Children and Young Persons (Children's Court) Regulations 2001
i
Children and Young Persons (Children's Court)
Regulations 2001
S.R. No. 88/2001
TABLE OF PROVISIONS
Regulation Page
1. Objectives 1
2. Authorising provision 1
3. Revocation 1
4. Definition 2
5. Supply of information by registrars and police 2
6. Remand in custody—prescribed regions 2
7. Placement of child 2
8. Youth supervision orders 2
9. Prescribed forms 2
10. Application for time to pay fine, for instalment order or for
variation of instalment order 2
11. Advice in other languages 3
__________________
SCHEDULES 4
SCHEDULE 1—Regulations revoked 4
SCHEDULE 2—Prescribed regions of the State 5
SCHEDULE 3—Prescribed regions of the State 6
SCHEDULE 4—Prescribed regions of the State 7
SCHEDULE 5—Forms 9
Form 1—Order to bring a child before the court prior to the adjourned
date 9
Form 2—Children's court search warrant 11
Form 3—Notice of protection application 13
Form 4—Irreconcilable difference application 17
Form 5—Interim accommodation order 19
Form 6—Statutory declaration 22
Form 7—Notice of application to vary an interim accommodation
order or for a new order 23
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Form 8—Application to revoke an interim accommodation order 25
Form 9—Non-accountable undertaking 27
Form 10—Accountable undertaking 29
Form 11—Notice to appear before the court—criminal division 31
Form 12—Good behaviour bond 33
Form 13—Probation order 35
Form 14—Application to vary or revoke a sentencing order 37
Form 15—Youth supervision order 39
Form 16—Youth attendance order 41
Form 17—Warrant of detention 43
Form 18—Order to bring a person before a court or coroner's inquest 45
Form 19—Advice in other languages 47
Form 20—Order for weekend detention—unpaid fines 48
Form 21—Witness summons 50
Form 22—Warrant to arrest 52
Form 23—Children's court remand warrant 54
Form 24—Application for a permanent care order 56
Form 25—Permanent care order 58
Form 26—Application to vary or revoke a permanent care order 60
Form 27—Application to restrict access to a protection report 62
Form 28—Application to vary or revoke a protection order or interim
protection order 64
Form 29—Notice to appear before the children's court—family division 66
Form 30—Undertaking—children's court family division 68
Form 31—Supervision order 69
Form 32—Custody to third party order 71
Form 33—Supervised custody order 73
Form 34—Custody to secretary order 75
Form 35—Guardianship to secretary order 77
Form 36—Application for an extension or additional extension of a
custody to secretary order or a guardianship to secretary
order 79
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Form 37—Application to revoke a guardianship to secretary order 81
Form 38—Interim protection order 83
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1
STATUTORY RULES 2001
S.R. No. 88/2001
Children and Young Persons Act 1989
Children and Young Persons (Children's Court)
Regulations 2001
The Governor in Council makes the following Regulations:
Dated: 11 September 2001
Responsible Minister:
ROB HULLS
Attorney-General
HELEN DOYE
Clerk of the Executive Council
1. Objectives
The objective of these Regulations is to
prescribe—
(a) forms for use in the Children's Court; and
(b) the manner of supplying certain information
for the purposes of section 35(2) of the
Children and Young Persons Act 1989;
(c) regions for the purposes of sections
129(4)(b), 130 and 163(2)(a) of the Act; and
(d) various other matters required or authorised
to be prescribed for the purposes of the Act.
2. Authorising provision
These Regulations are made under section 280 of
the Children and Young Persons Act 1989.
3. Revocation
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The Regulations listed in Schedule 1 are revoked.
4. Definition
In these Regulations, ''the Act" means the
Children and Young Persons Act 1989.
5. Supply of information by registrars and police
For the purposes of section 35(2) of the Act, the
prescribed manner of supplying information to the
Secretary or a probation officer nominated by the
Secretary is personal service or electronic or
facsimile transmission or orally or by post.
6. Remand in custody—prescribed regions
For the purposes of section 129(4)(b) of the Act,
the municipal districts of the councils referred to
in Schedule 2 are prescribed regions of the State.
7. Placement of child
(1) For the purposes of section 130 of the Act, the
municipal districts of the councils referred to in
Schedule 3 are prescribed regions of the State.
(2) For the purposes of section 130(1) of the Act, in
those regions, a child may by order be placed in a
police gaol if the period of remand is not more
than 2 working days.
8. Youth supervision orders
For the purposes of section 163(2)(a) of the Act
the municipal districts of the councils referred to
in Schedule 4 are prescribed regions of the State.
9. Prescribed forms
The forms to be used for or with respect to
proceedings in the Court are set out in Schedule 4.
10. Application for time to pay fine, for instalment order
or for variation of instalment order
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An application under section 154 of the Act is
made in the prescribed manner by the child
notifying the appropriate registrar of the Court
orally or in writing of the details of the
application.
11. Advice in other languages
(1) In a proceeding, a notice of advice in the form of
Form 19 must be included with and served with
any originating process served on a child or parent
of a child and any process served on a witness.
(2) The notice must be printed in the English, Arabic,
Cambodian, Chinese, Croation, Greek, Italian,
Macedonian, Polish, Spanish, Turkish and
Vietnamese languages.
(3) The notice forms part of any originating process
or other process with which it is served.
__________________
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SCHEDULES
SCHEDULE 1
Regulation 3
REGULATIONS REVOKED
S.R. No Title
165/1991 Children and Young Persons (Children's Court)
Regulations 1991
4/1992 Children and Young Persons (Children's Court)
(Amendment) Regulations 1992
52/1992 Children and Young Persons (Children's Court) (Further
Amendment) Regulations 1992
165/1992 Children and Young Persons (Children's Court) (Forms)
Regulations 1992
32/1995 Children and Young Persons (Children's Court)
(Amendment) Regulations 1995
26/2000 Children and Young Persons (Children's Court)
(Amendment) Regulations 2000
__________________
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SCHEDULE 2
Regulation 6
PRESCRIBED REGIONS OF THE STATE
Alpine Shire Council Mildura Rural City Council
Ararat Rural City Council Mitchell Shire Council
Ballarat City Council Moira Shire Council
Buloke Shire Council Mount Alexander Shire Council
Campaspe Shire Council Moyne Shire Council
Central Goldfields Shire Council Murrindindi Shire Council
Colac-Otway Shire Council Northern Grampians Shire Council
Corangamite Shire Council Pyrenees Shire Council
Delatite Shire Council Queenscliffe Borough Council
East Gippsland Shire Council Southern Grampians Shire Council
Gannawarra Shire Council Strathbogie Shire Council
Glenelg Shire Council Surf Coast Shire Council
Golden Plains Shire Council Swan Hill Rural City Council
City of Greater Bendigo Towong Shire Council
Greater Geelong City Council Wangaratta Rural City Council
Greater Shepparton City Council Warrnambool City Council
Hepburn Shire Council Wellington Shire Council
Hindmarsh Shire Council West Wimmera Shire Council
Horsham Rural City Council Wodonga Rural City Shire Council
Indigo Shire Council Yarriambiack Shire Council
Loddon Shire Council
__________________
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SCHEDULE 3
Regulation 7
PRESCRIBED REGIONS OF THE STATE
Ballarat City Council
Central Goldfields Shire Council
East Gippsland Shire Council
Greater Bendigo City Council
Greater Geelong City Council
Greater Shepparton City Council
Horsham Rural City Council
La Trobe Shire Council
Mildura Rural City Council
Southern Grampians Shire Council
Swan Hill Rural City Council
Wangaratta Rural City Council
Warrnambool City Council
—————————
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SCHEDULE 4
Regulations 8, 9
PRESCRIBED REGIONS OF THE STATE
Alpine Shire Council
Ararat Rural City Council
Ballarat City Council
Banyule City Council
Bass Coast Shire Council
Brimbank City Council
Campaspe Shire Council
Central Goldfields Shire Council
Colac-Otway Shire Council
Darebin City Council
East Gippsland Shire Council
Frankston City Council
Gannawarra Shire Council
Glenelg Shire Council
Greater Bendigo City Council
Greater Dandenong City Council
Greater Geelong City Council
Greater Shepparton City Council
Hindmarsh Shire Council
Horsham Rural City Council
Hume City Council
La Trobe Shire Council
Macedon Ranges Shire Council
Maroondah City Council
Melbourne City Council
Mildura Rural City Council
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Mitchell Shire Council
Moira Shire Council
Moonee Valley City Council
Moorabool Shire Council
Mornington Peninsula Shire Council
Mount Alexander Shire Council
Northern Grampians Shire Council
Southern Grampians Shire Council
Swan Hill Rural City Council
Towong Shire Council
Wangaratta Rural City Council
Warrnambool City Council
Wellington Shire Council
Wodonga Rural City Council
Wyndham City Council
Yarriambiack Shire Council
—————————
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SCHEDULE 5
FORMS
FORM 1
Children and Young Persons Act 1989
(section 25(4))
ORDER TO BRING A CHILD BEFORE THE COURT PRIOR
TO THE ADJOURNED DATE
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
To—
the Secretary to the Department of Human Services
the Officer in charge at (insert name of place where child has been remanded
in custody or name of secure welfare service where child has been placed)
all members of the police force of Victoria.
I order that the child is to be brought to the Children's Court at (name and
address of Children's Court or name and address of place where facilities
exist to enable the child to appear by audio visual link within the meaning of
Part IIA of the Evidence Act 1958)
at (time) am/pm on (date)
The child is to answer the charges written below.
What is the charge? (brief description)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
The charges were filed by—
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Name—
Agency and address—
The charge is filed at the Children's Court at—
OR
The child is to be brought before the Court on:
a Protection Application
an Irreconcilable Difference Application
other (give details)
Signed at—
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 2
Children and Young Persons Act 1989
(sections 69, 70, 79, 80, 80A, 95, 98, 110, 111, 265)
CHILDREN'S COURT SEARCH WARRANT
(Safe Custody)
Court Ref—
Name or description of Child *Male/*Female
[and address if applicable] Date of Birth—
AUTHORITY AND DIRECTIONS
To all members of the police force or
You are authorised to:
break enter and search any place where the child named or described in this
warrant is suspected to be; and take into safe custody the child named or
described in this warrant;
AND if the warrant is issued under section 69 or 70 of the Act, to
bring the child before the Court for the hearing of an application for an
interim accommodation order as soon as practicable and, in any event, within
one working day after the child was taken into safe custody. Unless the child
is brought before the Court within 24 hours after the child was taken into safe
custody, he or she must (unless the child is of tender years) be brought before
a bail justice as soon as possible within that period of 24 hours for the
hearing of an application for an interim accommodation order.
release the child on an interim accommodation order of the type referred to in
section 73(3)(a) or (b) of the Act in accordance with the endorsement below.
OR if the warrant is issued under section 79, 80, 80A, 95, 98, 110 or 111
of the Act, to
bring the child before the Court or a bail justice as soon as possible after
being taken into safe custody and in any event within 24 hours after that
event. Unless the child is brought before the Court within 24 hours after the
child was taken into safe custody, he or she must (unless the child is of
tender years) be brought before a bail justice as soon as possible within that
period of 24 hours for the hearing of an application for an interim
accommodation order.
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OR if the warrant is issued under section 265 of the Act,
the member of the police force who executed this warrant must take the child
to the place specified in this warrant or, if no place is specified, to a place
determined by the Secretary or, in the absence of a determination, to a place
referred to in section 124 of the Act.
Place specified:
......................................................................................................................
......................................................................................................................
ENDORSEMENT
The child may be released on an interim accommodation order to
appear at the Children's Court at
at am/pm on
Applicant's name—
Agency and address—
Phone—
Issued at—
Date—
*Registrar/*Judge/*Magistrate/*Authorised Bail Justice
*delete if not applicable
_______________
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FORM 3
Children and Young Persons Act 1989
(sections 68(1)(b), 68(2), 70)
NOTICE OF PROTECTION APPLICATION
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Grounds for the application
*(a) The child has been abandoned by his or her parents and after
reasonable enquiries—
(i) the parents cannot be found; and
(ii) no other suitable person can be found who is willing and
able to care for the child.
*(b) The child's parents are dead or incapacitated and there is no other
suitable person willing and able to care for the child.
*(c) The child has suffered, or is likely to suffer, significant harm as a
result of physical injury and the child's parents have not protected,
or are unlikely to protect, the child from harm of that type.
*(d) The child has suffered, or is likely to suffer, significant harm as a
result of sexual abuse and the child's parents have not protected, or
are unlikely to protect, the child from harm of that type.
*(e) The child has suffered, or is likely to suffer, emotional or
psychological harm of such a kind that the child's emotional or
intellectual development is, or is likely to be, significantly
damaged and the child's parents have not protected, or are unlikely
to protect, the child from harm of that type.
*(f) The child's physical development or health has been, or is likely to
be, significantly harmed and the child's parents have not provided,
arranged or allowed the provision of, or are unlikely to provide,
arrange or allow the provision of, basic care or effective medical,
surgical or other remedial care.
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Applicant's name—
Agency and address—
Phone—
Date—
(Signature)
Notice to Parents and child
To the child: You must come to the hearing of this application.
To the Parent(s): If your child is in your custody—the child must
appear or be produced before the Court for the hearing of this application.
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
(Reverse)
Affidavit/Declaration of Service of Notice of Protection Application
(*delete if not applicable)
I (full name) of (address)
(occupation)
*swear/declare that I served a true copy of this notice on:
(name of person served) who is the (capacity e.g. parent/child)
on (date) at am/pm
by
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delivering it to him/her personally at (address)
leaving it for him/her at (address) being that person's last known
place of *residence/*business with a person who apparently resided or
worked there and who apparently was not less than 16 years of age.
posting it by prepaid ordinary post at (address of posting) in an envelope
addressed to that person at his or her last known place of
*residence/*business. I obtained this address from
AND on (name of person served) who is the (capacity e.g. parent/child)
on (date) at am/pm
by
*delivering it to *him/her personally at (address)
*leaving it for *him/her at (address) being that person's last known
place of *residence/business with a person who apparently resided or worked
there and who apparently was not less than 16 years of age.
*posting it by prepaid ordinary post at (address of posting) in an envelope
addressed to that person at his or her last known place of
*residence/business. I obtained this address from
AND on (name of person served) who is the (capacity e.g. parent/child)
on (date) at am/pm
by
*delivering it to *him/her personally at (address)
*leaving it for *him/her at (address) being that person's last known
place of *residence/business with a person who apparently resided or worked
there and who apparently was not less than 16 years of age.
*posting it by prepaid ordinary post at (address of posting) in an envelope
addressed to that person at his or her last known place of
*residence/business. I obtained this address from
*Sworn at in the State of Victoria
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on (date) (Signature of person making affidavit)
Before—
(Name and address in legible writing, typing or stamp)
OR
*I acknowledge that this declaration is true and correct and make it in the
belief that a person making a false declaration is liable to the penalties of
perjury.
Declared at in the State of Victoria
on (date) (Signature of person making declaration)
Before—
(Name and address in legible writing, typing or stamp)
*delete if not applicable
_______________
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FORM 4
Children and Young Persons Act 1989
(sections 71, 72)
IRRECONCILABLE DIFFERENCE APPLICATION
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the application
Name of parent or custodian
Address—
Relationship to child *Mother/*Father/*Relative (state
relationship)/*Custodian
Grounds for the application
When the applicant is a person who has custody of the child
The person who has custody of the child believes that there is a substantial
and presently irreconcilable difference between himself or herself and the
child to such an extent that the care and control of the child are likely to be
seriously disrupted.
When the applicant is the child
The child believes that there is a substantial and presently irreconcilable
difference between himself or herself and the person who has custody of him
or her to such an extent that the care and control of the child are likely to be
seriously disrupted.
Applicant's name—
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Agency and address—
Phone—
Date—
(Signature)
Notice to custodian or child
To the child: You must come to the hearing of this application.
To the person who has custody of the child: You should come to the
hearing of this application.
(If you do not attend, the Court may proceed to hear and determine the
application in your absence.)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 5
Children and Young Persons Act 1989
(section 73)
INTERIM ACCOMMODATION ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Applicant's name—
Agency and address—
Phone—
Details of the application (Insert grounds—refer to reverse for correct
wording.)
......................................................................................................................
......................................................................................................................
......................................................................................................................
A hearing in this case will take place at am/pm on at
the Children's Court at
Interim Accommodation Order
Until the date of the next Court hearing I order that the child is to be:
*released on the signing by the child of an undertaking to appear on the
hearing of the relevant proceeding.
*released into the care of who is his or her parent pending the
hearing on the entering (whether orally or in writing) by that parent into an
undertaking to produce the child before the Court for the hearing of the
relevant proceeding.
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*placed with (name of person(s)) who is (are) a suitable person(s) pending
that hearing on the entering (whether orally or in writing) by that person or
those persons into an undertaking to produce the child before the Court for
the hearing of the relevant proceeding and following a report (whether oral or
written) from the Secretary on that person's or those persons' suitability.
*placed in a community service pending that hearing.
*placed in a secure welfare service pending that hearing as there is a
substantial and immediate risk of harm to the child.
The following conditions apply to this Interim Accommodation Order.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
UNDERTAKING
I undertake to *appear/*produce the child before the Court for the hearing of
the proceeding.
(Signature)
Order made by—
*Judge/*Magistrate/*Bail Justice
at (Place)—
Date—
(Reverse)
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Grounds for the making of an Interim Accommodation Order under
section 73(1) of the Children and Young Persons Act 1989 are—
• the child has been taken into safe custody by a protective intervener under
Part 3 of the Act;
• a protection application is filed with the appropriate registrar;
• an irreconcilable difference application is filed with the appropriate
registrar;
• an application for conciliation counselling is lodged with the Secretary
under section 72 of the Act;
• the hearing by the Court of a proceeding in the Family Division (including
a proceeding under section 73 of the Act) is adjourned;
• an application for an extension or further extension of the period of an
interim accommodation order has been made to the Court under section 78 of
the Act;
• an application for variation of an interim accommodation order has been
made to the Court under section 79(1) of the Act;
• an interim accommodation order or any condition attached to an interim
accommodation order (state the condition that has not been complied with)
has not been complied with;
• an application for a new interim accommodation order has been made to the
Court under section 80A(1) of the Act;
• the child has been taken into safe custody on a warrant issued under Part 3
of the Act; or
• an appeal has been instituted under Part 3 of the Act to the Supreme Court
or the County Court against an order made by the Court under Part 3 of the
Act.
*delete if not applicable
_______________
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FORM 6
Children and Young Persons Act 1989
(section 74(2))
STATUTORY DECLARATION
I, (full name) of (address) (occupation)
declare that I undertake to produce the child named (full name) born
(date of birth)
before the Children's Court at (venue) on (date) at (time) for the hearing,
or the resumption of the hearing, of the following proceeding (state type of
proceeding)
I acknowledge that this declaration is true and correct and I make it in the
belief that a person making a false declaration is liable to the penalties of
perjury.
Declared at (place)
in the State of Victoria on (date)
Before:
(name and address in legible writing, typing or stamp below signature)
a person authorised under section 107A(1) of the Evidence Act 1958 to
witness the signing of a statutory declaration.
_______________
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FORM 7
Children and Young Persons Act 1989
(sections 78, 80, 80A)
NOTICE OF APPLICATION TO VARY AN INTERIM
ACCOMMODATION ORDER OR FOR A NEW ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Interim Accommodation Order
The Interim Accommodation Order was made by the Children's Court at
on
The original Order was applied for by— (Full name)
Agency and address—
Phone—
Details of this application
This application is
*to vary the order.
*for a new interim accommodation order.
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The grounds for the application are:
......................................................................................................................
......................................................................................................................
......................................................................................................................
Applicant's name—
Agency and address—
Phone—
Date—
(Signature)
NOTE: The applicant must give notice of this application to:
the person who applied for the interim accommodation order; and
any other party to the proceeding in which that order was made; and
any person with whom the child is living.
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 8
Children and Young Persons Act 1989
(section 8 0)
APPLICATION TO REVOKE AN INTERIM
ACCOMMODATION ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Interim Accommodation Order
The Interim Accommodation Order was made by the Children's Court at
on
The original Order was applied for by— (Full name)
Agency and address—
Phone—
Details of this application
The grounds for the application are:
(Provide details of any condition which has not been, or is not being,
complied with.)
......................................................................................................................
......................................................................................................................
......................................................................................................................
Applicant's name—
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Agency and address—
Phone—
Date—
(Signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 9
Children and Young Persons Act 1989
(section 140)
NON-ACCOUNTABLE UNDERTAKING
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on found you
guilty of
You have not been convicted of these offences.
Details of the Order
The Court made the following Order:
That the charge(s) against you be dismissed
AND
That you give the following undertaking:
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That your parent (insert name) give the following undertaking:
NOTE: An undertaking is a promise to the Court that you will or will
not do the things specified in the undertaking.
I agree to comply with this undertaking.
Signature Signature
(child) (parent)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 10
Children and Young Persons Act 1989
(section 142)
ACCOUNTABLE UNDERTAKING
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on found you
guilty of
You have not been convicted of these offences.
Details of the Order
The Court made the following Order:
That the charge(s) against you be dismissed.
AND
That you give the following undertaking:
and that if you breach the undertaking you be made accountable and dealt
with for the breach.
That your parent (insert name) give the following undertaking:
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NOTE: An undertaking is a promise to the Court that you will or will
not do the things specified in the undertaking. If you fail to comply with
this undertaking the Court may direct that you be brought back before
the Court.
I agree to comply with this undertaking.
Signature Signature
(child) (parent)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 11
Children and Young Persons Act 1989
(sections 143, 146, 148, 155, l56A, l60, l65, l84)
NOTICE TO APPEAR BEFORE THE COURT—CRIMINAL
DIVISION
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
Details of the Sentencing or Fine Default Order
The order was made by the Children's Court at
on (date)
The charges were filed by— (Full name of informant)
Agency and address—
Phone—
The sentencing order was:
*an Accountable Undertaking *a Good Behaviour Bond *a Fine
*a Youth Supervision Order *a Youth Attendance Order
*Probation
The order was a *fine default order:
*Weekend Detention Order
Details of this notice
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Reasons for service of this notice
Applicant's name—
Agency and address—
Phone—
Date—
(Signature)
Details of the hearing
A hearing of this case will be held at am/pm on
at the Children's Court at
YOU MUST APPEAR BEFORE THE COURT AT THE HEARING
IF THE ORDER WAS MADE AGAINST YOU, AND YOU FAIL TO
APPEAR BEFORE THE COURT, THE COURT MAY ORDER THAT A
WARRANT TO ARREST YOU BE ISSUED
Issued at—
Date—
by Order of the Court
Registrar
*delete if not applicable
_______________
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FORM 12
Children and Young Persons Act 1989
(section 144)
GOOD BEHAVIOUR BOND
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on found you
guilty of—
(list offences)
You have not been convicted of these offences.
Details of the Order
The Court made the following Order:
That the proceeding be adjourned for (period) until (end date) on condition
that you enter into a Good Behaviour Bond.
The amount of your Bond is $
The following conditions apply to your Good Behaviour Bond
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That you appear, if so required by the Court, at the time to which the
proceeding has been adjourned. (You will receive a notice if you have to
come to Court).
That you appear before the Court, if required to do so, during the period of
the adjournment. (You will receive a notice if you have to come to
Court).
That you are of good behaviour during the period of the adjournment.
That you observe any special conditions imposed by the Court.
Special Conditions:
I agree to enter into this Good Behaviour Bond, to appear before the
Court if required, and to observe any special conditions imposed by the
Court.
(Signature of child)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 13
Children and Young Persons Act 1989
(sections 158, 159)
PROBATION ORDER
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on found you
guilty of
You *were/*were not convicted of these offences.
Details of the Order
The Court ordered that you be placed on probation *for (period) *until
(end date).
The following conditions apply to your probation order
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You must report to the Secretary to the Department of Human Services
within 2 working days after this order is made. (An officer of the Department
of Human Services will contact you to let you know when and where you are
to report).
You must report, during the period of the probation order, to your assigned
probation officer as required by the probation officer.
You must not re-offend during the period of the probation order.
You must not leave the State without the written permission of the Secretary
to the Department of Human Services.
You must notify your assigned probation officer of any change of residence,
school or employment within 48 hours after the change.
You must obey the reasonable and lawful instructions of your assigned
probation officer.
The Court also ordered that you comply with the following special
conditions:
I consent to this order being made.
(Signature of child)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 14
Children and Young Persons Act 1989
(sections 159(5), 164(4), 185, 195)
APPLICATION TO VARY OR REVOKE A SENTENCING
ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Sentencing Order
The order was made by the Children's Court at
on (date)
The charges were filed by— (Full name of informant)
Agency and address—
Phone—
The sentencing order was—
*a probation order/*a youth supervision order/*a youth attendance order
Details of this application
This application is to *vary the order/*revoke the order.
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The grounds for the application are—
Applicant's name—
Agency and address—
Phone—
Date—
(Signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 15
Children and Young Persons Act 1989
(sections 155, 163, 164)
YOUTH SUPERVISION ORDER
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on found you
guilty of
You *were/*were not convicted of these offences.
Details of the Order
The Court ordered that:
You be released on a youth supervision order *for (period) *until (end
date). You must obey all the conditions set out on the back of this order.
(If the order has been made under section 155(1)(d) of the Act for default in
the payment of a fine or of an instalment under an instalment order, the
amount still unpaid is $ ).
You must comply with the following special conditions:
I consent to this order being made.
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(Signature of child)
Date—
*Judge/*Magistrate
*delete if not applicable
(Reverse)
Conditions of a Youth Supervision Order
1. You must report to the Secretary to the Department of Human
Services within 2 working days after this order is made.
2. You must report, during the period of the youth supervision order,
to the Secretary to the Department of Human Services as required
by the Secretary.
3. You must not re-offend during the period of the youth supervision
order.
4. You must not leave the State without the written permission of the
Secretary to the Department of Human Services.
5. You must notify the Secretary to the Department of Human
Services of any change of residence, school or employment within
48 hours after the change.
6. You must attend a youth supervision unit or any other place
specified in the youth supervision order.
7. You must participate in a community service program or any other
program, if so directed by the Secretary to the Department of
Human Services.
8. You must obey the reasonable and lawful instructions of the
Secretary to the Department of Human Services.
NOTE: Any reference to the Secretary to the Department of Human
Services is to be taken as a reference to one of his or her delegated
officers.
_______________
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FORM 16
Children and Young Persons Act 1989
(sections 169–183)
YOUTH ATTENDANCE ORDER
Court Ref—
To— (name) *Male/*Female
Date of Birth—
Address—
The Children's Court at on convicted
you of
and made a youth attendance order.
Details of any concurrent or aggregate terms if the order relates to more than
one offence.
Details of the Order
You must attend the youth attendance project conducted by at
*for (period) *until (end date).
You must report to the Secretary to the Department of Human Services
within 2 working days after this order is made unless you are in custody. If
you are in custody, you must report to the Secretary at the time and on the
day specified in a notice sent or given to you.
You must not commit another offence during the period that the order is in
force.
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You must not leave the State without the written permission of the Secretary.
You must notify the Secretary of any change of residence, school or
employment within 48 hours after the change.
You must comply with the requirements for attendance of section 177(1)(a)
and (b) of the Act.
You must comply with any notice under section 177 of the Act setting out
the details of your attendance at the youth attendance project.
You must attend at any alternative day and time set by the Secretary or attend
for any extension of the term of the order as fixed by the Secretary under
section 177(6) of the Act.
You must carry out the reasonable and lawful directions of the Secretary or
any person acting under the authority of the Secretary under sections 182 and
183(1) of the Act.
NOTE: Any reference to the Secretary to the Department of Human
Services is to be taken as a reference to one of his or her delegated officers.
The Court also ordered that you comply with the following special
conditions:
I consent to this order being made.
(Signature of child)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 17
Children and Young Persons Act 1989
(sections 186, 188, 193)
WARRANT OF DETENTION
(not for unpaid fines)
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
The charges were filed by—
Name—
Agency—
The charges were heard in the Children's Court at
Detention order summary
Effective total term
Time spent in custody Taken into account *Yes/*No
Sentences imposed in this case to be—
*cumulative on other sentences presently being served
*part concurrent with other sentences presently being served.
(the concurrent portion of sentence— )
*cumulative on any period owed to the Youth Parole Board or the Youth
Residential Board
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*part concurrent with any period owed to the Youth Parole Board or Youth
Residential Board (the concurrent portion of sentence)
Date sentence imposed—
The Court also ordered:
Authority and directions
To all members of the police force, or
You are authorised to break, enter and search any place where the child
named in this warrant is suspected to be and to take and safely convey the
child named in this warrant to—
*a youth training centre *a youth residential centre
and to deliver the child to the officer in charge of the youth training centre or
youth residential centre.
To the Secretary to the Department of Human Services or any other
person into whose custody the child named in this warrant is transferred:
You are directed and authorised to receive that child into custody and safely
keep that child for the period specified, or in the circumstances described, in
this warrant or until that child is otherwise removed or discharged from
custody by due course of law.
Issued at—
Date—
*Registrar/*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 18
Children and Young Persons Act 1989
(section 258)
ORDER TO BRING A PERSON BEFORE A COURT OR
CORONER'S INQUEST
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
To—
the Secretary to the Department of Human Services
the Officer in charge at (insert name of place where child has been remanded
in custody or name of secure welfare service where child has been placed)
all members of the police force of Victoria.
I order that the child is to be brought to the Children's Court at (name and
address of Children's Court or name and address of place where facilities
exist to enable the child to appear by audio visual link within the meaning of
Part IIA of the Evidence Act 1958)
at (time) am/pm on (date)
The proceeding (Describe the proceeding)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
Reason for order (Set out reasons)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
AND the person is to remain in the custody of that member of the police
force, protective services officer or other officer acting under this order until
returned to the officer in charge of the place of detention or remand.
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Applicant's name—
Agency and address—
Phone—
Signed at—
Date—
*Judge/*Magistrate/*Registrar/*Coroner/*Coroner's Clerk
*delete if not applicable
_______________
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FORM 19
ADVICE IN OTHER LANGUAGES
IMPORTANT: DO NOT IGNORE THIS DOCUMENT
If you do not understand it, you should immediately have it interpreted and
explained to you. You may then get advice from:
A Registrar of the Children's Court
Your local solicitor
Victoria Legal Aid (Insert address and telephone number)
_______________
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FORM 20
Children and Young Persons Act 1989
(Sections 155, 156, l56A)
ORDER FOR WEEKEND DETENTION—UNPAID FINES
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Name of Informant—
Agency and address—
Phone—
Details of the Fine(s)
On / / you were fined by the Children's Court at
Charge Act/Section Fine Statutory costs Costs
Less amounts Paid
TOTAL AMOUNT UNPAID $
Default in payment of fine or instalment
On / / the Children's Court at found that for a period of
more than one month you have been in default in the payment of a fine or of
an instalment order.
The Court ordered that you be detained in a
Youth Training Centre
Youth Residential Centre
for a period of weekends.
The Court ordered that this detention be served
From 7.00 p.m. Friday until 7.00 p.m. Sunday
for 48 hour periods from 7.00 p.m. on (specify day) being a
weekday
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from 7.00 p.m. on (specify day) for hours
such order to commence on / /
You are to report to the Secretary to the Department of Human Services or
any other person into whose custody the person named in this order is
transferred:
You are directed and authorised to receive the child into custody and safely
keep the child for the period specified in the order or until otherwise
removed or discharged from custody by due course of law.
If the amount unpaid is paid you are to release the child named in this order
and immediately send the amount to the Registrar of the Children's Court
named above.
If the amount is partly paid you must reduce the term of detention using the
formula set out in section 71(1)(b) of the Magistrates' Court Act 1989,
amend the execution copy of the order, receive the payment and forward it
without delay to the Registrar of the Children's Court named above.
Date—
Issued by—
*Registrar/*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 21
Children and Young Persons Act 1989
WITNESS SUMMONS
Court Ref—
To the Witness— *Male/*Female
Address—
Details of the case
Name of child
Type of hearing
Charges (brief description)
Protection application
Irreconcilable difference application
Other (specify)
Name of informant/applicant—
Agency and address—
Phone—
WHAT YOU HAVE TO DO
You must bring this summons with you and come to court to give evidence
in the proceeding; come to court to give evidence and also produce at the
hearing the following documents or things that are in your possession or
control:
(specify documents or things)
produce at the hearing the following documents or things that are in your
possession or control:
(specify documents)
You may produce this summons and the documents or things referred to
above to the Registrar of the Children's Court at by hand or
by post, in either case so that the registrar receives them not later than 2 days
before the date on which you are required to attend.
If you are required to give evidence, you must attend at the hearing.
Where and when will the case be heard?
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The case will be heard at the Children's Court at (venue) at
(address) Phone
at am/pm on (date)
Issued at—
Date—
*Registrar/*Judge/*Magistrate
Summons filed by— (identify party)
*delete if not applicable
_______________
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FORM 22
Children and Young Persons Act 1989
(Section 193)
WARRANT TO ARREST
Court Ref—
Name of person to be arrested— *Male/*Female
Date of Birth—
Address—
Statement of Reasons for this Warrant
*The defendant failed to appear before the Court on (date) in answer to a
charge and summons.
*The defendant failed to attend before the Court on (date) in accordance with
his or her bail.
*The person failed to appear before the Court on (date) in answer to a notice
to appear before the Court.
*The person was served with a witness summons and failed to attend before
the Court on (date) in answer to that witness summons.
*Other—give details.
The defendant was charged with—
The charges were filed by—
Agency and address—
Phone—
Directions
To all members of the police force, or
You are authorised to:
break, enter and search, if necessary, any place where the person named or
described in this warrant is suspected to be;
arrest the person named or described in this warrant;
AND TO
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bring him or her before a bail justice or the Court within a reasonable time of
being arrested to be dealt with according to law. If the warrant is issued in
respect of a sentencing order alleged to have been breached, the child must
be brought before the Court within a reasonable time of being arrested but
not later than the next working day after the child is arrested and in the
meantime must be placed as provided by the Children and Young Persons
Act 1989;
OR
release him or her on bail in accordance with the endorsement below;
OR
discharge him or her on bail under section 10 of the Bail Act 1977.
Issued at—
Date—
*Registrar/*Judge/*Magistrate
ENDORSEMENT FOR BAIL
A judge or magistrate has authorised the following endorsement:
The person named may be released upon entering an undertaking of bail to
appear at the Children's Court at on the following conditions:
Date—
*Registrar/*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 23
Children and Young Persons Act 1989
(section 193)
CHILDREN'S COURT REMAND WARRANT
Court Ref—
Name of defendant (or Witness)— *Male/*Female
Date of Birth—
Address—
The defendant (or witness) has been *remanded in custody *returned to the
custody of the Secretary to the Department of Human Services
The proceeding has been adjourned and the defendant is to be brought before
the Children's Court at at 10.00 a.m. on
The defendant has been committed to stand trial.
The defendant was charged with—
The charges were filed by—
Agency and address—
Phone—
The charge is filed
at the Children's Court at
with the Bail Justice making this order.
AUTHORITY AND DIRECTIONS
If a child is remanded in custody
To all members of the police force or the Secretary to the Department of
Human Services or
You must take and safely convey the child named in this warrant to—
a remand centre
other (only in prescribed regions). Specify place where child is to be
placed:
and deliver the child to the officer in charge of that facility.
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If an adult is remanded in custody
To all members of the police force or all prison officers or—
You must take and safely convey the person named in this warrant to-
*a prison *a police gaol *a youth training centre
and deliver the person to the officer in charge of that facility.
To the Secretary to the Department of Human Services or to the Secretary to
the Department of Justice or to the Chief Commissioner of Police (as the case
may be), or any other person into whose custody the person is transferred.
You must receive the person named in this warrant into custody and safely
keep that person—
(i) for the period specified, or in the circumstances described, in this
warrant;
or
(ii) until that person is otherwise removed or discharged from custody
by due course of law.
ENDORSEMENTS
The defendant did not apply for bail.
I certify that the defendant's application for bail was refused. The reasons for
my refusal are:
I certify that bail was granted and the defendant is to be released from
custody when he or she signs an undertaking with the conditions which are
endorsed below:
The defendant was legally represented by—
Signed at—
Date—
*Registrar/*Judge/*Magistrate/*Bail Justice
*delete if not applicable
_______________
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FORM 24
Children and Young Persons Act 1989
(section 112)
APPLICATION FOR A PERMANENT CARE ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the application
Applicant's name—
Agency and address—
Phone—
(Signature)
Name of child's mother—
Address—
Name of child's father—
Address—
Name of proposed carer 1—
Address—
Name of proposed carer 2—
Address—
Relationship of carer(s) to child: Relative(s) (specify)
Foster parent(s)
Other (specify)
The applicant applies for a permanent care order in respect of the child
named above.
A statement of approval from the Secretary to the Department of Human
Services or a person authorised under section 7(2) of the Act *is/*is not
attached. If not give reason.
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A protection order *is/*is not in force in respect of the child. If in force give
details.
An application to revoke the protection order *has/*has not been made. It
*has/*has not been determined.
There *are/*are not current proceedings under the Family Law Act 1975 of
the Commonwealth with respect to the child. If there are current proceedings
give details, stating who commenced the proceeding.
Notice to parties
To the child and applicant: You must come to the hearing of this
application.
To the parent(s) and authorised person: You should come to the hearing
of this application. If you do not attend, the Court may proceed to hear and
determine the application in your absence.
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 25
Children and Young Persons Act 1989
(section 112)
PERMANENT CARE ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Name of child's mother—
Address—
Name of child's father—
Address—
Details of the order
The Children's Court at on made a
permanent care order in respect of the child named above.
Custody and guardianship of the child was granted to:
Name—
Address—
Name—
Address—
(if applicable) Guardianship of the child was vested in:
The Court made the following conditions with regard to access to the child
by the child's parent(s):
......................................................................................................................
......................................................................................................................
......................................................................................................................
Order made at—
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Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 26
Children and Young Persons Act 1989
(section 115)
APPLICATION TO VARY OR REVOKE A PERMANENT
CARE ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Permanent Care Order
The Children's Court at on made an order
granting custody and guardianship of the child to (Give names and
addresses)
The parents of the child are (Give names and addresses)
Details of this application
This application is:
to vary the permanent care order
to revoke the permanent care order.
The grounds for the application are:
Applicant's name—
Agency and address—
Phone—
The applicant is:
the child
a parent of the child
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a person granted custody and guardianship of the child under the order
the Secretary.
Date—
(Applicant's signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 27
Children and Young Persons Act 1989
(section 47)
APPLICATION TO RESTRICT ACCESS TO A PROTECTION
REPORT
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Order for the Protection Report
The Children's Court at on ordered the Secretary to the
Department of Human Services Victoria to submit to the Court a protection
report concerning the child named above. The report is to be considered at a
hearing of the protection application on .
Details of this application
I apply to the Court for an order restricting access by:
the child who is the subject of the report
that child's parent
any other person specified by the Court namely.
Access is to be restricted to:
the whole of the report
a part of the report (specify).
This application is based on the grounds that information in the report, or the
part of the report, may be prejudicial to the physical or mental health of the
child or a parent of the child.
Applicant's name—
Address—
Phone—
Agency or relationship to the child—
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Date—
(Applicant's signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 28
Children and Young Persons Act 1989
(sections 90, 94, 97, 98, 104, 105, 110A)
APPLICATION TO VARY OR REVOKE A PROTECTION
ORDER OR INTERIM PROTECTION ORDER
(Not for Breach of Protection Order or Interim Protection Order)
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address Postcode
Details of the Order
On the application of (Full name)
Agency and address—
Phone—
the Children's Court at on made the
following order:
an Undertaking
a Supervision Order
a Custody to Third Party Order
a Supervised Custody Order
a Custody to Secretary Order
an Interim Protection Order.
Details of this application
This application is:
to vary the order
to revoke the order.
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The grounds for the application are:
......................................................................................................................
......................................................................................................................
This application is made:
by the child
by a parent of the child
by a person with whom the child is living
by a person who has been granted custody of the child
on behalf of the child
by the Secretary to the Department of Human Services.
Applicant's name—
Address—
Phone—
Date—
(Signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 29
Children and Young Persons Act 1989
(sections 95, 98, 111)
NOTICE TO APPEAR BEFORE THE CHILDREN'S COURT—
FAMILY DIVISION
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Order
On the application of (Full name)
Agency and address—
Phone—
the Children's Court at on made an order for:
a Supervision Order
a Supervised Custody Order
an Interim Protection Order.
Details of this notice
Reason for the service of this Notice:
There has been a failure to comply with any condition of the order.
There has been a failure to comply with any direction given by the
Secretary under section 93(2) of the Children and Young Persons Act
1989. (Not applicable for Interim Protection Orders).
The child is living in conditions which are unsatisfactory in terms of the
safety and well-being of the child.
Applicant's name—
Agency and address—
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Phone—
Date—
(Applicant's signature)
Notice to parent or child
To the child: You must appear before the Court on the date and at the time
listed below.
To the parent(s) or other person with whom the child is living: You must
bring the child to Court on the date and at the time listed below.
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
by Order of the Court
Registrar
*delete if not applicable
_______________
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FORM 30
Children and Young Persons Act 1989
(section 89)
UNDERTAKING—CHILDREN'S COURT FAMILY DIVISION
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address Postcode
The Children's Court at on found that
the child named above is in need of protection.
there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court made the following Order:
That the child give the following undertaking:
That gives the following undertaking:
The undertaking is to last *for (period) *until (end date).
NOTE: An undertaking is a promise to the Court that you will or will
not do the things specified in the undertaking.
I consent to the making of this order and agree to comply with this
undertaking.
Signature Signature
(child) (*parent/*custodian)
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 31
Children and Young Persons Act 1989
(sections 91–93)
SUPERVISION ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address Postcode
The Children's Court at on found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that the child named above be placed on a supervision
order.
This order remains in force *for (period) *until (end date).
A supervision order gives the Secretary to the Department of Human
Services responsibility for the supervision of the child.
The parent or other person with whom the child is living must permit the
Secretary to visit the child at his or her place of residence and to carry out the
duties of the Secretary under the order.
If the order is for a period exceeding 12 months, the Court directs the
Secretary to review the operation of the order before the end of the period of
12 months after the making of the order and to notify the Court, the child, the
child's parent and such other persons as the Court directs before the end of
that period if he or she considers that, to ensure the safety and well-being of
the child, the order should continue for the duration of the period specified in
the order.
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The following conditions apply to this supervision order:
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 32
Children and Young Persons Act 1989
(section 96)
CUSTODY TO THIRD PARTY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address Postcode
The Children's Court at on found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that sole or joint custody of the child named in this order
be granted to:
Name—
Address—
Name—
Address—
This order remains in force *for (period) *until (end date).
The following conditions apply to this custody to third party order:
.....................................................................................................................
.....................................................................................................................
......................................................................................................................
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Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 33
Children and Young Persons Act 1989
(section 98)
SUPERVISED CUSTODY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
The Children's Court at on found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that sole or joint custody of the child named in this order
be granted to:
Name—
Address—
Name—
Address—
This order remains in force *for (period) *until (end date).
The parent, or other person with whom the child is living, must permit the
Secretary to the Department of Human Services to visit the child at his or her
place of residence and carry out the duties of the Secretary under the order.
The Court directs the parties to take all appropriate steps to enable the
re-unification of the child with his or her parent before the end of the period
for which the order remains in force.
The following conditions apply to this supervised custody order—
Date—
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*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 34
Children and Young Persons Act 1989
(sections 99–102)
CUSTODY TO SECRETARY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
The Children's Court at on found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court granted sole custody of the child named in this order to the
Secretary to the Department of Human Services.
This order remains in force *for (period) *from (start date) *until
(end date).
*This is not an extension of an existing custody to Secretary order.
This order extends an existing custody to Secretary order. The application to
extend the order is made under *section 100 *section 101 *section 102.
The following conditions apply to this custody to Secretary order
.....................................................................................................................
.....................................................................................................................
(Delete if not applicable)
The Court directs the Secretary to take steps to ensure that at the end of the
period of the order a person other than the child's parent or the Secretary
applies to a court for an order relating to—
(i) the custody; or
(ii) the custody and guardianship; or
(iii) the custody and joint guardianship—
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of the child.
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 35
Children and Young Persons Act 1989
(sections 106–108)
GUARDIANSHIP TO SECRETARY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
The Children's Court at on found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the Order
The Court granted custody and guardianship of the child named in this order
to the Secretary to the Department of Human Services to the exclusion of all
other persons.
This order remains in force *for (period) *from (start date) *until
(end date).
This is not an extension of an existing guardianship to Secretary order.
This order extends an existing guardianship to Secretary order. The
application to extend the order was made under *section 107 *sections 101
and 108 *sections 102 and 108.
If the Court has specified a period exceeding 12 months for the order to
remain in force it now directs the Secretary to the Department of Human
Services to review the operation of the order before the end of the period of
12 months after the making of the order and to notify the Court, the child, the
child's parent and such other persons as the Court directs before the end of
that period if he or she considers that, to ensure the safety and well-being of
the child, the order should continue for the duration of the period specified in
the order.
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The Court directs that the following should be notified of the decision to
continue the order:
Name—
Address—
Name—
Address—
(Delete if not applicable)
The Court directs the Secretary to the Department of Human Services to take
steps to ensure that at the end of the period of the order a person other than
the child's parent or the Secretary to the Department of Human Services
applies to a court for an order relating to—
(i) the custody; or
(ii) the custody and guardianship; or
(iii) the custody and joint guardianship—
of the child.
Date—
*Judge/*Magistrate
*delete if not applicable
_______________
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FORM 36
Children and Young Persons Act 1989
(sections 100–102, 107, 108)
APPLICATION FOR AN EXTENSION OR ADDITIONAL
EXTENSION OF A CUSTODY TO SECRETARY ORDER OR A
GUARDIANSHIP TO SECRETARY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
The Children's Court at on made
*a custody to Secretary order
*a guardianship to Secretary order
*for (period) *until (end date).
(If the order has since been extended) The Children's Court at
on last extended this order
*for (period) *until (end date).
Details of the application
The applicant applies for:
(if the application relates to a custody to Secretary order)
*an extension of custody to Secretary order by up to 12 months under
section 100
[for orders that have been in force for 12 months or less]
*an extension of custody to Secretary order beyond 2 years under section 101
[for orders that have been in force for more than 12 months but not more
than 2 years]
*an additional extension of custody to Secretary order under section 102
[for orders that have been in force for more than 2 years]
(if the application relates to a guardianship to Secretary order)
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*an extension of guardianship to Secretary order by up to 12 months under
section 107
[for orders that have been in force for 12 months or less]
*an extension of guardianship to Secretary order beyond 2 years under
sections 101 and 108
[for orders that have been in force for more than 12 months but not more
than 2 years]
*an additional extension of guardianship to Secretary order under
sections 102 and 108
[for orders that have been in force for more than 2 years]
Applicant's name—
Agency and address—
Phone—
(Signature)
Notice to parties
To the child and applicant: You must come to the hearing of this
application.
To the parent(s): You should come to the hearing of this application. If you
do not attend, the Court may proceed to hear and determine the application in
your absence.
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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FORM 37
Children and Young Persons Act 1989
(section 109)
APPLICATION TO REVOKE A GUARDIANSHIP TO
SECRETARY ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Details of the Order
On the application of (Full name)
Agency and address—
Phone—
the Children's Court at on made a
Guardianship to Secretary order.
Details of the application
This application is made on the grounds that—
*circumstances have changed since the making of the guardianship to
Secretary order and the applicant has asked the Secretary to the Department
of Human Services to review the case plan and the Secretary has either
refused to review the case plan or has reviewed it in a way which the
applicant finds unsatisfactory.
*the Secretary to the Department of Human Services makes a notification in
accordance with section 106(2) in respect of the order.
The Court *has/*has not granted any extensions of this guardianship to
Secretary order. [If so, gives dates and venue of the Court.]
Applicant's name—
Agency and address—
Phone—
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The applicant is *the child *a parent of the child *the Secretary to the
Department of Human Services.
Date— (Signature)
Details of the hearing
A hearing of this application will be held at am/pm on
at the Children's Court at
Issued at—
Date—
Registrar
*delete if not applicable
_______________
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2001
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FORM 38
Children and Young Persons Act 1989
(section 110)
INTERIM PROTECTION ORDER
Court Ref—
Name of Child— *Male/*Female
Date of Birth—
Address—
Applicant's name—
Agency and address—
Phone—
The Children's Court at on found
that—
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who
has custody of the child and the child to such an extent that the care and
control of the child are likely to be seriously disrupted.
Details of the order
The Court ordered that the child named in this order be placed on an interim
protection order.
The Secretary to the Department of Human Services is accountable to the
Court for the implementation of this order.
The responsibility for the supervision of the child is with:
The Court directs the preparation and submission to the Court of an
additional report by: (state person)
This order remains in force *for (period) *until (end date).
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The following conditions apply to this Interim Protection Order—
.....................................................................................................................
.....................................................................................................................
Details of the further hearing
.....................................................................................................................
.....................................................................................................................
A further hearing of this case will be held at am/pm on
at the Children's Court at
Date—
*Judge/*Magistrate
*delete if not applicable
═══════════════
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