Copyright (c) Queen's Printer, Victoria, British Columbia, Canada | License Disclaimer |
B.C. Reg. 417/98 O.C. 1444/98 | Deposited November 25, 1998 effective December 1, 1998 |
[Last amended December 7, 2020 by B.C. Reg. 236/2020]
[am. B.C. Reg. 61/2019, s. 4.]
General Forms
[en. B.C. Reg. 132/2012, s. 27.]
APPLICATION TO OBTAIN AN ORDER
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name ............................................................................................... Date of birth ...........................
(APPLICANT)
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address for service.......................................................................................................
City .......................................... Province .................... Postal Code .................................
Phone ................................... Fax ........................E-mail ......................................................................
Notice to:
Name ............................................................................................... Date of birth ......................
(RESPONDENT)
Address for service .......................................................................................................
City ........................Province .................... Postal Code .................................
Phone ................................... Fax ........................
IMPORTANT NOTES TO RESPONDENT:
If this application contains a claim for support, 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 support to be paid. The applicant has estimated your gross annual income as set out in item 3 below.
If you fail to file a reply within 30 days after 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.
I am applying for:
[ ] guardianship
[ ] allocation of parental responsibilities
[ ] parenting time
[ ] contact with a child
[ ] child support
[ ] spousal support
[ ] a protection order
[ ] other order (specify)...............................................................................................................
1 — Orders and agreements
Are there any court orders or written agreements between the parties concerning separation, guardianship, parenting arrangements, contact with a child or support?
[ ] No orders | [ ] I am attaching copies of all orders |
[ ] No written agreements | [ ] I am attaching copies of all written agreements |
2 — Children
Name(s) of child(ren) | Birthdate(s) |
My relationship to the child(ren) is .............................................................................
The respondent's relationship to the child(ren) is .........................................................
The present arrangements for guardianship, parenting arrangements or contact with a child are: ........................................................................................................................................................................................................................
........................................................................................................................................................................................................................
(Complete the following if you are asking for guardianship, parenting arrangements or contact with a child.) I am asking for guardianship, parenting arrangements or contact with a child as follows: ........................................................................................................................................................................................................................
........................................................................................................................................................................................................................
3 — Support (Complete if you are asking for child or spousal support.)
The current support arrangements are:
......................................................................................................................................................................
I believe that the respondent's gross annual income is $................... because ..............................................
......................................................................................................................................................................
......................................................................................................................................................................
I am asking for: (Complete only if you are asking for child support.)
[ ] support in the amount set out in the Child Support Guidelines for ..........[number]......... children
[ ] special or extraordinary expenses, as follows:
....................................................................................................................................
....................................................................................................................................
I am asking for: (Complete only if you are asking for retroactive child support or retroactive spousal support.)
[ ] child support retroactive to ..........[mmm/dd/yyyy]......... because ..................................................
[ ] spousal support retroactive to ..........[mmm/dd/yyyy]......... because ..............................................
Information for Applicant and Respondent
You must complete Form 4, following the instructions on that form, if:
• there is a claim for spousal support,
OR
• there is a claim for child support and one or more of the following applies:
• you are the person being asked to pay;
• the claim is for an amount other than the amount set out in the tables of the Child Support Guidelines, including a claim under section 8, 9 or 10 of the Child Support Guidelines;
• there is a claim under section 7 [special or extraordinary expenses] of the Child Support Guidelines;
• one or more of the children for whom support is claimed is 19 years of age or older;
• the person who is being asked to pay is a stepparent, or a guardian who is not a parent, of one or more of the children for whom support 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 support 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 support.
4 — Protection Orders (Complete if you are asking for a protection order.)
I am asking for an order in the following terms:.............................................................................................................................................
Dated ..........[mmm/dd/yyyy]........... | Signature .................................................................. | |
................................................................................ | ||
Name of applicant's lawyer |
If the applicant in this proceeding is represented by a lawyer, the lawyer must complete the following certificate.
LAWYER'S CERTIFICATE (FAMILY LAW ACT, s. 8 (2))
I, ....................................., lawyer for .....................[name of party].............. certify that, in accordance with section 8 (2) of the Family Law Act, I have
(a) discussed with the party the advisability of using various types of family dispute resolution to resolve the matter, and
(b) informed the party of the facilities and other resources, known to me, that may be available to assist in resolving the dispute.
Dated ..........[mmm/dd/yyyy]........... | .................................................................................. | ||
Signature of lawyer | |||
...........................[type or print name].......................... |
[en. B.C. Reg. 132/2012, s. 27; am. B.C. Reg. 122/2014, s. 6.]
APPLICATION RESPECTING EXISTING ORDERS OR AGREEMENTS
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name .................................................................................. Date of birth ...........................
(APPLICANT)
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address for service.......................................................................................................
City .......................................... Province .................... Postal Code .................................
Phone ................................... Fax ........................E-mail ......................................................................
Notice to:
Name ....................................................................................Date of birth ......................
(RESPONDENT)
Address for service ....................................................................................................... City ........................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
and to:
[ ] Director of Maintenance Enforcement | [ ] Minister under the Employment and Assistance Act or the Employment and Assistance for Persons with Disabilities Act |
IMPORTANT NOTE:
If this claim involves an order for support, you may be required to file financial information. If you do not, the court may attribute income to you and set the amount of support to be paid.
IMPORTANT NOTE TO RESPONDENT: If you fail to file a reply within 30 days after 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.
[ ] I ask that the attached order dated ......[mmm/dd/yyyy]...... be changed to the following:....................
Or
[ ] I ask that the attached order dated ......[mmm/dd/yyyy]...... be suspended.
Or
[ ] I ask that the attached order dated ......[mmm/dd/yyyy]...... be terminated.
Or
[ ] I ask that arrears of support be reduced or cancelled as follows: ...........................................................
Or
[ ] I ask that the attached agreement dated ......[mmm/dd/yyyy]...... be set aside in whole or in part.
Or
[ ] I ask that the attached agreement dated ......[mmm/dd/yyyy]...... be replaced.
Or
[ ] I ask for an order under section 19 (2) of the Interjurisdictional Support Orders Act to set aside the registration of a foreign order under that Act.
Or
[ ] I ask for an order under section 35 of the Interjurisdictional Support Orders Act to vary a support order registered in British Columbia.
The reasons for my application are as follows:
..........................................................................................................................................................................................................................................................
..........................................................................................................................................................................................................................................................
Dated ..........[mmm/dd/yyyy]........... | Signature .................................................................. | |
................................................................................ | ||
Name of applicant's lawyer |
If the applicant in this proceeding is represented by a lawyer, the lawyer must complete the following certificate.
LAWYER'S CERTIFICATE (FAMILY LAW ACT, s. 8 (2))
I, ....................................., lawyer for .....................[name of party].............. certify that, in accordance with section 8 (2) of the Family Law Act, I have
(a) discussed with the party the advisability of using various types of family dispute resolution to resolve the matter, and
(b) informed the party of the facilities and other resources, known to me, that may be available to assist in resolving the dispute.
Dated ..........[mmm/dd/yyyy]........... | .................................................................................. | ||
Signature of lawyer | |||
...........................[type or print name].......................... |
[en. B.C. Reg. 132/2012, s. 27.]
REPLY
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To:
Name ...................................................................................................................................
(APPLICANT)
Address for service.......................................................................................................
City .......................................... Province .................... Postal Code .................................
Phone ................................... Fax ........................E-mail ......................................................................
From:
Name ...............................................................................................................................
(RESPONDENT)
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address for service.......................................................................................................
City .......................................... Province .................... Postal Code .................................
Phone ................................... Fax ........................E-mail ......................................................................
IMPORTANT NOTE TO APPLICANT:
If the respondent's reply includes a claim for support, you, the original applicant, are required to file financial information. If you do not, the court may attribute income to you and set the amount of support to be paid. The respondent has estimated your gross annual income as set out in item 2 below.
Agreement with application:
I agree with the request(s) of the applicant for:
[ ] guardianship
[ ] allocation of parental responsibilities
[ ] parenting time
[ ] contact with a child
[ ] child support
[ ] spousal support
[ ] a change in or suspension or termination of an earlier order dated .....[mmm/dd/yyyy].......
[ ] an order to set aside or replace an agreement dated .....[mmm/dd/yyyy].......
[ ] an order that arrears of support be reduced or cancelled
[ ] an order for retroactive support
[ ] a protection order
[ ] other order (specify) ...................................................................................................
I wish to make the following comments regarding the request(s) even though I agree:
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
Disagreement with application:
I disagree with the request(s) of the applicant for:
[ ] guardianship
[ ] allocation of parental responsibilities
[ ] parenting time
[ ] contact with a child
[ ] child support
[ ] spousal support
[ ] a change in or suspension or termination of an earlier order dated .....[mmm/dd/yyyy].......
[ ] an order to set aside or replace an agreement dated .....[mmm/dd/yyyy].......
[ ] an order that arrears of support be reduced or cancelled
[ ] an order for retroactive support
[ ] a protection order
[ ] other order (specify) ...................................................................................................
I disagree because:
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
Counterclaim (Respondent's own application)
I wish to make application for the following:
[ ] guardianship
[ ] allocation of parental responsibilities
[ ] parenting time
[ ] contact with a child
[ ] child support
[ ] spousal support
[ ] a change in or suspension or termination of an earlier order dated .....[mmm/dd/yyyy].......
[ ] an order to set aside or replace an agreement dated .....[mmm/dd/yyyy].......
[ ] an order that arrears of support be reduced or cancelled
[ ] an order for retroactive support
[ ] a protection order
[ ] other order (specify) ...................................................................................................
1 — Children
Name(s) of child(ren) | Birthdate(s) |
2 — Support (Complete if you are asking for child or spousal support.)
The current support arrangements are: ........................................................................................................ .....................................................................................................................................................................
I believe that the applicant's gross annual income is $................... because..............................................
......................................................................................................................................................................
......................................................................................................................................................................
I am asking for: (Complete only if you are asking for child support.)
[ ] support in the amount set out in the Child Support Guidelines for ....... [number]...... children
[ ] special or extraordinary expenses, as follows:
...................................................................................................................................................... ......................................................................................................................................................
I am asking for: (Complete only if you are asking for retroactive child support or retroactive spousal support.)
[ ] child support retroactive to ....... [mmm/dd/yyyy]...... because .......................................................
[ ] spousal support retroactive to ....... [mmm/dd/yyyy]...... because ...................................................
3 — Protection Orders (Complete if you are asking for a protection order.)
I am asking for an order in the following terms: .............................................................................................................................................
Dated ......[mmm/dd/yyyy]...... Signature ..................................................................
.........................................................................
Name of respondent's lawyer
If the respondent in this proceeding is represented by a lawyer, the lawyer must complete the following certificate.
LAWYER'S CERTIFICATE (FAMILY LAW ACT, s. 8 (2))
I, ....................................., lawyer for .....................[name of party].............. certify that, in accordance with section 8 (2) of the Family Law Act, I have
(a) discussed with the party the advisability of using various types of family dispute resolution to resolve the matter, and
(b) informed the party of the facilities and other resources, known to me, that may be available to assist in resolving the dispute.
Dated ..........[mmm/dd/yyyy]........... | .................................................................................. | ||
Signature of lawyer | |||
...........................[type or print name].......................... |
[am. B.C. Regs. 159/2003, s. 5; 132/2012, s. 28.]
FINANCIAL STATEMENT
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
I, ........................................[name]....................................................... ,
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address for service .......................................................................................................
City ........................Province .................... Postal Code .................................
Phone ................................... Fax ........................E-mail ....................................................
swear or affirm that:
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)
[ ] my income, including benefits and adjustments, if any, in Part 1,
[ ] my expenses, in Part 2,
[ ] my assets and debts, in Part 3.
3 [ ] I do not anticipate any significant changes in the information set out in this financial statement.
Or
[ ] I anticipate the following significant changes in the information set out in this financial statement: ............................................................................................................................................
SWORN OR AFFIRMED BEFORE ME | ) | |
at ..........[city etc.].........., British Columbia | ) | |
on ......[mmm/dd/yyyy]...... | ) | ......................................................................... |
..................................................................
A commissioner for taking affidavits
for British Columbia
For the purposes of this form:
"social assistance" includes assistance within the meaning of the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act;
"support" includes maintenance.
PART 1 INCOME
You must complete Part 1 if:
(a) there is a claim, either by you or against you, for spousal 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.
1 I am
[ ] employed as ................................... [describe occupation] ....................................................
by ....................................... [name and address of employer] ...................................................
[ ] self-employed ...................... [name and address of business] ................................................
[ ] unemployed since ......[mmm/dd/yyyy]......
2 I am paid
[ ] every 2 weeks [ ] twice a month [ ] monthly
[ ] 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
[ ] (if you are self-employed) for the three most recent taxation years
(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
[ ] (if you control a corporation) for its three most recent taxation years
(i) the financial statements of the corporation and its subsidiaries, 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 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.
ANNUAL INCOME
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 line 150 on line A. 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 = $___ |
(*do not add these items into the total at A)
TOTAL BENEFITS
List all allowances and amounts received and all non-monetary benefits from all sources, that are not included in total income [line A]. You do not have to include here any Child Tax Benefit or BC Family Bonus that you receive for your children.
B | Total benefits: | B = $.......... |
ADJUSTMENTS TO INCOME
You must complete this section if:
(a) there is a claim, either by you or against you, for spousal 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 to Schedule III of the Child Support Guidelines) Specify: | + $___ | |
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 = $___ |
Additions to Income:
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 Support Complete this section only if there is a claim, either by you or against you, for spousal 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 = $___ |
INCOME SUMMARY
Annual Income for a Child Support Claim
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 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 support claim | = $___ | |
Total Benefits [from line B] | $___ |
PART 2 EXPENSES
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.)
ANNUAL EXPENSES
Estimate your annual expenses:
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 | $___ | Childrena | ||
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 | ||
Healtha | 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 = $___ |
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. |
PART 3 ASSETS AND DEBTS
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 = $___ |
SCHEDULE 1 — SPECIAL OR EXTRAORDINARY EXPENSES
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. |
SCHEDULE 2 — UNDUE HARDSHIP
Complete if you plead undue hardship in respect of a child support claim.
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 parenting time or contact with 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: | |||
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 $___ |
SCHEDULE 3 — INCOME OF OTHER PERSONS IN HOUSEHOLD
Complete this section if there is an undue hardship claim | |||
Other person's name: | Annual income $___ $___ $___ $___ |
Form 5 (Rules 2 (5) and 9 (10) (b) )
AFFIDAVIT OF PERSONAL SERVICE
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
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.] .......................................................................................................................................
The party served was identified to me in this manner: | [ ] I know the person. | |
[ ] He/She admitted to being this person. | ||
[ ] Other (specify) ................................................ |
SWORN OR AFFIRMED BEFORE ME | ) | |
at ..........[city etc.].........., British Columbia | ) | |
on ......[mmm/dd/yyyy]...... | ) | ......................................................................... |
.........................................................................
A commissioner for taking affidavits
for British Columbia
[en. B.C. Reg. 219/2015, s. 4.]
AFFIDAVIT OF PERSONAL SERVICE OF PROTECTION ORDER
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
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 attached protection order made under Part 9 of the Family Law Act, marked as Exhibit "A".
The party served was identified to me in this manner: | [ ] I know the person. | |
[ ] He/She admitted to being this person. | ||
[ ] Other (specify) ................................................ |
SWORN OR AFFIRMED BEFORE ME | ) | |
at ..........[city etc.].........., British Columbia | ) | |
on ......[mmm/dd/yyyy]...... | ) | ......................................................................... |
.........................................................................
A commissioner for taking affidavits
for British Columbia
Form 6 (Rules 5 (5) and 6 (7) )
[am. B.C. Reg. 132/2012, ss. 6 and 29.]
REFERRAL REQUEST
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Confirmation of attendance with family justice counsellor
The applicant/respondent met with a family justice counsellor, as required under the Provincial Court (Family) Rules.
Dated ....................[mmm/dd/yyyy].................... | ................................................................................. | |
Family justice counsellor |
Statement of referral results by applicant/respondent
I, ........................................................................................................, [ ] applicant [ ] respondent
ask for a referral to a judge.
Complete the following:
I [ ] met with a family justice counsellor but did not seek referral to any person, program or service
[ ] enrolled in and completed a Parenting After Separation Program
[ ] attended with a person designated by the Attorney General to provide specialized support assistance
[ ] attended with a family justice counsellor for the purposes of pursuing dispute resolution
[ ] attended with a family dispute resolution professional
[ ] other (attach a separate sheet if necessary) ......................................................................................
The following issues have been resolved: .....................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
The following issues have yet to be resolved: ................................................................................................
....................................................................................................................................................................
....................................................................................................................................................................
Dated ......[mmm/dd/yyyy]...... | ................................................................................. | |
Signature of applicant/respondent |
Form 7 (Rules 6 (4) (e) and (10) (f) and 17 (5) )
[am. B.C. Reg. 132/2012, s. 30.]
SUMMONS
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To:
Name ............................................................................................................................... (RESPONDENT)
Address ..................................................................................................... City ...........................................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
............................................................ has applied for an order under the Family Law Act or the Family Maintenance Enforcement Act. The application is attached.
You have:
[ ] failed to file a reply as required under the Provincial Court (Family) Rules, or
[ ] failed to appear in court as directed by a judge.
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.
Dated ......[mmm/dd/yyyy]...... | ........................................................................................................................................................................ | ||||
By the Court or a clerk on behalf of ............................... [name of judge].................................................. | |||||
[en. B.C. Reg. 103/2001, s. 3; am. B.C. Reg. 132/2012, s. 6.]
SUMMONS TO A DEFAULT HEARING
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To:
Name ........................................................................................................................................ (DEBTOR)
Address .................................................................................................................... City ...........................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
Because you have defaulted in payment under a support order, ...............[name].............. has applied for an order under the Family Maintenance Enforcement Act.
A statement of arrears is attached.
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 support 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.
Dated ......[mmm/dd/yyyy]...... .................... | ..... ................................................................................. Judge or Justice of the Peace in and for the Province of British Columbia |
[en. B.C. Reg. 103/2001, s. 3.]
SUMMONS TO A COMMITTAL HEARING
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To:
Name ........................................................................................................................................ (DEBTOR)
Address .................................................................................................................... City ...........................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
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.
Dated ......[mmm/dd/yyyy]...... ................ | ..... ................................................................................. Judge or Justice of the Peace in and for the Province of British Columbia |
Form 8 (Rules 6 (10) (g) and (15) (a), 10 (6) and 17 (6) )
[am. B.C. Regs. 132/2012, s. 31; 219/2015, s. 5.]
WARRANT FOR ARREST
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To all police officers in British Columbia:
This court orders you to arrest ......................................................[name]......................................................
.........................................................................[address]..............................................................................
and bring that person before a justice/judge as soon as practicable.
The reason for the arrest is that the person did not attend this court at .................[court location]............. on ...................[date].................
[ ] as required by a summons served on the person
[ ] as ordered by the Court in the presence of the person
[ ] as specified on a release
[ ] as required by a subpoena
[ ] other reason (specify): ................................................................................................
Dated ......[mmm/dd/yyyy]...... | .................................................................................................................................................................................................... | |
by the Court or clerk on behalf of ................................... [name of justice/judge].............................................. | ||
Form 9 (Rules 6 (13) and 10 (9) (a) )
RELEASE
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[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 ........................
......................................................................... | ........................................................................ | |
Signature of person being released | by the Court |
Dated ......[mmm/dd/yyyy]...... at ...................................................., British Columbia
Form 10 (Rule 9 (1) (a) (iii) )
FAX COVER PAGE
Court File No. ..............................
Court Location ..............................
In the Provincial Court of 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): ..................................................................................
......................................................................................................................................................................
Date faxed: ......[mmm/dd/yyyy]......
This fax constitutes service to you under the Provincial Court (Family) Rules.
You will not be served in any other way.
[am. B.C. Reg. 132/2012, s. 32.]
NOTICE OF CHANGE OF ADDRESS
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
I, .......................................[name]....................................................... wish to notify the court and the other parties that my address for service is now changed to:
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address .......................................................................................................
City .......................................... Province ................ Postal Code ........................
Phone ........................... Fax ........................ E-mail ......................................................................
The change is effective as of ......[mmm/dd/yyyy]......
Dated ......[mmm/dd/yyyy]...... | ................................................................................. | |
Party [or party's solicitor] |
Provincial Court (Family) Rule 9 (5) provides that:
If a party's address for service changes, the party must promptly file a notice of change of address in Form 11 and serve a copy of the notice on the other parties.
NOTICE BY ADVERTISEMENT
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
To ................[name of person to be served]................:
...........................[name of applicant]......................... is applying to the Provincial Court for an order ......................................... [general description 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.
To respond to the application you must:
[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]..........
If you do not respond, the Court may make an order in your absence.
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]...... .
[am. B.C. Reg. 132/2012, s. 33.]
AFFIDAVIT OF SERVICE
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
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.] .......................................................................................................................................
The party was served in this manner: | [ ] Fax (attach a copy of Form 10) | |
[ ] By substituted service as ordered by the court |
SWORN OR AFFIRMED BEFORE ME | ) | |
at ..........[city etc.].........., British Columbia | ) | |
on ......[mmm/dd/yyyy]...... | ) | ......................................................................... |
.........................................................................
A commissioner for taking affidavits
for British Columbia
CERTIFICATE OF SERVICE
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).
Dated ......[mmm/dd/yyyy]...... | ................................................................................. | |
Signature |
SUBPOENA
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To:
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]...................
You must bring the following records and other things to court:
......................................................................................................................................................................
......................................................................................................................................................................
What happens if you do not attend?
A judge may issue a warrant for your arrest.
Can the subpoena be cancelled?
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.
[ ] Money for travelling expenses was offered but declined.
Dated ......[mmm/dd/yyyy]...... | ................................................................................. | |
Signature of person issuing subpoena |
[en. B.C. Reg. 132/2012, s. 34.]
NOTICE OF MOTION
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name ............................................................................................................................................................
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address for service ........................................................................................................
City ...................................... Province .................... Postal Code .................................
Phone ................................... Fax ............................ E-mail .........................................
Notice to:
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:
[ ] An order shortening or extending a time limit set out in the Provincial Court (Family) Rules
[ ] An interim order under section 216 or 217 of the Family Law Act
[ ] An order changing, suspending or terminating the attached order made in my absence
[ ] An order settling the terms of an order made ......[mmm/dd/yyyy].............
[ ] An order that a person not remove, or that a person be allowed to remove, a child from a geographical area
[ ] An order to prohibit the relocation of a child
[ ] An order for blood or tissue samples, for parentage tests, to be taken from .... [name(s)].............
[ ] An order for service of .................[identify document(s)].................. by ....[method of service]...........
[ ] An order for access to information under section 242 of the Family Law Act
[ ] An order for information to be disclosed by .....................[name]................
[ ] An order transferring this file to the court registry at: ..................................................................
[ ] Directions on a procedural matter
[ ] An order changing or setting aside the determination of a parenting coordinator dated .......[mmm/dd/yyyy]...............
[ ] An order to enforce
[ ] the order made .......[mmm/dd/yyyy]...........................
[ ] the agreement dated .......[mmm/dd/yyyy]...................
[ ] compliance with the determination of a parenting coordinator dated .....[mmm/dd/yyyy]......
[ ] A review of a filed agreement or order respecting spousal support or maintenance under the Family Law Act or the Family Relations Act
[ ] An order determining whether there are arrears owing under a support order made under the Family Law Act or under a support or maintenance order made under the Family Relations Act and, if so, the amount of those arrears
[ ] Other order (specify) .....................................................................................................................
Details of order(s) requested:
......................................................................................................................................................................
......................................................................................................................................................................
NOTICE: If you do not appear, the Court may make an order in your absence.
[ ] Any affidavits in support of this notice of motion are attached.
Dated ......[mmm/dd/yyyy]...... | Signature .................................................................. |
.........................................................................
Name of lawyer of party bringing the motion
AFFIDAVIT
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[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 ..............................................................................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
SWORN OR AFFIRMED BEFORE ME | ) | |
at ..........[city etc.].........., British Columbia | ) | |
on ......[mmm/dd/yyyy]...... | ) | ......................................................................... |
.........................................................................
A commissioner for taking affidavits
for British Columbia
(*"Application" also includes a notice of motion.)
[am. B.C. Reg. 132/2012, s. 35.]
REQUEST
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Required:
[ ] Desk Consent Order — Draft order and supporting material attached
Dated .......[mmm/dd/yyyy]...... | ................................................................................. | |
at ..............[city]..........., British Columbia | Name of requesting party |
FOR THE USE OF THE COURT:
[ ] I direct that the parties attend before a judge to explain why this order should be made.
Dated ......[mmm/dd/yyyy]...... | ................................................................................. | |
by the Court |
Form 19 (Rules 4 (3) and 14 (1.1) (b) )
[am. B.C. Reg. 132/2012, s. 36.]
CONSENT
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
To a judge of the Provincial Court of British Columbia:
WE AGREE as follows:
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
WE CONSENT to an order as follows:
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
NOTE TO THE PARTIES: You may seek independent legal advice prior to signing this Consent.
Approved and consented to:
......................................................................... | ........................................................................ | |
Applicant | Witness | |
Date ......[mmm/dd/yyyy]...... | Date ......[mmm/dd/yyyy]...... | |
........................................................................ | ........................................................................ | |
Respondent | Witness | |
Date ......[mmm/dd/yyyy]...... | Date ......[mmm/dd/yyyy]...... |
[am. B.C. Regs. 132/2012, s. 37; 122/2014, s. 7.]
CONSENT ORDER
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
BEFORE THE HONOURABLE JUDGE | ) | .............day, the .............. day |
) | of ........................., ....[yyyy].... | |
) |
On the application of ...................................[name].....................................
[ ] without a hearing
[ ] after a hearing at .......................[Court location]..................... on ......[mmm/dd/yyyy]......
Persons appearing: | ........................................................ | Lawyer: ............................................................. |
......................................................... | Lawyer: ............................................................. |
(For guardianship, parenting arrangements, contact with a child and child support orders, include the following):
On the court being advised that the name and birthdate of each child is:
Name(s) of child(ren) | Birthdate(s) of child(ren) | ||
mmm | dd | yyyy | |
(if applicable) On the court also being advised that ................................[name].................................... and ...........................[name].................................. is/are guardian(s) of the child/children named above/ ..................[name(s) of child/children and date(s) of birth if this list is different than the list above]...................... .
(if applicable) THIS COURT ORDERS THAT:
(specify terms of orders for guardianship, parenting arrangements or contact with a child).
(For child support orders, include the following):
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 support orders in the child support table amount include the following):
THIS COURT ORDERS THAT:
pursuant to the Family Law 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 Law Act.
(For child support orders in other amounts)
(If applicable) THIS COURT ORDERS THAT:
(specify other terms of the order):
Consented to: | ||
................................................................. Signature of party or lawyer | ||
........................................................................ Signature of party or lawyer | ................................................................................. by the Court | |
Repealed. [B.C. Reg. 132/2012, s. 38.]
[en. B.C. Reg. 132/2012, s. 39.]
APPLICATION TO RECOGNIZE AN EXTRAPROVINCIAL ORDER FOR
GUARDIANSHIP, PARENTING ARRANGEMENTS OR CONTACT
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name ..............................................................................................................
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address .....................................................................................................
City ........................................... Province .................... Postal Code .................................
Phone ........................................ Fax ............................ E-mail ..................................................................
Notice to:
Name .........................................................................................................
Address .......................................................................................................
City ........................................... Province .................... Postal Code .................................
Phone ................................... Fax ........................
I am asking for recognition of an order of an extraprovincial tribunal made on ......[mmm/dd/yyyy]...... at ...............................[court location]..................................... respecting guardianship, parenting arrangements or contact with a child or an order that is similar in nature.
A certified copy of the order is attached.
Dated ......[mmm/dd/yyyy]...... | Signature .................................................................. | |
......................................................................... Applicant's lawyer |
[am. B.C. Reg. 132/2012, ss. 6 and 40.]
REQUEST FOR COURT ENFORCEMENT
UNDER THE FAMILY MAINTENANCE ENFORCEMENT ACT
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name .............................................................................................................. (APPLICANT/CREDITOR)
Address ..................................................................................................... City ...........................................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
Notice to:
Name .............................................................................................................. (RESPONDENT/DEBTOR)
Address ..................................................................................................... City ...........................................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
An order* was made on ......[mmm/dd/yyyy]...... at ...............................[court location]..................................... and [ ] a copy of the order is attached
[ ] requiring the debtor to pay support
[ ] requiring the attachee to comply with attachment order/notice of attachment
[ ] requiring the debtor to pay arrears
[ ] requiring the debtor to report by filing a statement of income and expenses
[ ] requiring the debtor to provide a statement of finances or other prescribed document.
In connection with this order, I request:
[ ] 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.
Dated ......[mmm/dd/yyyy]...... | Signature .................................................................. | |
......................................................................... Creditor/Creditor's lawyer |
(*"Order" includes a filed agreement.)
[am. B.C. Reg. 132/2012, ss. 6 and 41.]
NOTICE OF MOTION IN MAINTENANCE ENFORCEMENT PROCEEDINGS
Court File No. ..............................
Court Location ..............................
F.M.E.P. File No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
Filed by:
Name ................................................................................................................................... (APPLICANT)
Address for service....................................................................................................... City ........................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
Notice to:
Name ............................................................................................................................... (RESPONDENT)
Address for service ....................................................................................................... City ........................
Province .................... Postal Code ................................. Phone ................................... Fax ........................
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 extending the time for filing a statement of finances.
[ ] 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 for payment by an attachee.
[ ] an order determining liability under a notice of attachment or determining a related issue.
[ ] an order changing the attached order dated ......[mmm/dd/yyyy]...... .
[ ] an order changing the amount exempt from attachment.
[ ] an order setting aside an attachment order or notice of attachment.
[ ] an order discharging or postponing the registration of a support 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 support order under section 14.2 (2) of the Family Maintenance Enforcement Act.
[ ] an order under section 29.2 (2) of the Family Maintenance Enforcement Act 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 or a notice not to issue or renew the licence and corresponding number plates for any motor vehicle or trailer owned by a debtor.
[ ] another order (specify) ................................................................................................................
NOTICE: If you do not appear, the Court may make an order in your absence.
[ ] Any affidavits in support of this notice of motion are attached.
Dated ......[mmm/dd/yyyy]...... | Signature .................................................................. | |
......................................................................... Party/Party's lawyer |
[en. B.C. Reg. 132/2012, s. 42.]
PROTECTION ORDER
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
BEFORE THE HONOURABLE JUDGE | ) | .............day, the .............. day |
) | of ........................., ....[yyyy].... | |
) |
Persons appearing: | ........................................................ | Lawyer: ............................................................. |
........................................................ | Lawyer: ............................................................. |
[ ] By Consent [ ] Without notice to others
(if applicable) [ ] After a hearing at .............[court location].............. the order dated ......[mmm/dd/yyyy]...... is changed as stated below:
(Select one or more of the 10 following provisions, as applicable, complete the selected provision(s) and remove the provisions(s) that is/are not selected so that it/they do(es) not appear in the draft order when submitted for filing.)
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]............................... is restrained from directly or indirectly communicating with or contacting.........................[set out full name(s) of protected person(s)]..................................................
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]...... is restrained from attending at, nearing or entering .........................[set out place(s) where person is not to attend]................................................. .
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]...... is restrained from following.........................[set out full name(s) of protected person(s)]................................................. .
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]...... is restrained from possessing a weapon or firearm.
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]...... must not communicate with .........................[set out full name(s) of protected person(s)]............. other than as follows: .................[specify]................... .
THIS COURT ORDERS, under section 183 of the Family Law Act, that........[full name and date of birth of person restrained]...... must report to the court [or to ...............[specify person(s)]................] as follows: .................... [specify].................. .
THIS COURT ORDERS that any police officer, including any R.C.M.P. officer having jurisdiction in the province of British Columbia, who is provided with a copy of this order is directed to remove ........[full name and date of birth of person restrained]...... from ...............[location]..................... immediately [or within a specified period of time].
THIS COURT ORDERS that any police officer, including any R.C.M.P. officer having jurisdiction in the province of British Columbia, who is provided with a copy of this order is directed to accompany ........[full name and date of birth of person]...... to ................[location]..................... as soon as practicable [or within a specified period of time] to supervise the removal of his/her personal belongings.
THIS COURT ORDERS that any police officer, including any R.C.M.P. officer having jurisdiction in the province of British Columbia, who is provided with a copy of this order is directed to seize from ........[full name and date of birth of person from whom seizure is to be made]...... any weapons or firearms and related documents.
THIS COURT ORDERS that this order expires on ........[mmm/dd/yyyy].......... .
(Add any further terms of protection order.)
Checked by | ||
Dated ......[mmm/dd/yyyy]...... | .................................................................. by the Court | ................. Initials |
DISOBEYING THIS ORDER IS A CRIMINAL OFFENCE UNDER SECTION 127 OF THE
CRIMINAL CODE PUNISHABLE BY FINE OR IMPRISONMENT
TAKE NOTICE THAT any police officer, including any R.C.M.P. officer having jurisdiction in the province of British Columbia, having reasonable and probable grounds to believe that the person against whom this order is made has contravened a term of this order may take action to enforce the order, whether or not there is proof that the order has been served on the person and, if necessary, may use reasonable force. Enforcement action may include arresting the person against whom this order is made without warrant in accordance with section 495 of the Criminal Code.
AND TAKE NOTICE THAT if no expiry date is ordered in relation to this order, this order expires one year after the date it is made.
Form 25.1 (Rule 18 (2.1) (b) )
[en. B.C. Reg. 132/2012, s. 43.]
RESTRAINING ORDER UNDER FAMILY MAINTENANCE ENFORCEMENT ACT
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
BEFORE THE HONOURABLE JUDGE | ) | .............day, the .............. day |
) | of ........................., ....[yyyy].... | |
) |
Persons appearing: | ........................................................ | Lawyer: ............................................................. |
........................................................ | Lawyer: ............................................................. |
[ ] By Consent [ ] Without notice to others
THIS COURT ORDERS THAT:
pursuant to section 46 (1) (a) of the Family Maintenance Enforcement Act, ................[name(s) of party(ies)]....... is restrained from molesting, annoying, harassing or communicating with, or attempting to molest, annoy, harass or communicate with, .................................[name(s)].................................;
Further details of restraining order:
...................................................................................................................................................................... ...................................................................................................................................................................... ......................................................................................................................................................................
(Complete if applicable.) [ ] Order to expire on.............[mmm/dd/yyyy]..............
Checked by | ||
Dated ......[mmm/dd/yyyy]...... | .................................................................. by the Court | ................. Initials |
TAKE NOTICE THAT any police officer, including any R.C.M.P. officer having jurisdiction in the province of British Columbia, who finds the party ..............[name(s) of party(ies)]..................................... breaching any of the terms of this restraining order may immediately arrest that party without warrant in accordance with section 495 of the Criminal Code.
[am. B.C. Reg. 132/2012, s. 44.]
ORDER
Court File No. ..............................
Court Location ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
BEFORE THE HONOURABLE JUDGE | ) | .............day, the .............. day |
) | of ........................., ....[yyyy].... | |
) |
THIS MATTER coming on for hearing at .............[court location].............. on .....[mmm/dd/yyyy]......
Persons appearing: | ........................................................ | Lawyer: ............................................................. |
........................................................ | Lawyer: ............................................................. |
[ ] Interim Order [ ] Final Order [ ] By Consent [ ] Without notice to others
THIS COURT ORDERS:
THIS COURT FURTHER ORDERS:
Approved (if applicable)
................................................................. Lawyer's signature | ||
........................................................................ Lawyer's signature | ................................................................................. by the Court |
[am. B.C. Reg. 132/2012, s. 45.]
TRANSFER CONSENT
Court File No. ..............................
Court Location ..............................
F.M.E.P. File No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[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
[ ] for all purposes.
Dated .......[mmm/dd/yyyy]...... Signature of party......................................................
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address .....................................................................................................
City ...........................................Province .................... Postal Code .................................
Phone ................................... Fax ........................ E-mail ............................................................................
Dated .......[mmm/dd/yyyy]...... Signature of party......................................................
(Set out the street address of the address for service. One or both of a fax number and an e-mail address may be given as additional addresses for service.)
Address .....................................................................................................
City ...........................................Province .................... Postal Code .................................
Phone ................................... Fax ........................ E-mail ............................................................................
Repealed. [B.C. Reg. 132/2012, s. 46.]
(not enacted)
[en. B.C. Reg. 102/2001, s. 4; am. B.C. Regs. 159/2003, s. 6; 96/2006, s. 2; 270/2010, s. 2; 111/2012, s. 2; 132/2012, s. 47; 122/2014, s. 8.]
PARENTING AFTER SEPARATION
EXEMPTION REQUEST
Court File No. ..............................
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:
1 | [ ] | I attended PAS in the last 24 months at: |
.......................[Location]..................................... .................[Date (approximately)]................. |
Dated ......[mmm/dd/yyyy]...... ..................[Signature of person requesting exemption].....................
2 | [ ] | A Consent Order under section 219 of the Family Law 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.) |
5.1 | [ ] | This application is for a matter related to the Convention on the Civil Aspects of International Child Abduction signed at The Hague on October 25, 1980. (In these cases the requirement does not apply to either the applicant or the respondent.) |
PLEASE TURN THIS FORM OVER TO SEE
WHAT OTHER EXEMPTIONS MAY APPLY TO YOUR CASE
OTHER REASONS
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 have no electronic access to PAS. I live in community .................[name of community]..................... . |
7 | [ ] | I am not fluent in English. I am fluent in this (or these) language(s): |
.......................................................................................................................................................................... | ||
Note that the Program Administrator may require parties to complete online PAS if it is offered in a language in which the parties are fluent. | ||
8 | [ ] | I am incapable of attending due to a serious medical condition. 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.
FOR USE OF PROGRAM ADMINISTRATOR (PA) ONLY
[ ] | ..................[Name of person applying for exemption]............................... is required to attend online PAS in English or ..........................[Name of language]............................ and file a Certificate of Completion. |
[ ] | 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].....................
PARENTING AFTER SEPARATION PROGRAM
NOTICE OF REQUIREMENT AND EXEMPTION FORM
For Applicants. If you are:
— | applying for an order for guardianship, parenting arrangements or contact with a child or a 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, suspend or terminate an existing order for guardianship, parenting arrangements or contact with a child or a child support order in these courts, |
the court requires you to attend a Parenting after Separation (PAS) session before you appear in court.
For Respondents. If you are named as the other party (respondent):
— | 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, |
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.
Attending a PAS Session:
Register for a PAS session. The PAS brochure in this package tells you who to contact for PAS sessions in your area. Attend the session and receive a Certificate of Attendance. File the Certificate of Attendance at the court registry.
When this requirement may not apply:
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.
IMPORTANT NOTE
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.
[en. B.C. Reg. 111/2012, s. 3; am. B.C. Reg. 99/2018, Sch. 2, s. 13.]
[en. B.C. Reg. 132/2012, s. 48.]
ELECTRONIC FILING STATEMENT
Court File No. ..............................
Court Location ..............................
F.M.E.P. File No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[name]......................................................................................
(Check whichever one of the following boxes is correct and complete the required information.)
[ ] I, .................[name]....................., am the lawyer acting for .......................[name(s) of party(ies)]......................................... .
[ ] I, .................[name]....................., am not represented by a lawyer.
I advise as follows:
1 | The .....................[type and identifying description of document].................... is being submitted for filing electronically [add the following if applicable] on behalf of the ....................[party(ies)].................., ....................[name(s) of party(ies)].............. . | |
2 | The original paper version of the document being submitted for filing electronically appears to bear an original signature of the person identified as the signatory and I have no reason to believe that the signature placed on the document is not the signature of the identified signatory; | |
3 | The version of the document that is being submitted for filing electronically appears to be a true copy of the original paper version of the document and I have no reason to believe that it is not a true copy of the original paper version. |
Dated ..........[mmm/dd/yyyy]........... | Signature .................................................................. | |
[en. B.C. Reg. 40/2013, s. 6.]
AFFIDAVIT
Court File No. ..............................
Court Location ..............................
F.M.E.P. No. ..............................
In the Provincial Court of British Columbia
In the case between:
.....................................................................[name]......................................................................................
and
.....................................................................[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.
1 I am applying under the Family Law Act to become a guardian of the following child(ren):
Full name of child | Birth date of child | Name(s) of current guardian(s) of child | Name(s) of parent(s) who are not current guardian(s) of child |
2 My date of birth is ..................[dd/mmm/yyyy]............................ .
3 The nature and length of my relationship with the child(ren) referred to in paragraph 1 of this affidavit is as follows:
Name of child | Nature of relationship [specify if parent, step-parent, grandparent, aunt, uncle, family friend, etc.] | Length of relationship |
4 The current living arrangements applicable to the child(ren) referred to in paragraph 1 of this affidavit are as follows:
Name of child | Current living arrangements |
5 I plan to care for the child(ren) referred to in paragraph 1 of this affidavit as follows: .......................[set out detailed plans for how the child(ren) is/are to be cared for]................................ .
6 [Check whichever paragraph is correct.]
[ ] I am not aware of any incidents of family violence, as that term is defined in section 1 of the Family Law Act, that affect the child(ren) referred to in paragraph 1 of this affidavit.
[ ] I am aware of the following incidents of family violence, as that term is defined in section 1 of the Family Law Act, that affect the child(ren) referred to in paragraph 1 of this affidavit: .................[describe the incidents of family violence of which you are aware].................... .
7 [Check whichever paragraph is correct.]
[ ] I am not a parent, step-parent or guardian of any children except that child/those children referred to in paragraph 1 of this affidavit.
[ ] I am the parent, step-parent or guardian of the following child(ren) who is/are not referred to in paragraph 1 of this affidavit:
Full name of child | Birth date of child | Nature of relationship to child [specify whether parent, step-parent or guardian] |
8 [Check whichever paragraph is correct.]
[ ] I have not been involved in court proceedings in British Columbia under the Child, Family and Community Service Act, the Family Relations Act, the Family Law Act or the Divorce Act (Canada) concerning children under my care, or in any other court proceedings under comparable legislation in any other jurisdiction concerning children under my care.
[ ] I have been involved in the following court proceedings in British Columbia under the Child, Family and Community Service Act, the Family Relations Act, the Family Law Act or the Divorce Act (Canada) concerning children under my care, and in the following court proceedings under comparable legislation in any other jurisdiction concerning children under my care:
Item | Names of parties to the proceeding | Name and location of court in which the proceeding was conducted | Date of any orders concerning children under my care made in the proceeding |
1 | |||
2 |
The orders referred to in the table above are attached as Exhibits to this affidavit as follows:
(a) the order dated ......[dd/mmm/yyyy].... referred to in ....[Item 1, 2, etc.].... above is attached as Exhibit ..... to this affidavit.
(b) the order dated ......[dd/mmm/yyyy].... referred to in ....[Item 1, 2, etc.].... above is attached as Exhibit ..... to this affidavit.
9 Attached to this affidavit and marked as Exhibit ...... is a copy of a British Columbia Ministry of Children and Family Development records check dated .....[dd/mmm/yyyy].......... . [Note that under rule 18.1, if there is to be no hearing for this application, this records check must be dated within 60 days of the date on which this affidavit is filed.]
10 Attached to this affidavit and marked as Exhibit ..... is a copy of a Protection Order Registry protection order records check dated ....[dd/mmm/yyyy].......... . [Note that under rule 18.1, if there is to be no hearing for this application, this records check must be dated within 60 days of the date on which this affidavit is filed.]
11 Attached to this affidavit and marked as Exhibit ..... is a copy of a criminal records check dated ......[dd/mmm/yyyy]....... obtained from the .....[name and location of police force or department from which the criminal records check was obtained]....... . [Note that under rule 18.1, if there is to be no hearing for this application, this records check must be dated within 60 days of the date on which this affidavit is filed.]
12 [Check whichever paragraph is correct.]
[ ] There are no criminal offences, other than those, if any, specified in the criminal records check referred to in paragraph 11 of this affidavit, of which I have been convicted and not pardoned.
[ ] In addition to the convictions, if any, specified in the criminal records check referred to in paragraph 11 of this affidavit, I have been convicted of, and not pardoned for, the following criminal offences:
...........................[provide details of any criminal convictions, not referred to in the criminal records check, for which you have not received a pardon]......................... .
13 [Check whichever paragraph is correct.]
[ ] I am not currently charged with any criminal offences.
[ ] I am currently charged with criminal offences. The particulars of each charge are set out below:
Nature of alleged offence | Date of alleged offence | Name and location of court in which proceedings are outstanding |
SWORN (OR AFFIRMED) BEFORE | ) | |
ME at ....................., British Columbia | ) | |
on ...............[dd/mmm/yyyy]................. . | ) | ........................................................................... |
) | ||
.............................................................. | ) | |
A commissioner for taking | ) | |
affidavits for British Columbia | ) | |
....[print name or affix stamp of commissioner].... |
Contents | Rules 1 to 22 | Appendix A | Appendix B | Appendix C
Copyright (c) Queen's Printer, Victoria, British Columbia, Canada