FORM 1
NORTHERN TERRITORY OF AUSTRALIA
Domestic & Family Violence Act
Section 30
Case No:
APPLICATION FOR DOMESTIC VIOLENCE ORDER
APPLICANT:
Name:
Address:
D.O.B:
DEFENDANT:
Name:
Address:
D.O.B:
DETAILS OF PERSON/PERSONS SOUGHT TO BE PROTECTED:
(name & address for service and date of birth)
BASIS OF APPLICATION
(see pamphlet 1 – How do I apply?)
DOMESTIC VIOLENCE ORDERS YOU WANT THE COURT TO MAKE: (please delete, amend or add orders as appropriate).
The defendant is restrained from:
(1Approaching, contacting or remaining in the company of the protected person/persons directly or indirectly;
2)approaching, contacting or remaining at any place where the protected person/persons may be living, working, staying, visiting or located.
(3)assaulting, threatening or attempting to assault the protected person/persons;
(4)damaging, threateningor attempting to damage the property of the protected person/persons;
(5)Intimidating, harassing or verbally abusing the protected person/persons;
(6)other
OR
(1)contacting or approaching or remaining in the company of the protected person/persons directly or indirectly except via or in the presence of a solicitor, family dispute resolution practitioner or Centacare worker for the purposes of making arrangements for the children and/or property of the parties or in accordance with a Parenting Plan and/or Family Law Order.
(2)approaching, entering or remaining at any place where the protected person/persons are living, working, staying, visiting or located except, via or in the presence of a solicitor, family dispute resolution practitioner or Centacare worker for the purposes of making arrangements for the children and/or property of the parties or in accordance with a Parenting Plan and/or Family Law Order.
(3)assaulting, threatening or attempting to assault the protected person/persons;
(4)damaging, threatening or attempting to damage the property of the protected person/persons;
(5)Intimidating, harassing or verbally abusing the protected person/persons;
(6)Other
ORDERS IN FORCE NOW:
(Eg, Family Court Orders)
Signature:……………………………………………………………………..
Date:……………………………………………………………………...
Place:……………………………………………………………………...
NOTICE TO PARTIES
An application has been made asking the Local Court to make a Domestic Violence Order against the defendant.
THE APPLICATION WILL BE DEALT WITH:
by the Local Court
at ...... ……… in the Northern Territory on ...... at ...... ……….... am./pm.* The defendant must attend the hearing at the court on the day set out above if he/she* wishes to defend the application. IF THE DEFENDANT DOES NOT ATTEND AT COURT, the Court may make the orders set out in the application or other similar orders in his/her* absence. A domestic violence order made in the Northern Territory may be registered and enforced, without notice to the defendant, in a State or another Territory of the Commonwealth or in New Zealand if there is a law in force in the relevant jurisdiction to provide for the registration and enforcement of the order.
Registrar
Date
Place
*Delete if inapplicable
EVIDENCE REQUIRED:
It is recommended that you file with the Court a Statutory Declaration or Affidavit setting out the facts and circumstances which establish a domestic relationship between the Defendant and the Protected person(s) and the basis for the application, what has happened to make this application necessary and what you expect in the future between the protected person and the Defendant.
NOTE: UPON THE HEARING OF AN APPLICATION ORAL EVIDENCE MAY ALSO BE REQUIRED.
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