Provincial Court (Family) Rules

.....................................................................[name]......................................................................................

Name .................................................................................. Date of birth ........................... (APPLICANT)

Address for service....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Name ....................................................................................Date of birth ...................... (RESPONDENT)

Address for service ....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

IMPORTANT NOTE TO RESPONDENT:

If this application contains a claim for maintenance, you are required to file financial information with your reply. If you do not, the court may attribute income to you and set the amount of maintenance to be paid. The applicant has estimated your gross annual income as set out in item3 below.

[ ] an order prohibiting the respondent from interfering with the child(ren) and/or ................................[name]...........................

[ ] an order restraining the respondent from harassing the child(ren) and/or ................................[name]...........................

[ ] other order (specify)

...............................................................................................................

Are there any court orders or written agreements between the parties concerning separation, custody, access or maintenance?

[ ] No orders [ ] I am attaching copies of all other orders

[ ] No written agreements [ ] I am attaching copies of all other written agreements

2 — Children (complete if you are asking for custody, access, or child maintenance or a restraining order)

My relationship to the child(ren) is .............................................................................

The respondent's relationship to the child(ren) is .........................................................

The present custody arrangements for the child(ren) are: ..................................................

......................................................................................................................................................................

(If applying for access) I am asking for access to the child(ren) as follows: ..................................................

......................................................................................................................................................................

3 — Maintenance (complete if you are asking for child or spousal maintenance)

......................................................................................................................................................................

I believe that the respondent's gross annual income is $................... because ..............................................

......................................................................................................................................................................

......................................................................................................................................................................

[ ] maintenance in the amount set out in the Child Support Table for ..........[number]......... children

[ ] special or extraordinary expenses, as follows:

....................................................................................................................................

....................................................................................................................................

If this application contains a claim for maintenance, you must complete Form 4, following the instructions on that form, if:

• there is a claim for child maintenance and one or more of the following applies:

• the claim is for an amount other than the amount set out in the tables of the Child Support Guidelines;

• the parents have split custody (that is, there are 2 or more children and each parent has sole custody of at least one child);

• the parents have shared custody (that is, each parent exercises access to or has physical custody of a child for not less than 40% of the time over the course of a year);

• one or more of the children for whom maintenance is claimed is of the age of majority (19 years in B.C.) or older;

• the person who is being asked to pay is not a biological or adoptive parent of the child but has acted as a parent to one or more of the children for whom maintenance is claimed.

You may also provide this financial information before receiving the respondent's reply, in order to avoid delay, if you believe that the income of a respondent from whom child maintenance is claimed is over $150 000 per year or that the respondent will claim undue hardship, special or extraordinary expenses or make a counterclaim for maintenance.

4 — Restraining Orders (complete if you are asking for a restraining order)

I am asking for an order prohibiting the respondent from interfering with or harassing the child(ren) and/or myself because .............................................................................................................................................

Note to respondent: If you fail to file a reply within 30 days of being served with this application you will not receive notice of any part of the proceeding and the court may make an order against you.

Dated ......[mmm/dd/yyyy]...... Signature ..................................................................

.........................................................................

Name of applicant's lawyer

.....................................................................[name]......................................................................................

IMPORTANT NOTE TO APPLICANT AND RESPONDENT:

If this claim involves an order for maintenance, you may be required to file financial information with your reply. If you do not, the court may attribute income to you and set the amount of maintenance to be paid.

[ ] I ask that the attached order¹ dated ......[mmm/dd/yyyy]...... be cancelled.

[ ] I ask that the attached order¹ dated ......[mmm/dd/yyyy]...... be changed to the following:

......................................................................................................................................................................

Since the order dated ......[mmm/dd/yyyy]...... was made, circumstances have changed as follows:

......................................................................................................................................................................

Notice to respondent:If you fail to file a reply within 30 days of being served with this application you will not receive notice of any part of the proceeding and the court may make an order against you.

Dated ......[mmm/dd/yyyy]...... Signature ..................................................................

.........................................................................

Name of applicant's lawyer

(*"Order" includes a written agreement filed under the Family Relations Act (section 121) )

.....................................................................[name]......................................................................................

Name ................................................................................................................................... (APPLICANT)

Address for service....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Name ............................................................................................................................... (RESPONDENT)

Address for service ....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

IMPORTANT NOTE TO APPLICANT:

If the respondent's reply includes a claim for maintenance and you, the original applicant, do not file the required financial information with your reply, the court may attribute income to you and set the amount of maintenance to be paid. The respondent has estimated your gross annual income as set out in item2 below.

[ ] other order (specify) ...................................................................................................

I wish to make the following comments regarding the request(s) even though I agree:

......................................................................................................................................................................

......................................................................................................................................................................

......................................................................................................................................................................

......................................................................................................................................................................

......................................................................................................................................................................

[ ] other order (specify) ...................................................................................................

I disagree because:

......................................................................................................................................................................

......................................................................................................................................................................

......................................................................................................................................................................

......................................................................................................................................................................

[ ] an order that arrears under the Family Relations Act be cancelled or reduced

[ ] other order (specify) ...................................................................................................

1 — Children(complete if you are asking for custody, access or child maintenance)

2 — Maintenance(complete if you are asking for child or spousal maintenance)

I believe that the applicant's gross annual income is $................... because..............................................

......................................................................................................................................................................

......................................................................................................................................................................

3 — Restraining Orders(complete if you are asking for a restraining order)

I am asking for an order prohibiting the applicant from interfering with or harassing the child(ren) and/or myself because .............................................................................................................................................

Dated ......[mmm/dd/yyyy]...... Signature ..................................................................

.........................................................................

Name of respondent's lawyer

.....................................................................[name]......................................................................................

I, ................................................................................[name].......................................................................,

Address for service....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

1 The information set out in this financial statement is true, to the best of my knowledge.

2 I have made complete disclosure in this financial statement of (check applicable boxes)

3 [ ] I do not anticipate any significant changes in the information set out in this financial statement.

[ ] I anticipate the following significant changes in the information set out in this financial statement: ............................................................................................................................................

..................................................................

A commissioner for taking affidavits

for British Columbia

"social assistance" includes assistance within the meaning of the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act;

(a) there is a claim, either by you or against you, for spousal or parental support, or

(b) there is a claim, either by you or against you, for child support and you are required by the Child Support Guidelines to provide income information.

[ ] employed as ................................... [describe occupation] ....................................................

by ....................................... [name and address of employer] ...................................................

[ ] self-employed ...................... [name and address of business] ................................................

[ ] other (specify) .........................................................................................................................

3 I have attached a copy of each of the applicable documents to my financial statement [check applicable boxes]

[ ] every personal income tax return I have filed for each of the three most recent taxation years, together with any attachments

[ ] every income tax notice of assessment or reassessment I have received for each of the three most recent taxation years

[ ] (if you are an employee) my most recent statement of earnings indicating the total earnings paid in the year to date, including overtime, or where such a statement is not provided by my employer, a letter from my employer setting out that information, including my rate of annual salary or remuneration

[ ] (if you are receiving Employment Insurance benefits) my three most recent EIC benefit statements

[ ] (if you are receiving Workers' Compensation benefits) my three most recent WCB benefit statements

[ ] (if you are receiving Social Assistance) a statement confirming the amount that I receive

(i) the financial statements of my business or professional practice, other than a partnership, and

(ii) a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or on behalf of, persons or corporations with whom I do not deal at arm's length

[ ] (if you are a partner in a partnership) confirmation of my income and draw from, and capital in, the partnership for its three most recent taxation years

(ii) a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or on behalf of, persons or corporations with whom the corporation and every related corporation does not deal at arm's length, and

[ ] (if you are a beneficiary under a trust) the trust settlement agreement and the trust's three most recent financial statements.

If line 150 (total income) of your most recent federal income tax return sets out what you expect your income to be for this year, skip to total income (line A) and record the amount from line150 on lineA. Otherwise, record what you expect your income for this year to be from each source of income that applies to you. Record gross annual amounts unless otherwise stated.

1	Employment income (include wages, salaries, commissions, bonuses, tips and overtime)	$___
2	Other employment income	+ $___
3	Pension income (include CPP, Old Age Security, disability, superannuation and other pensions)	+ $___
4	Employment insurance benefits	+ $___
5	Taxable dividends from Canadian corporations	+ $___
6	Interest and other investment income	+ $___
7	Net partnership income: limited or non-active partners only	+ $___
8	Rental income Gross $ ____Net	+ $___
9	Taxable capital gains	+ $___
10	Child support
	(a) Total amount for children from another relationship or marriage a. $___*
	(b) Total amount for children from this relationship or marriage b. $___*
	(c) Taxable amount for children from another relationship or marriage	c. + $___
	(d) Taxable amount for children from this relationship or marriage	d. + $___
11	Spousal support
	(a) From another relationship or marriage	a. + $___
	(b) From this relationship or marriage	b. + $___
12	Registered retirement savings plan income	+ $___
13	Other income (include any taxable income that is not included on lines 1 to 17)	+ $___
14	Net self-employment income (include business, professional, commission, fishing and farming income)	+ $___
15	Workers' compensation benefits	+ $___
16	Total social assistance payments	+ $___
17	Net federal supplements	+ $___
A	Total income:	A = $___

List all allowances and amounts received and all non-monetary benefits from all sources, that are not included in total income [lineA]. You do not have to include here any Child Tax Benefit or BC Family Bonus that you receive for your children.

Total benefits:

B = $..........

(a) there is a claim, either by you or against you, for spousal or parental support, or

(b) there is a claim, either by you or against you, for child support and you are required by the Child Support Guidelines to provide income information.

Deductions from Income:
1	Taxable amount of child support I receive		$___
2	Spousal support I receive from the other party		+ $___
3	Union and professional dues		+ $___
4	Other employment expenses (Refer toSchedule III of the Child Support Guidelines)		+ $___
5	Social assistance I receive for other members of my household and included in my total income.		+ $___
6	Dividends from taxable Canadian corporations
	(a) Taxable amount of dividends	a. $___
subtract (b) Actual amount of dividends		—b. $___
	Excess portion of dividends (a — b)	= $___	+ $___
7	Actual business investment losses during the year		+ $___
8	Carrying charges and interest expenses paid and deductible under the Income Tax Act (Canada)		+ $___
9	Prior period earnings
	(a) If net self-employment income included in total income includes an amount earned in a prior period, the amount earned in the prior period	a. $___
subtract (b) Reserves		—b. $___
	Prior period earnings (a — b)	= $___	+ $___
10	Portion of partnership and sole proprietorship income required to be reinvested		+ $___
C	Total deductions from income:		C= $___

1	Capital gains
	(a) Actual capital gains	a. $___
subtract(b) Actual capital losses		—b. $___
subtract(c) Taxable capital gains		—c. $___
	Total capital gains (a — b — c)	= $___	$___
(If amount is zero or less than zero, record "0" on this line)
2	Payments to family members and other non-arm's length persons
	(a) Salaries, benefits, wages or other payments to family members or other non-arm's length persons, deducted from self-employment income	a. $___
subtract(b) Portion of payments necessary to earn self-employment income		—b. $___
	Non arm's length payments (a—b)	= $___	+ $___
3	Allowable capital cost allowance for real property		+ $___
4	Employee stock options in Canadian-controlled private corporations exercised (If some or all of the shares are disposed of in the same year you exercise the option, do not include those shares in the calculation)
	(a) Value of shares when options are exercised		a. $___
subtract(b) Amount paid for shares		—b. $___
subtract(c) Amount paid to acquire option to purchase shares		—c. $___
	Value of employee stock options (a — b — c)	= $___	+ $___
D	Total additions to income:		D = $___
OTHER ADJUSTMENTS TO INCOME — Spousal or Parental Support Complete this section only if there is a claim, either by you or against you, for spousal or parental support.
1	Total child support I receive		$___
2	Social assistance I receive for other members of my household		+ $___
3	Child Tax Benefit		+ $___
4	BC Family Bonus		+ $___
E	Total other adjustments:		E = $___

Total income [from line A]		$___
subtract	Total deductions from income [from line C]	—$___
add	Total additions to income [from line D]	+ $___
Annual income to be used for a Child Support Table amount		= $___
add	Spousal support received from the other party (if any)	+ $___
subtract	Spousal support paid to the other party (if any)	—$___
Annual income to be used for a special or extraordinary expenses claim		= $___
Annual Income for a Spousal or Parental Support Claim
Total income [from line A]		$___
subtract	Total deductions from income [from line C]	—$___
add	Total additions to income [from line D]	+ $___
add	Total other adjustments [from line E]	+ $___
Annual income to be used for a spousal or parental support claim		= $___
Total Benefits [from line B]		$___

You do not have to complete Part 2 if the only support claimed is child support in the amount set out in the Child Support Tables and all children for whom support is claimed are under the age of majority (19 years in B.C.)

Compulsory deductions		Personal
CPP contributions	$___	Clothing	$___
Employment insurance premiums	$___	Hair care	$___
Income taxes	$___	Toiletries, cosmetics	$___
Employee pension contributions to a Registered Pension Plan	$___	Education (specify)	$___
	$___	Life insurance	$___
Other (specify)	$___	Dry cleaning/laundry	$___
Housing		Entertainment, recreation	$___
Rent or mortgage	$___	Alcohol, tobacco	$___
Property taxes	$___	Gifts	$___
Homeowner's/Tenant's insurance	$___	Other (specify)	$___
Water, sewer and garbage	$___	Children^a
Strata fees	$___	Child care	$___
House repairs and maintenance	$___	Clothing	$___
Other (specify)	$___	Hair care	$___
Utilities		School fees and supplies	$___
Heat	$___	Entertainment, recreation	$___
Electricity	$___	Activities, lessons	$___
Telephone	$___	Gifts	$___
Cable TV	$___	Insurance	$___
Other (specify)	$___	Other (specify)	$___
Household expenses		Savings for the future
Food	$___	RRSP	$___
Household supplies	$___	RESP	$___
Meals outside the home	$___	Other (specify)	$___
Furnishings and equipment	$___	Support payments to others
Other (specify)	$___	(specify)^b
Transportation
Public transit, taxis	$___
Gas and oil	$___	Debt payments
Car insurance and licence	$___	(specify)
Parking	$___
Repairs and maintenance	$___
Lease payments	$___
Other (specify)	$___	Other
Health^a		Charitable donations	$___
MSP premiums	$___	Vacation	$___
Extended health plan premiums	$___	Pet care	$___
Dental plan premiums	$___	Newspapers, publications	$___
Health care (net of coverage)	$___	Reserve for income tax	$___
Drugs (net of coverage)	$___
Dental care (net of coverage)	$___
Other (specify)	$___	F Total expenses	F = $___

You do not have to complete Part 3 if the only support claimed is child support in the amount set out in the Child Support Tables and all children for whom support is claimed are under the age of majority (19 years in B.C.).

Assets
Real estate equity......................................................	$___
Market value: $___
Mortgage balance: $___
Cars, boats, vehicles.................................................	+ $___
Make and year:........................................................
Market value: $___
Loan balance: $___
Pension plans............................................................	+ $___
Other property..........................................................	+ $___
Bank or other account (include RRSPs).....................	+ $___
Stocks and bonds......................................................	+ $___
Life insurance (cash surrender value).......................	+ $___
Money owing to me...................................................	+ $___
Name of debtor.........................................................
Other....................................... (attach list if necessary)	+ $___
G Asset value total.................................................	G = $___
Annual debt payments
Credit card..............................................................	$___
Balance owing: $___
Date of last payment:.................................................
Reason for borrowing:...............................................
Bank or finance company....................................... (do not include amount owing on mortgage)	+ $___
Balance owing: $___
Date of last payment:.................................................
Reason for borrowing:...............................................
Department store...................................................	+ $.........
Balance owing: $___
Date of last payment:.................................................
Reason for borrowing:...............................................
Other (attach list if necessary)	+ $.........
Balance owing: $___
Date of last payment:.................................................
Reason for borrowing:...............................................
H Debt payment total..........................................	H = $___

Complete if you claim special or extraordinary expenses as part of a child support claim.

Name of child:
Child care expenses	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......
Medical/dental insurance premiums attributable to child	$.......	$.......	$.......	$.......
Health related expenses (over $100)	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......
Extraordinary expenses for primary or secondary school	$.......	$.......	$.......	$.......
Post secondary education expenses	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......	Gross Net* $....... $.......
Extraordinary extracurricular expenses	$.......	$.......	$.......	$.......
Subtractcontributions from child	$.......	$.......	$.......	$.......
Total	$.......	$.......	$.......	$.......

*To calculate the net amount, subtract from the gross amount subsidies, benefits, income tax deductions

or credits related to the expense. Give details below.


Responsibility for unusually high debts reasonably incurred to support the family prior to separation or to earn a living:
Owed to:	Terms of debt:		Monthly amount $___ $___

Unusually high expenses for exercising access to a child:
Details of expense:			Monthly amount $___

Legal duty under a court order or separation agreement to support another person:
Name of person:	Relationship:	Nature of duty:	Monthly amount $___ $___

Legal duty to support a child, other than a child for whom support is claimed in this application, who is: (a) under the age of majority (19 years in B.C.), or (b) the age of majority or over but unable to support himself or herself because of illness, disability or other cause:
Name of person:	Relationship:	Nature of duty:	Monthly amount $___ $___

Legal duty to support a person who is unable to support himself or herself because of illness or disability:
Name of person:	Relationship:	Nature of duty:	Monthly amount $___ $___

Other undue hardship circumstances:
Details of other undue hardship circumstances:			Monthly amount $___

Complete this section if there is an undue hardship claim

Other person's name:		Annual income $___ $___ $___ $___

I swear or affirm that I, ......................[name]..........................., ..........................[occupation].................... of ................[address]......................... personally served ......................[name of person served]..................... on ......[mmm/dd/yyyy]...... at ...................................................[address].......................................................... with a copy of the following document(s): (Make sure a copy of each document is attached and marked with the correct exhibit letter.)

Exhibit "A": [name of document] ....................................................................................................................

Exhibit "B": [etc.] .......................................................................................................................................

.........................................................................

A commissioner for taking affidavits

for British Columbia

.....................................................................[name]......................................................................................

The applicant/respondent met with a family justice counsellor, as required under the Provincial Court (Family) Rules.

I, ........................................................................................................, [ ] applicant [ ] respondent

ask for a referral to a judge.

I [ ] met with a family justice counsellor but did not seek referral to any person, program or service

[ ] attended with a person designated by the Attorney General to provide specialized maintenance assistance

[ ] attended with a family justice counsellor for the purposes of pursuing dispute resolution

[ ] other (attach a separate sheet if necessary) ......................................................................................

The following issues have been resolved: .....................................................................................................

...................................................................................................................................................................

The following issues have yet to be resolved: ................................................................................................

....................................................................................................................................................................

.....................................................................[name]......................................................................................

Name ............................................................................................................................... (RESPONDENT)

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

............................................................ has applied for an order under the Family Relations Act or the Family Maintenance Enforcement Act. The application is attached.

[ ] failed to file a reply as required under the Provincial Court (Family) Rules, or

You must appear before a judge of the Provincial Court, to respond to the application, on .......[mmm/dd/yyyy]...... at ..........[time]..........a.m./p.m. at .....................................[court location].............

If you do not appear the Court may make an order in your absence or may issue a warrant for your arrest.

.....................................................................[name]......................................................................................

Name ........................................................................................................................................ (DEBTOR)

Address .................................................................................................................... City ...........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Because you have defaulted in payment under a maintenance order, ...............[name].............. has applied for an order under the Family Maintenance Enforcement Act.

You must appear before a Judge of the Provincial Court on .....................[mmm/dd/yyyy]...... at .....[time].....a.m./p.m. at ......................................[court location].................... to show cause why the maintenance order should not be enforced.

If you do not appear the Court may make an order in your absence or may issue a warrant for your arrest.

.....................................................................[name]......................................................................................

Because you the Debtor have not obeyed the Court's order as set out in the attached Statement, you are ordered to appear at a Court hearing to give reason why you should not be imprisoned for disobeying the Court's order.

You must attend the Provincial Court of British Columbia on ......[mmm/dd/yyyy]...... at .....[time].....a.m./p.m. at ....................[court location]....................

If you do not attend the committal hearing you may be arrested and brought to the Court.

.....................................................................[name]......................................................................................

This court orders you to arrest ......................................................[name]......................................................

.........................................................................[address]..............................................................................

and bring that person before a justice of the peace as soon as practicable.

The reason for the arrest is that the person did not attend this court at .................[court location]............. on ...................[date].................

[ ] other reason (specify): ................................................................................................

.....................................................................[name]......................................................................................

I promise to attend the Provincial Court at ....................................[court location]......................... on ......[mmm/dd/yyyy]...... at ..........[time]..........a.m./p.m.

My name, address, phone number and fax number as shown below on this release form are correct. I understand that, if I do not attend court on the above-stated date and time, the judge may issue a warrant for my arrest.

Name ............................................................................................................................................................

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Dated ......[mmm/dd/yyyy]...... at ...................................................., British Columbia

To: ...........................[name of party to be served or party's solicitor]............................... Fax No. .........................

From: .........................[name and fax number from which document was transmitted]..............................................

Name and telephone number of person to contact

in the event of transmission problems: ..........................................................................................................

List or provide a brief description of the document(s): ..................................................................................

......................................................................................................................................................................

This fax constitutes service to you under the Provincial Court (Family) Rules.

You will not be served in any other way.

.....................................................................[name]......................................................................................

I, .......................................[name]............................... wish to notify the court and the other parties that my address for service is now changed to:

Address ........................................................................................................................ City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

If a party's address for service changes, the party must promptly file in the registry a notice of change of address and serve a copy of the notice on the other parties.

...........................[name of applicant]......................... is applying to the Provincial Court for an order ......................................... [generaldescription of order(s) sought].................................................

The Court has ordered that the application [or name the other document to be served by advertisement] be served on you by way of this advertisement.

[option 1] file a reply form within 30 days (or other time period specified by the court) in the court registry at .....................[address of court].....................

[option 2] appear in court at .....................[address of court]..................... on .........[date and time application will be heard]..........

You may obtain forms or view documents in your case at the court registry at the above address. Refer to court file number .....[court file number]...... .

I swear or affirm that I, ......................[name]..........................., ..........................[occupation].................... of ...................[address].................................. served ..........................[name of person served]...................... on ......[mmm/dd/yyyy]...... at ...............................................[address]....................................................... with a copy of the following document(s): (Make sure a copy of each document is attached and marked with the correct exhibit letter.)

Exhibit "A": [name of document] ....................................................................................................................

Exhibit "B": [etc.] .......................................................................................................................................

.........................................................................

A commissioner for taking affidavits

for British Columbia

I certify that I, .....................[name]..........................., ............................[occupation].................... of ...................[address]...................................... served ...............[name of person served].............. on ......[mmm/dd/yyyy]...... at .....................................................[address].................................................... with a copy of:

(List each document served, and indicate whether a copy of the document is attached and marked as an exhibit or is on the back of this certificate of service. Make sure each attached document is marked with the correct exhibit letter.)

by leaving the copy with him or her personally. (Note: only a peace officer can use a certificate to prove personal service).

.....................................................................[name]......................................................................................

Name ....................................................................................................................................... (WITNESS)

Address ..................................................................................................... City ...........................................

Province ........................................... Postal Code ................................. Phone ...........................................

You have been subpoenaed as a witness by ......................................[name].................................... and must appear in court on ......[mmm/dd/yyyy]...... at ..........[time]..........a.m./p.m. at .................[court location]...................

......................................................................................................................................................................

If you believe that you are not needed as a witness or if it would be a hardship for you to attend court, you may apply to a judge at least 2 full days before the court date to cancel the subpoena.

[ ] The amount of $..................... is attached for use as travelling expenses to enable you to come to the court.

.....................................................................[name]......................................................................................

Name ............................................................................................................................................................

Address for service....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Name ............................................................................................................................................................

Address for service ....................................................................................................... City ........................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

I, ..........................[name of person making application]................, will apply to this court at ....................................[court location]................................... on ......[mmm/dd/yyyy]......at ..........[time]..........a.m./p.m. for:

[ ] Permission to file in the court registry at: ................................................................................

[ ] An order transferring this file to the court registry at: .............................................................

[ ] An interim order under section 9 of the Family Relations Act as set out below.

[ ] An order for blood or tissue samples for paternity tests to be taken from the person named below.

[ ] An order for service of .............................[name of document]............................... by a peace officer.

[ ] An order for access to information under section 40 or 100 of the Family Relations Act.

[ ] An order changing as set out below, or cancelling, the attached order made in my absence.

Details of order(s) requested: ........................................................................................................................

......................................................................................................................................................................

.........................................................................

Name lawyer of party bringing the motion

.....................................................................[name]......................................................................................

I, ..............................................[name]............................................, ....................[occupation]...................., of .......................................[address]............................................. swear or affirm that:

I know or believe the following facts to be true. If these facts are based on information from others, I believe that information to be true.

I make this affidavit in relation to an application* by ..............................[name]................................. for .......................................................................................................................................................

[ ] I am making the application* OR [ ] I am responding to the application*

OR I am ..............................................................................................................................................

.............................................................................................................................................................

.............................................................................................................................................................

.............................................................................................................................................................

.............................................................................................................................................................

.............................................................................................................................................................

.........................................................................

A commissioner for taking affidavits

for British Columbia

.....................................................................[name]......................................................................................

[ ] I direct that the parties attend before a judge to explain why this order should be made.

.....................................................................[name]......................................................................................

......................................................................................................................................................................

NOTE TO THE PARTIES: You may seek independent legal advice prior to signing this Consent.

.........................................................................		........................................................................
Applicant		Witness
Date ......[mmm/dd/yyyy]......		Date ......[mmm/dd/yyyy]......
........................................................................		........................................................................
Respondent		Witness
Date ......[mmm/dd/yyyy]......		Date ......[mmm/dd/yyyy]......

.....................................................................[name]......................................................................................

On the application of ...................................[name].....................................

[ ] after a hearing at .......................[Court location]..................... on ......[mmm/dd/yyyy]......

(For custody, access, guardianship and child maintenance orders, include the following):

Name(s) of child(ren)	Birthdate(s) of child(ren)
Name(s) of child(ren)	mmm	dd	yyyy

(if applicable) THIS COURT ORDERS THAT:

(specify terms of custody, access and guardianship orders).

The ..............[name].................... (payor) having been found to be a resident of ..............[province or country if outside Canada]................. and to have an annual income of $.................. [ ] (if applicable) as agreed to by the parties.

(if applicable) The ................[name]............ (recipient) having been found to be a resident of ..............[province or country if outside Canada].................) and to have an annual income of $.................... [ ] (if applicable) as agreed to by the parties.

(For child maintenance orders in the child support table amount include the following):

THIS COURT ORDERS THAT:

pursuant to the Family Relations Act and the .........[province]........ Child Support Table, ............[name]..................... (payor) must pay to .................[name].................. (recipient) the sum of $.................... per month for the support of the child(ren) ....................................[name(s) and birthdate(s) of child(ren)]............................., payable on the .............. day of each month, commencing ......[mmm/dd/yyyy]...... and continuing for so long as the child is a child as defined in the Family Relations Act.

(If applicable) THIS COURT ORDERS THAT:

(specify other terms of the order):

.....................................................................[name]......................................................................................

Name ................................................................................................................................... (APPLICANT)

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Name ............................................................................................................................... (RESPONDENT)

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

[ ] permission to have this application heard without giving notice to the other party.

[ ] that the following child(ren) be apprehended by a peace officer and brought to me. A certified copy of the order awarding me custody is attached:

Name(s) of child(ren)	Birthdate(s) of child(ren)			Current address (if known)
Name(s) of child(ren)	mmm	dd	yyyy
Name(s) of child(ren)

......................................................................................................................................................................

APPLICATION TO RECOGNIZE A CUSTODY OR ACCESS ORDER

MADE BY AN EXTRAPROVINCIAL TRIBUNAL

.....................................................................[name]......................................................................................

Name .............................................................................................................. (APPLICANT/CREDITOR)

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Name .............................................................................................................. (RESPONDENT/DEBTOR)

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

An order was made on ......[mmm/dd/yyyy]...... at ...............................[Court location].....................................

[ ] recognition of a custody order made outside British Columbia. A certified copy of the custody order is attached.

[ ] recognition of an access order made outside British Columbia. A certified copy of the access order is attached.

.....................................................................[name]......................................................................................

An order* was made on ......[mmm/dd/yyyy]...... at ...............................[court location]..................................... and [ ] a copy of the order is attached

[ ] requiring the debtor to provide a statement of finances or other prescribed document.

[ ] a summons requiring the debtor to provide a statement of finances or other prescribed document.

[ ] a summons requiring the debtor to attend a default hearing. An affidavit of arrears or statement of arrears is attached.

[ ] a summons requiring the attachee to attend a default hearing. An affidavit of arrears or statement of arrears is attached.

[ ] a summons requiring the debtor to attend a committal hearing. An affidavit of arrears or statement of arrears is attached.

[ ] a summons requiring the debtor to appear in court for failing to comply with the attached order to file a statement of income and expenses. A supporting affidavit is attached.

[ ] a summons requiring the debtor to appear in court for failing to comply with the attached order to file a statement of finances or other prescribed document. A supporting affidavit is attached.

[ ] a garnishing order. A completed garnishing order form and supporting affidavit are attached.

[ ] a warrant of execution against the debtor's goods. A completed warrant of execution form and supporting affidavit are attached.

[ ] a warrant for arrest of the debtor for failing to comply with the attached order to file a statement of finances, a statement of income and expenses (reporting order) or other prescribed document. A supporting affidavit is attached.

[ ] a warrant for the arrest of the debtor, who is about to leave British Columbia.

(*"Order" includes a written agreement filed under the Family Relations Act (section 121) )

.....................................................................[name]......................................................................................

I will apply to this Court at .....................................[court location]....................................... on ......[mmm/dd/yyyy]...... at ..........[time]..........a.m./p.m. for:

[ ] an order for access to information, as follows: .....................................................................................

[ ] an order requiring the debtor to file a statement of finances or prescribed documents.

[ ] an order requiring the debtor to pay an amount on failing to file a statement of finances or prescribed documents.

[ ] an order determining liability under a notice of attachment or determining a related issue.

[ ] an order discharging or postponing the registration of a maintenance order registered against land.

[ ] an order requiring .....................................[name].................................. to attend a default hearing or a committal hearing before the Court and to file with the Court, by a date specified by the Court, financial information, financial statements or other prescribed documents under section 39 of the Family Maintenance Enforcement Act.

[ ] a restraining order, under section 46 of the Family Maintenance Enforcement Act.

[ ] an order that a corporation is jointly and separately liable with the debtor for payments required under the maintenance order under section 14.2 (2) of the Family Maintenance Enforcement Act.

[ ] an order that the Director of Maintenance Enforcement direct the Insurance Corporation of British Columbia to disregard a notice not to issue or renew the driver's licence of a debtor under section 29.2 (2) of the Family Maintenance Enforcement Act.

[ ] another order, as follows: ......................................................................................................................

Notice to respondent: If you do not appear, the Court may make an order in your absence.

.....................................................................[name]......................................................................................

[ ] Interim Order [ ] Final Order [ ] By Consent [ ] Without notice to others (ex parte)

(if applicable) [ ] After a hearing at .............[court location].............. the order dated ......[mmm/dd/yyyy]...... is changed as stated below;

THIS COURT ORDERS THAT:

...............................[name(s) of party(s)]............................ .........[mmm/dd/yyyy]........ is prohibited from entering any premises occupied by ................[name of party].................... or other person

Name(s) of child(ren)	Birthdate(s) of child(ren)
Name(s) of child(ren)	mmm	dd	yyyy

or making contact with or interfering with any of them, until further order of this court.

THIS COURT FURTHER ORDERS THAT:

...............................[name(s) of party(s)]............................

[ ] pursuant to [ ] s. 37 (a) F.R.A. or [ ] s. 46 (a) F.M.E.A, is prohibited from molesting, annoying, harassing or communicating with either ..............................................[name of party]......................................... or the child(ren) named above, or attempting to molest, annoy, harass or communicate with any of them;

[ ] pursuant to s. 38 (1) (a) F.R.A., is prohibited from entering a premises where the child(ren) named above reside from time to time;

[ ] pursuant to s. 38 (1) (b) F.R.A., is prohibited from making contact or endeavoring to make contact with or otherwise interfering with either the child(ren) named above or .............................................[name of party]......................................... .

......................................................................................................................................................................

1	(a)	Any peace officer including any R.C.M.P. officer having jurisdiction in the Province of British Columbia who finds the party ..............................[name(s) of party(s)]............................ breaching any of the terms of this restraining order may immediately arrest that party without warrant pursuant to s. 495 (1) (b) of the Criminal Code, and may cause that person to be detained in custody, and to be taken before a justice to be dealt with according to law.
	(b)	Any peace officer including any R.C.M.P. officer having jurisdiction in the Province of British Columbia who on reasonable and probable grounds believes that the party ..............................[name(s) of party(s)]............................ has, in the past, breached any of the terms of this restraining order may arrest that party with a warrantobtained pursuant to s. 26 of the Offence Act, and may cause that person to be detained in custody, and to be taken before a justice to be dealt with according to law.

.....................................................................[name]......................................................................................

THIS MATTER coming on for hearing at .............[court location].............. on .....[mmm/dd/yyyy]......

[ ] Interim Order [ ] Final Order [ ] By Consent [ ] Without notice to others (ex parte)

.....................................................................[name]......................................................................................

We agree to the court file being transferred to the Provincial Court at ..........................[court location]............................

[ ] for the purpose of having an application for ...................................................... heard at that location, or

Dated .......[mmm/dd/yyyy]...... Signature of party......................................................

Address ..................................................................................................... City ...........................................

Province .................... Postal Code ................................. Phone ................................... Fax ........................

Dated ......[mmm/dd/yyyy]...... Signature of party......................................................

I, .................................................................................................................................................................., consent to the filing of the attached agreement in the Provincial Court of British Columbia and to the enforcement of all the provisions contained in the agreement for

.........................................................................

A commissioner for taking affidavits

for British Columbia

[en. B.C. Reg. 102/2001, s. 4; am. B.C. Regs. 159/2003, s. 6; 96/2006, s. 2; 270/2010, s. 2.]

Name .................................................................................. Tick one: [ ] Applicant [ ] Respondent

Address .................................................................................................................... City ...........................

Province .............. Postal Code ...................... Telephone .......................... Message Phone ........................

When am I not required to attend a Parenting after Separation (PAS) session?

In some situations, you are not required to attend a Parenting After Separation (PAS) session. This form describes those situations. Read through the form now. If you tick off any of boxes 1 to 5, file the Exemption Form with the court now. Note that more than one box may apply.

The requirement to attend a Parenting after Separation (PAS) session does not apply to me because:

Dated ......[mmm/dd/yyyy]...... ..................[Signature of person requesting exemption].....................

2	[ ]	A Consent Order under section 10 of the Family Relations Act is filed for this application. (In these cases the requirement does not apply to either the applicant or the respondent.)
3	[ ]	This application is for child support only and the person who has rights to child support receives assistance under the Employment and Assistance Act or the Employment and Assistance for Persons with Disabilities Act and has assigned those rights to the government. (In these cases the requirement does not apply to either the applicant or the respondent.)
4	[ ]	The Ministry for Children and Families is one of the parties. (The `Director' is defined by the Child, Family and Community Service Act.) (In these cases the requirement does not apply to either the applicant or the respondent.)
5	[ ]	This application is for a matter related to the Interjurisdictional Support Orders Act. (In these cases the requirement does not apply to either the applicant or the respondent.)

If you tick off any of boxes 6 to 8 below, your request for an exemption must be approved by the Program Administrator. You should hear from the Program Administrator within 5 working days of sending in this form. Be sure to fill out the contact information at the beginning of this form because the Program Administrator might need to contact you for more information about your request.

6	[ ]	There is no PAS session in my community. I live in: .................[Name of community].........................................
7	[ ]	I am not fluent in English. I am fluent in this (or these) language(s):
		..........................................................................................................................................................................
	Note that in some Lower Mainland communities, the Program Administrator may require parties to attend a PAS session which is offered in a language in which they are fluent.
8	[ ]	I am incapable of attending due to a serious health issue. Please explain: .............................................................
		.........................................................................................................................................................................
		........................................................................................................................................................................;

Dated ......[mmm/dd/yyyy]...... ..................[Signature of person requesting exemption]................................................

Remember, if you tick any one of boxes 6 to 8, you must have this form reviewed by the Program Administrator. Mail this Exemption Form to the PAS Program Administrator at ....................................... or fax this Exemption Form to the PAS Program Administrator at (....)............................................

The Program Administrator should contact you within 5 working days of receiving this form with a decision and will also file this form with the ................................. Provincial Court Registry.

Remember to include a telephone number where the Program Administrator can contact you to get more information about your request.

[ ]	......................................................................[Name of person applying for exemption for language].................... is required to attend a PAS session in .............................[Name of language]..........................................................
[ ]	approved - .............................................[Name of person applying for exemption].................... is exempted from the requirement to attend a PAS session.
[ ]	not approved - .................................................[Name of person applying for exemption].................... must attend a PAS session.

Dated ......[mmm/dd/yyyy]...... ..................[Signature of Program Administrator].....................

—	applying for a child custody, access, guardianship or child support order in the Abbotsford, Campbell River, Chilliwack, Courtenay, Kamloops, Kelowna, Nanaimo, New Westminster, North Vancouver, Penticton, Port Coquitlam, Prince George, Richmond, Surrey, Vancouver (Robson Square), Vernon or Victoria registry of the Provincial Court, or
—	applying to change an existing child custody, access, guardianship or child support order in these courts,

the court requires you to attend a Parenting after Separation (PAS) session before you appear in court.

Also, check the information in the package of court documents you receive to see what other steps you have to take if you wish to respond to an application.

In some situations you may not be required to attend a PAS session (be exempt). Look at the Exemption Form now to see if you are exempt. Sometimes one or both parties are automatically exempt. These situations are listed on the front page of the form. The reasons listed on the back page of the form apply only if you receive permission from the PAS Program Administrator to be exempt from attending.

If your situation is urgent, for example: you are concerned about your safety or the safety of your children, be sure to tell staff at the Provincial Court Registry or the Family Justice Centre or your lawyer. Other exemptions might apply to you.

A first court appearance cannot be set until one of the parties (applicant or respondent) files a Certificate of Attendance or shows that he or she did not have to attend. Both parties must file a certificate before they appear in court or show that they are exempt.

Canada: Province of British Columbia

Ministry of Attorney General

Court Services Branch

This form must be used when transmitting documents to the court registry by fax for filing.

This is a pilot project, not available at all Court locations, and is subject to limitations set out in Court Rules, Practice Directives and at the Court Services website at www.ag.gov.bc.ca/courts/fax/fax.htm.

It is the responsibility of the person transmitting a document to ensure that the document is filed in the registry within the required filing time. The registry takes no responsibility for difficulty experienced when transmitting a document by fax to the registry. The registry cannot guarantee that any document will be filed on the day it is received in the registry.

Documents transmitted to the registry will be processed in the order they are received. Confirmation of acceptance or refusal will be forwarded as soon as possible to you at the return fax number set out below or by mail if indicated.

To:		Fax numbers for transmitting documents to registries are available through the Court Services website at www.ag.gov.bc.ca/courts/fax/fax.htm or through Enquiry BC at 1-800-663-7867
	Court Location

	Fax Number
From:
	Name — Firm or Individual	Address

	Contact Name	City

	Phone Number	Province	Postal Code
This is the fax number your confirmation of acceptance or refusal will be set to unless you indicate otherwise. If you require it to be mailed to the address you have given please check the "return by mail" box.

		[ ] Return by mail
	Return Fax Number	[ ] Return by mail

Credit Card Account Number (Visa or MasterCard)

Expiry Date on Card

Name as it appears on the Card

OR (Note: BC Online is available only in the Prince George Registry)

BC Online Account Number:

Registry Use Only — Imprint —

Authorization number

Author

Attached:

Type of Document: (e.g. Notice of Motion, Notice of Claim, Reply)	No. of Pages in Document	Statutory Fee Amount




Total No. of Pages in Submission (Maximum 20 including the Cover Sheet)		$ Fee Total
Plus Confirmation Fee		$ 10.00
Total statutory fees due

File Number or Name (style of cause) e.g. - 013654 or "Steward vs. Parakeet"

Comments

Payment Information:

I authorize you to bill to my credit card or BC Online Account the total amount of the statutory fee for filing and the confirmation fee. I include the payment information for that purpose.

Authorizing Signature

Print Name

Registry Use Only

Registry Clerk Manager

Accounting Clerk

Court Services Branch may use your contact information for the purposes of

conducting an evaluation of the fax service.

[Provisions of the Court Rules Act, R.S.B.C. 1996, c. 80, relevant to the enactment of this regulation: section 1]

The party served was identified to me in this manner:		[ ] I know the person.
		[ ] He/She admitted to being this person.
		[ ] Other (specify) ................................................

The party was served in this manner:		[ ] Fax (attach a copy of Form 7)
		[ ] Mail
		[ ] By substituted service as ordered by the court

Persons appearing:	........................................................	Lawyer: .............................................................
	.........................................................	Lawyer: .............................................................

Consented to:
................................................................. Signature of party or lawyer
........................................................................ Signature of party or lawyer		................................................................................. by the Court

Persons appearing:	........................................................	Lawyer: .............................................................
Persons appearing:	........................................................	Lawyer: .............................................................

SWORN OR AFFIRMED BEFORE ME	)
at ..........[city etc.].........., British Columbia	)
on ......[mmm/dd/yyyy]......	)	.........................................................................


a	If you claim child support and special or extraordinary expenses, you must also complete Schedule 1.
b	List only the names of those for whom support is not claimed in this application. Indicate whether the payments are tax deductible to you and whether you make the payments under a court order or agreement.

Dated ....................[mmm/dd/yyyy]....................		.................................................................................
		Family justice counsellor

Dated ......[mmm/dd/yyyy]......		.................................................................................
		Signature of applicant/respondent

Dated ......[mmm/dd/yyyy]......		........................................................................................................................................................................
		By the Court or a clerk on behalf of ............................... [name of judge]..................................................

Dated ......[mmm/dd/yyyy]......		....................................................................................................................................................................................................
		by the Court or clerk on behalf of ................................... [name of judge]..............................................

.........................................................................		........................................................................
Signature of person being released		by the Court

Dated ......[mmm/dd/yyyy]......		.................................................................................
		Party [or party's solicitor]

SWORN OR AFFIRMED BEFORE ME	)
at ..........[city etc.].........., British Columbia	)
on ......[mmm/dd/yyyy]......	)	.........................................................................

Dated ......[mmm/dd/yyyy]......		.................................................................................
		Signature

BEFORE THE HONOURABLE JUDGE	)	.............day, the .............. day
	)	of ........................., ....[yyyy]....
	)

Dated ......[mmm/dd/yyyy]......		.................................................................................
		Signature of person issuing subpoena

Dated .......[mmm/dd/yyyy]......		.................................................................................
at ..............[city]..........., British Columbia		Name of requesting party

Dated ......[mmm/dd/yyyy]......		Signature ..................................................................
......................................................................... Applicant's lawyer		........................................................................ Respondent's lawyer

("Order" includes a written agreement filed under the Family Relations Act* (section 121) )

		Checked by
Dated ......[mmm/dd/yyyy]......	.................................................................. by the Court	................. Initials

1	[ ]	I attended PAS in the last 24 months at:
		.......................[Location]..................................... .................[Date (approximately)].................

—	in an application in the Abbotsford, Campbell River, Chilliwack, Courtenay, Kamloops, Kelowna, Nanaimo, New Westminster, North Vancouver, Penticton, Port Coquitlam, Prince George, Richmond, Surrey, Vancouver (Robson Square), Vernon or Victoria registry of the Provincial Court, and
—	you wish to appear in court to respond to this application,