Notification of Breach of Prohibition Order

Form 42 (version 1)

IN THE CHILDREN’S COURT

OF NEW SOUTH WALES

AT

CASE NUMBER

Notification of breach of prohibition order

Section 90A(2) Children and Young Persons (Care and Protection) Act 1998

Date of application

Date filed

Notifier

Name Secretary, Department of Family and Community Services

Name of delegate

Address of Community
Service Caseworker

Position

Children or young persons

Child 1 / Child 2 / Child 3
Given name
Family name
Date of birth
Age [as at date of application]
Gender
KiDS number
[Community Services identifier]
Child 4 / Child 5 / Child 6
Given name
Family name
Date of birth
Age [as at date of application]
Gender
KiDS number
[Community Services identifier]

Parents/Carers

Mother 1 / Father 1 / Carer 1
Family name
Given name
Date of birth
Address
Mother 2 / Father 2 / Carer 2
Family name
Given name
Date of birth
Address

[NOTE: Include details of parents/carers whether or not a party to the prohibition order]

[NOTE: Include carer details where the carer is a guardian or otherwise providing care for the child under an arrangement with the parents. Do not include where the carer is an authorised carer arranged by Community Services or an NGO unless the carer is a member of the extended family or kinship group and consents to disclosure of their details]

Prohibition order details

[NOTE: Copy of prohibition order to be attached]

Name of person subject
to prohibition order

Address

Relationship to child or
young person

Date of prohibition order

Term of order

Breach details

[List the orders that are alleged to have been breached (for example: <party name> prohibited from contacting <child’s name>]

1. 

2. 

Grounds for notification

[How has the prohibition order been breached]

1. 

2. 

Orders sought

[What orders are sought if the breach is established]

1. 

2. 

Signature

Signature

Name

Capacity

Date

Notice of listing

This Children’s Court has received notification of an alleged breach of a prohibition order. The Court intends to consider the alleged breach before the:

Children’s Court

Date

Time

Signature of Registrar

[NOTE: The Notifier and Respondent are required to attend. A copy of this notice must be served on all parties to the original care proceedings. Unless the Court orders otherwise, other parties to the care proceedings are not required to attend unless and until the breach is established]

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