Form 21.05AF. No. CSA

In the Family Court for the Province of Nova Scotia

BETWEEN:

(Children’s Aid Society/Family and Children’s Services of)

(Minister of Community Services)

- Applicant

- and -

- Respondent

Protection Application and Notice of Hearing

TAKE NOTICE that the Applicant makes application to the Family Court for the Province of Nova Scotia for a finding that the child(ren):

Full Name / Birth date / Sex

is (are) in need of protective services under the Children and Family Services Act, Section 22(2), paragraph(s) ______, which state(s):

AND TAKE NOTICE that an interim hearing will take place at the Family Court, located at ______, on ______the ____ day of ______, 19___ at the hour of ______in the_____ noon or so soon thereafter as the application can be heard for an order

(general nature of interim order requested)

AND TAKE NOTICE that in support of the application will be read the attached affidavit(s) and such other material as counsel may advise, a true copy of which will be delivered to you or your counsel before the interim hearing.

AT THIS INTERIM HEARING, the Court may make an order affecting the custody of the child(ren) noted above and, should you fail to appear, an order may be made in your absence without further notice to you. YOU HAVE THE RIGHT TO BE REPRESENTED BY COUNSEL ENGAGED BY YOU and, should you be unable to afford a lawyer, a lawyer is available through the local legal aid office.

AT THE HEARING at the time and place set out above, the Court is required to decide whether there are reasonable and probable grounds to believe that the child(ren) is (are) in need of protective services upon the basis of affidavits filed by any party, including you, but witnesses will not be heard by the Court unless leave of the Court is granted.

DATED at ______, Nova Scotia, this ____ day of ______, 19____.

Counsel for the
To:______