining order: summary of evidence Person who is bound by the restraining order: Other people: Other notes Terms of the order Order made
Date order made: Time order made: Registrar
Signature: Date:
20 June 2017 GOVERNMENT GAZETTE, WA 3049 Magistrates Court (Civil Proceedings) Amendment Rules 2017
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Form 15 — Application to register an interstate restraining order
Part A — Application to register an interstate restraining order
Number:
Restraining Orders Act 1997 s. 75
Interstate restraining order Jurisdiction: Location: Application to register
Applicant Are you: [If not the
the person to be protected the parent or guardian of a child to be protected person seeking
a police officer the legal guardian of a person to be protected to be protected]
Family name: Date of birth: Other names:
Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Person to be Family name: Date of birth: protected by Other names: the order Address: street:
suburb: postcode:
Phone nos.: work: home: mobile:
Person who is Family name: Date of birth: to be bound Other names: by this order Home street: [Fill in as many address:
suburb: postcode: details as you Work street: can]
address: suburb: postcode:
Phone nos.: work: home: mobile:
Interstate State where order was made: Order Court in which order was made:
Date order was made: Order/matter no.: Does the order relate to family violence? Notice
I do do not want notice of the registration of this order to be given to the person who
is bound by this orderApplicant
Signature: Date: Registered
Date of registration: Time of registration: [To be filled in
Registrar: Date: by the court] Notification I certify that on __ __/__ __/__ __ at ______ am/pm at _______________________________ [To be filled in I notified the applicant that the order had been registered. by the court] Registrar: When you lodge this application you must also give the registrar the original interstate order or a copy certified to be a true copy by an officer of the court in which it was made. The registrar may also ask for evidence to show that the interstate order has been served on the person who is to be bound by the order.
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Form 15 — Application to register an interstate restraining order Part B — Information to be on the copy of the application given to
the applicant
Notification to applicant
The interstate restraining order described in this form has been registered in Western
Australia. It can now be enforced in this State as if it had been made here.Form 15 — Application to register an interstate restraining order Part C — Information to be on the copy of the application given
to the Commissioner of Police
Notification to the Commissioner of Police
The interstate order described in this form has been registered in Western Australia.
A copy of the interstate order is attached.Form 15 — Application to register an interstate restraining order Part D — Information to be on the copy of the application given
to the interstate court where the relevant interstate order was
made
Notification to the Registrar
The restraining order described above and made in your court has been registered in registrar of the court mentioned above.
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Form 16 — Restraining order — summons Part A — Restraining order — summons
Restraining Orders Act 1997 Number:
s. 26(3) and 39 Jurisdiction:
Restraining order Location: Summons
An application has been made for a restraining order against you. The details of the application are set out below. You are required to attend a court hearing on this matter at the place and time set out below.
Respondent Family name: Date of birth Other names:
Home street: address:
suburb: postcode: Work street: address:
suburb: postcode:
Phone nos.: work: home: mobile:
Person Family name: Date of birth seeking to be Other names: protected
Applicant The applicant is: person seeking to be protected [If not the
person seeking parent or guardian of a child who is seeking to be protected a police officer
to be protected] the legal guardian of a person seeking to be protected Family name: Other names:
Type of order The application is for: Family Violence Restraining Order Violence Restraining Order Misconduct Restraining Order Grounds for application
Hearing Court: Date: Time: Registrar: If you do not attend the court hearing a restraining order may be made against or a firearms licence.
you in your absence.
A restraining order may prohibit you from going to certain places (such as the
home of the person seeking to be protected) and place other restrictions on
where you may go and what you may do.
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Form 16 — Restraining order — summons
Part B — Information to be on the proof of service copy
Certificate of service
Restraining order no.:
Court of issue:
Person Name of person serving summons: serving I am: summons
the registrar of the court
a police officer Rank, number and station: _____________________________ a prison officer Prison: ____________________________________________
a person authorised by the registrar Date of authorisation: ____________________ Service
Method of service: personal by post substituted service Place where summons served:
Date of service: Time of service: Person Name: served Date of birth: [Person bound or person protected by the Signature: ……………………………………………. order] (If possible to obtain) Certificate I certify that on the day and at the time and place set out above:
I personally served this summons on the person to be summonsed I posted this summons to the person to be summonsed I took the steps directed by the court to effect substituted service of this summons on
the person to be summonsed in accordance with the Restraining Orders Act 1997
Part 6 Division 2.Signature: Date:
OR
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Summons Name of person attempting to serve summons: not served I am:
the registrar of the court
a police officer Rank, number and station: _______________________________ a prison officer Prison: ______________________________________________
a person authorised by the registrar Date of authorisation: __________________
Attempted method of service: personal by post substituted service Steps taken to attempt service: I was unable to serve this summons because:
the person to be summonsed does not appear to live or work at the addresses given
and cannot be found elsewhere the person to be summonsed appears to be deliberately avoiding being served with
this summons other [give details]
Signature: Date:
Please return this proof of service copy of the summons to the court before the hearing date, even if you have been unable to serve it.
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Form 17 — Application to have final order under section 32(2) of
the Act set aside
Restraining Orders Act 1997 s. 32(5) Number: Application to set aside final order under the Jurisdiction: Restraining Orders Act 1997
Location:
section 32(2)
Applicant’s Family name: Date of birth: details Other names
Home street: address: suburb: postcode:
Phone nos.: work: home: mobile:
Respondent’s Family name: Date of birth: details Other names
Home street: address: suburb: postcode:
Phone nos.: work: home: mobile:
Details of Family violence restraining order final order Violence restraining order
Date of This application is made within 21 days from the date that I was notified that the interim
application order had become a final order
This application is not made within 21 days from the date that I was notified that the
interim order had become a final order
Application I apply for the following orders —
Leave be granted to proceed with this application out of time The final order be set aside Grounds for I rely on the following grounds in support of this application. application [Outline grounds, if insufficient space please attach further information.]
Signature of Date applicant
Noticeof Court:
court hearing Address:
Date and time of hearing:
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Form 18 — Application to have decision under section 42 of the
Act set aside
Restraining Orders Act 1997 s. 43A Number: Application to set aside
Jurisdiction:
decision under the
Restraining Orders Act 1997
Location:
section 42
Applicant’s Family name: Date of birth: details Other names Home street:
address: suburb: postcode:
Phone nos.: work: home: mobile:
Respondent’s Family name: Date of birth: details Other names Home street:
address: suburb: postcode:
Phone nos.: work: home: mobile:
Order to Family violence restraining order which this Violence restraining order application
relatesDate of decision
Date of
This application is made within 21 days from the date that I first became aware of/was application served with a copy of the order
This application is not made within 21 days from the date that I first became aware
of/was served with a copy of the order
Application I apply for the following orders —
Leave be granted to proceed with this application out of time. The decision and orders made in this matter on the date above be set aside. Grounds for I rely on the following grounds in support of this application. application [Outline grounds, if insufficient space please attach further information.] Signature of
applicant
NoticeDate
of Court:
court hearing Address:
Date and time of hearing:S. HEATH, Chief Magistrate, Magistrates Court in Perth.
Date 16 June 2017.
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