Western Australian Consolidated Regulations Western Australian Consolidated RegulationsFORM 1 — HEADINGS
[Rule 5(2)(c)]
In the Family Court of Western Australia
No. of .
IN THE MATTER
OF............................................................................................
.................................................................................................................................
.................................................................................................................................
BETWEEN.............................................................................................................
.................................................................................................................................
.................................................................................................................................
[ Applicant/s/Appellant/s ]
AND........................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ Other parties to application/appeal ]
_______________
FORM 2 — NOTICE OF ADDRESS (OR CHANGE IN ADDRESS) FOR SERVICE
[Rule 6]
Notice of Address (or Change in Address) for Service
Name.......................................................................................................................
.................................................................................................................................
Name of lawyer and lawyer’s firm (if
applicable):.................................................
.................................................................................................................................
.................................................................................................................................
Address for
Service:................................................................................................
.................................................................................................................................
.................................................................................................................................
[ address must be within Western Australia ]
Telephone no: (
)................................................................................................
Fax no: (
)...........................................................................................................
DX
no:.....................................................................................................................
DATED this day
of .
.................................................................
SIGNATURE of
party or party’s lawyer
_______________
FORM 3 — APPLICATION (GENERAL)
[Rule 9]
Application
(other than for an adoption order)
I/We.........................................................................................................................
of.............................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name/s and address/es ]
apply under section of the Adoption Act 1994 for
the following order/s —
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
DATED this day of
.
....................................................................................
SIGNATURE of applicant/s or lawyer of applicant/s
TAKE NOTICE that if you wish to oppose this application you must file a notice
of address for service within 14 days of the day on which you received
this copy of the application.
_______________
FORM 4 — APPLICATION FOR ADOPTION ORDER
[Rule 11]
Application for an adoption order
I/We
........................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name, address and occupation of each prospective adoptive parent
]
apply to
adopt..........................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name by which prospective adoptee is known and the date and place
of birth of the prospective adoptee ]
a child from [ insert the name of the Convention country ], a Convention
country, who is to live in Western Australia. [ include if applicable ]
In the event that an adoption order is made, I/we apply for the Court to
declare that the adoptee be known by the
name..................................................................
................................................................................................................................
DATED this day of
.
...................................................
SIGNATURE/S of applicant/s
[* Note that if the application for the adoption order is in relation to a
child, a written memorandum of the provisions of the adoption plan in relation
to the child is to be filed with the application unless an application will be
made for the Court to dispense with the requirement for the adoption plan:
section 62 of the Act. ]
[Form 4 inserted in Gazette 21 Mar 2000 p. 1498.]
_______________
FORM 4A — APPLICATION FOR ADOPTION ORDER UNDER
SECTION 78A OF THE ADOPTION ACT 1994
[Rule 11A]
Application for an adoption order of child who is to live in a
Convention country
I/We
........................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name, address and occupation of each prospective adoptive parent
]
apply to
adopt..........................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name by which prospective adoptee is known and the sex and date
and place of birth of the prospective adoptee ]
an Australian child who is to live in [ insert the name of the Convention
country ], a Convention country.
In the event that an adoption order is made, I/we apply for the Court to
declare that the adoptee be known by the
name..................................................................
................................................................................................................................
DATED this day of
.
...................................................
SIGNATURE/S of applicant/s
[ Note that a written memorandum of the provisions of the adoption plan in
relation to the child is to be filed with the application unless an
application will be made for the Court to dispense with the requirement for
the adoption plan: section 62 of the Act. ]
[Form 4A inserted in Gazette 21 Mar 2000 p. 1498‑9.]
_______________
FORM 4B — APPLICATION FOR ORDER
[Rule 12A]
Application for an order terminating the legal relationship of child and
parent in relation to a simple adoption
I/We
........................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name, address and occupation of each applicant ]
apply, under section 136B of the Adoption Act 1994 , for an order
terminating the relationship between
........................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State the full names of the pre‑adoptive parents and any other names
by which either parent is, or was previously, known ]
and
..........................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State the full name, sex, and date and place of birth of the child ]
DATED this day of
.
...................................................
SIGNATURE/S of applicant/s
[Form 4B inserted in Gazette 21 Mar 2000 p. 1499; amended in
Gazette 17 Sep 2002 p. 4675.]
_______________
FORM 4C — APPLICATION FOR A DECLARATION
[Rule 12B]
Application for a declaration under section 136F of the
Adoption Act 1994
I...............................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State full name and address of the State Central Authority ]
, the State Central Authority, apply, under section 136F of the
Adoption Act 1994 , for a declaration by the Court that the adoption
of*/decision made in accordance with Article 27 of the Hague Convention in
relation to*[ whichever is applicable
]...........................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ State the full name, sex, date and place of birth of the child ]
is not recognised.
DATED this day of
.
...................................................
SIGNATURE/S of applicant/s
[Form 4C inserted in Gazette 21 Mar 2000 p. 1500.]
_______________
FORM 5 — NOTICE OF APPEAL
[Rule 16]
Notice of Appeal under section 114
TAKE notice that the appellant appeals against — [strike out
that which is inapplicable]
[ section 114(1) ] a decision of the Director‑General on the review
under Division 1 of Part 5 of the Act made
on [date] as follows —
[ section 114(2) ] a decision of the adoption applications committee made
on [date] as follows —
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ set out decision appealed from ]
The decision appealed from is the whole of OR part of the decision of the
Director General OR adoption applications committee . [strike out that which
is inapplicable]
The grounds on which this appeal is made are as follows —
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
[ Set out the grounds of the appeal briefly but with particularity ]
The appellant seeks the following orders —
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
DATED this day of
.
....................................................................................
SIGNATURE of appellant/s or lawyer of appellant/s
NOTICE OF DIRECTIONS HEARING
This appeal has been SET DOWN FOR A DIRECTIONS HEARING in the Family Court of
Western Australia at 150 Terrace Road, Perth in the State of Western Australia
on the.....................................day
of........................................ at
a.m./p.m.
.................................................
REGISTRAR
[Form 5 amended in Gazette 20 Jun 2003 p. 2236.]
_______________
FORM 6 — ACKNOWLEDGMENT OF SERVICE
[Rules 23(b)(ii) and 25(2)]
.................................................................................................................................
[ State full name of person served with documents ]
Date of
service:.......................................................................................................
Document/s
served:.................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
I acknowledge that the documents specified above were served on me on the date
specified above.
........................................................................................
[ Signature of person served ]
.........................................................................................
[ Date of signing ]
OR
I am the lawyer for the person served. On behalf of my client I acknowledge
that the documents specified above were served on my client on the date of
service specified above.
.........................................................................................
[ Signature of lawyer ]
.........................................................................................
[ Date of signing ]
.........................................................................................
[ Name of lawyer and name of firm (print) ]
.........................................................................................
.........................................................................................
[ Address ]
.........................................................................................
[ Telephone no. ]
.........................................................................................
[ Fax no. ]
.........................................................................................
[ DX no. ]
_______________
FORM 7 — WITNESS SUMMONS
[Rule 28(2)]
Summons to Witness
To:...........................................................................................................................
.................................................................................................................................
of.............................................................................................................................
.................................................................................................................................
You are hereby ordered to attend at this Court
at....................................a.m./p.m.
on __________________ the
__________________ day of ________________
at 150 Terrace Road, Perth in the
State of Western Australia and to attend from day to day unless excused by the
Court or a Registrar, until the hearing of the above‑mentioned matter is
completed, to —
(a) give evidence; or
(b) give evidence and produce any books, documents
or things in your possession or custody or under your control as are set out
below; or
(c) produce any books, documents or things in your
possession or custody or under your control as are set out below.
[Delete the inapplicable paragraphs]
The books, documents or things to be produced
are...............................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
If you fail or refuse to comply with this summons then —
(a) a warrant may issue for your arrest; and
(b) if you so fail without reasonable cause or
excuse you commit an offence punishable by a fine not exceeding $1 000.
DATED this day of
.
........................................................
REGISTRAR
[Form 8 deleted in Gazette 5 Dec 1995 p. 5587.]
[Schedule 1 amended in Gazette 5 Dec 1995 p. 5587;
21 Mar 2000 p. 1498‑1500; 17 Sep 2002
p. 4675; 20 Jun 2003 p. 2236.]