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Volume 64, No. 2
5/2021
The British Columbia Gazette, Part II
January 26, 2021

B.C. Reg. 5/2021, deposited January 25, 2021, under the COURT RULES ACT [section 1]. Order in Council 26/2021, approved and ordered January 25, 2021.

On the recommendation of the undersigned, made after consultation with the Chief Justice of the Supreme Court, the Lieutenant Governor, by and with the advice and consent of the Executive Council, orders that

(a) the Supreme Court Family Rules, B.C. Reg. 169/2009, are amended as set out in the attached Schedule 1, and

(b) B.C. Reg. 208/2020 is amended as set out in the attached Schedule 2.

— D. EBY, Attorney General and Minister Responsible for Housing; M. FARNWORTH, Presiding Member of the Executive Council.

Schedule 1

1 Form F3 in Appendix A of the Supreme Court Family Rules, B.C. Reg. 169/2009, is amended

(a) in section 2 by striking out "[ ] were married on ................[dd/mmm/yyyy]................." and substituting "[ ] were married on ................[dd/mmm/yyyy]................. at ................[city or town; province or state; country].................",

(b) in section 4 by adding the following after "[ ] An order for costs":

[ ] An order to [ ] confirm or [ ] set aside [check whichever one of the following boxes is correct and complete the required information] a written agreement dated ................[dd/mmm/yyyy]................. in respect of

[ ] spousal support

[ ] child support

[ ] division of property and/or debt

[ ] other

for the following reasons:

.......................................................................................... ,

(c) by striking out the following:

7 The claimant's address for service is [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:

Fax (optional)                              E-mail (optional) 
Date: ................[dd/mmm/yyyy]................. ..................................................................................
  Signature of
  [ ] claimant  [ ] lawyer for claimant(s)

...........................[type or print name]..........................

and substituting the following:

7 The claimant's address for service is [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:

Fax (optional)                              E-mail (optional) 
Date: ................[dd/mmm/yyyy]................. ..................................................................................
  Signature of
  [ ] claimant  [ ] lawyer for claimant(s)

...........................[type or print name]..........................
Note to Claimant AND Respondent: you must file financial information (Form F8) if any of the following apply:
  •  there is a claim against you for spousal support or you are claiming spousal support;
  •  there is a claim by either party for the division of property and/or debts under Part 5 or 6 of the Family Law Act;
  •  there is a claim against you for the support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the person being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

(d) in Schedule 1 by striking out "This is Schedule 1 to the Claimant's notice of family claim.",

(e) in section 2 of Schedule 1 by striking out "(ii) [ ] Other grounds, under section 8 (2) (b) of the Divorce Act (Canada): ...............[state the grounds]..............." and substituting the following:

(ii)  [ ]  Other grounds, under section 8 (2) (b) of the Divorce Act (Canada):

[ ] Adultery (the respondent has committed adultery)

[ ] Cruelty (the respondent has treated the applicant with physical or mental cruelty of such a kind as to make continued cohabitation intolerable) ,

(f) in section 3 of Schedule 1 by striking out "There has been no collusion, as defined in section 11 (4) of the Divorce Act (Canada), in relation to this claim for divorce." and substituting "I do not know about and I am not involved in any arrangement to make up or to hide evidence or to deceive the court to obtain a divorce.",

(g) in Schedule 2 by striking out "This is Schedule 2 to the Claimant's notice of family claim.",

(h) by repealing section 7 of Schedule 2 and substituting the following:

7 Proposed child support arrangements [Check the correct box(es) and complete the required information.]

The claimant is asking for:

[ ] support in the amount set out in the child support guidelines table, commencing on .......... [date] ........,
for the following child(ren): ...............[name(s) and date(s) of birth of child(ren)]...............

[ ] special or extraordinary expenses in accordance with section 7 of the child support guidelines, commencing on ........[date]........., for the following child(ren): ...............[name(s) and date(s) of birth of child(ren)]...............

[ ] an order for support in an amount different than the amount set out in the child support guidelines table, commencing on ........[date]........., for the following child(ren): ..........[name(s) and date(s) of birth of child(ren)]..........

The claimant is asking for an order for child support under [Check one or both of the following boxes, as applicable]

[ ] the Divorce Act (Canada)    [ ] the Family Law Act

(i) in Schedule 2 by striking out the following:

Note to Claimant AND Respondent: you must file financial information (Form F8) if:
  •  there is a claim against you for support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the party being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

(j) in Schedule 3 by striking out "This is Schedule 3 to the Claimant's notice of family claim." and by striking out "You may be required to file financial information" and substituting "You must file financial information",

(k) in Schedule 4 by striking out "This is Schedule 4 to the Claimant's notice of family claim.",

(l) by repealing section 1 of Schedule 4 and substituting the following:

1 The claimant's claims

A. Property and debt claims under the Family Law Act
[Check whichever one of the following boxes is correct and complete any required information in relation to family property and family debt, as those terms are defined in the Family Law Act.]

The claimant is asking for an order for:

[ ] equal division of family property and family debt

[ ] unequal division of family property and family debt, as follows and on the following grounds: ...............[set out details of proposed unequal division and the grounds on which it is made].....................

Identify any relevant debt to the extent that it is known at this time:

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

The address and legal description of any real property (land and buildings) in which the claimant claims an interest as a family property is:

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

The claimant pleads the following property as excluded from family property under section 85 of the Family Law Act (explain the basis for the exclusion):

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

B. Other property claims
[Check the correct box(es) and complete the required information.]

The claimant claims:

[ ] occupancy rent / occupational rent

[ ] an interest in the following property: ..........................[specify every interest claimed in property and if an interest is claimed in real property, provide the address and legal description of that real property] ..........................

[ ] an order for compensation instead of an interest in the property described as .......................[identify every property for which compensation is claimed and if compensation is claimed for real property, provide the address and legal description of that real property]..................................................................................................

on the following grounds: ......................[set out the grounds on which any claim under this paragraph for interest or compensation is based]...............................

(m) in section 2 of Schedule 4 by adding "(land or building)" after "the following real property", and

(n) in Schedule 5 by striking out "This is Schedule 5 to the Claimant's notice of family claim." and by striking out "the following orders under the Family Law Act" and substituting "the following additional orders under the Family Law Act".

2 Form F4 in Appendix A is amended

(a) by repealing section 2 and substituting the following:

2 Response to claims in notice of family claim:

This is my response to claims made against me in the Schedules to the notice of family claim:
[For each of the claims identified below that are made in the notice of family claim, indicate whether you agree or disagree with that claim by checking the correct box opposite that claim
Claim for divorce (Schedule 1, section 2)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Parenting arrangements (Schedule 2, section 4)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Child support (Schedule 2, section 7)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Spousal support (Schedule 3, section 2)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Division of family property and family debt (Schedule 4, section 1)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Other property claim(s) (Schedule 4, section 1)
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
Other orders (Schedule 5) [identify each claim made in Schedule 5 of the notice of family claim and indicate whether you agree or disagree with that claim by checking the correct box opposite that claim
[claim
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 
[claim
If you disagree, briefly explain why:

 

[ ] Agree  [ ] Disagree 

(b) by striking out the following:

Note to Claimant AND Respondent: You may be required to file financial information (Form F8) if there is a claim by you or against you for support of a child or spouse. See the note at the end of Schedule 2 of the notice of family claim for details.

If you do not file the financial information that is required, the court may attribute an amount of income to you and make a support award against you, based on that amount. 

and substituting the following:

Note to Claimant AND Respondent: you must file financial information (Form F8) if any of the following apply:
  •  there is a claim against you for spousal support or you are claiming spousal support;
  •  there is a claim by either party for the division of property and/or debts under Part 5 or 6 of the Family Law Act;
  •  there is a claim against you for the support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the person being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

3 Form F5 in Appendix A is amended

(a) in section 1 by striking out "[ ] Were married on ................[dd/mmm/yyyy]................." and substituting "[ ] Were married on ................[dd/mmm/yyyy]................. at.................[city or town; province or state; country].................",

(b) in section 2 by adding the following after "[ ] An order for costs":

An order to [ ] confirm or [ ] set aside [check whichever one of the following boxes is correct and complete the required information] a written agreement dated ..............[dd/mmm/yyyy].............. in respect of

[ ] spousal support

[ ] child support

[ ] division of property and/or debt

[ ] other

for the following reasons:

..................................................................................................................... ,

(c) by striking out the following:

Note to Claimant AND Respondent: You may be required to file financial information (Form F8) if there is a claim by you or against you for support of a child or spouse. See the note at the end of Schedule 2 of the notice of family claim for details.

If you do not file the financial information that is required, the court may attribute an amount of income to you and make a support award against you, based on that amount. 

and substituting the following:

Note to Claimant AND Respondent: you must file financial information (Form F8) if any of the following apply:
  •  there is a claim against you for spousal support or you are claiming spousal support;
  •  there is a claim by either party for the division of property and/or debts under Part 5 or 6 of the Family Law Act;
  •  there is a claim against you for the support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the person being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

(d) in Schedule 1 by striking out "This is Schedule 1 to the counterclaim of.......[party(ies)].......",

(e) in Schedule 1 by striking out "(ii)[ ] Other grounds, under section 8 (2) (b) of the Divorce Act (Canada)...............[state the grounds]............." and substituting the following:

(ii)[ ] Other grounds, under section 8(2) (b) of the Divorce Act (Canada):

[ ] Adultery (the claimant has committed adultery)

[ ] Cruelty (the claimant has treated the applicant with physical or mental cruelty of such a kind as to make continued cohabitation intolerable) ,

(f) in Schedule 1 by striking out "There has been no collusion, as defined in section 11(4) of the Divorce Act (Canada), in relation to this claim for divorce" and substituting "I do not know about and I am not involved in any arrangement to make up or to hide evidence or to deceive the court to obtain a divorce.",

(g) in Schedule 2 by striking out "This is Schedule 2 to the counterclaim of ................[party(ies)]................",

(h) by repealing section 7 of Schedule 2 and substituting the following:

7 Proposed child support arrangements [Check the correct box(es) and complete the required information.]

The respondent is asking for:

[ ] support in the amount set out in the child support guidelines table, commencing on...........[date]........., for the following child(ren): ...............[name(s) and date(s) of birth of child(ren)]...............

[ ] special or extraordinary expenses in accordance with section 7 of the child support guidelines, commencing on...........[date]........., for the following child(ren): ...............[name(s) and date(s) of birth of child(ren)]...............

[ ] an order for support in an amount different than the amount set out in the child support guidelines table, commencing on...........[date]........., for the following child(ren): ..........[name(s) and date(s) of birth of child(ren)]..........

The respondent is asking for an order for child support under [Check one or both of the following boxes, as applicable.]

[ ] the Divorce Act (Canada)    [ ] the Family Law Act 

(i) in Schedule 2 by striking out the following:

Note to Claimant AND Respondent: you must file financial information (Form F8) if:
  •  there is a claim against you for support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the party being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

(j) in Schedule 3 by striking out "This is Schedule 3 to the counterclaim of ................[party(ies)]................",

(k) in Schedule 4 by striking out "This is Schedule 4 to the counterclaim of ................ [party(ies)] ................",

(l) in Schedule 4 by repealing section 1 and substituting the following:

1 The respondent's claims

A. Property and debt claims under the Family Law Act
[Check whichever one of the following boxes is correct and complete any required information in relation to family property and family debt, as those terms are defined in the Family Law Act.]

The respondent is asking for an order for:

[ ] equal division of family property and family debt

[ ] unequal division of family property and family debt, as follows and on the following grounds: ...............[set out details of proposed unequal division and the grounds on which it is made]............... Identify any relevant debt to the extent that it is known at this time:

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

The address and legal description of any real property (land and buildings) in which the respondent claims an interest as a family property is:

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

The respondent pleads the following property as excluded from family property under section 85 of the Family Law Act (explain the basis for the exclusion):

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

B. Other property claims
[Check the correct box(es) and complete the required information.]

The respondent claims:

[ ] occupancy rent / occupational rent

[ ] an interest in the following property: .................[specify every interest claimed in property and if an interest is claimed in real property, provide the address and legal description of that real property]................................................. ....................................................................................................................................................................................

[ ] an order for compensation instead of an interest in the property described as ............................[identify every property for which compensation is claimed and if compensation is claimed for real property, provide the address and legal description of that real property]...........................................................................................................

on the following grounds:................[set out the grounds on which any claim under this paragraph for interest or compensation is based]................ 

(m) in section 2 of Schedule 4 by adding "(land or building)" after "the following real property", and

(n) in Schedule 5 by striking out "This is Schedule 5 to the counterclaim of ................[party(ies)]................" and by striking out "the following orders under the Family Law Act" and substituting "the following additional orders under the Family Law Act".

4 Form F8 in Appendix A is amended

(a) by striking out everything before "PART 1 – INCOME" and substituting the following:

Form F8 (Rules 5-1 and 7-1 (8), (10) and (11) )

This is the ......[1st/2nd/3rd/etc.]...... affidavit
of ..............[name].............. in this case
and was made on .........[dd/mmm/yyyy].........

Court File No.: .........................

Court Registry: ..........................

In the Supreme Court of British Columbia

Claimant:

Respondent:

FINANCIAL STATEMENT

[Rule 21-1 of the Supreme Court Family Rules applies to all forms.]

Instructions for Completion

You must file financial information (Form F8) if any of the following apply:

  •  there is a claim against you for spousal support or you are claiming spousal support;
  •  there is a claim by either party for the division of property and/or debts under Part 5 or 6 of the Family Law Act;
  •  there is a claim against you for the support of a child, OR
  •  you are claiming child support unless all of the following conditions apply:

(a) you are making no claim for any other kind of support;
(b) the child support is for children who are not stepchildren;
(c) none of the children for whom child support is claimed is 19 years of age or older;
(d) the income of the person being asked to pay child support is under $150 000 per year;
(e) you are not applying for special expenses under section 7 of the child support guidelines;
(f) you are not applying for an order under section 8 of the child support guidelines;
(g) you are not applying for an order under section 9 of the child support guidelines;
(h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

If you do not file the financial information that is required, the court may attribute an amount of income to you, and make a support award against you, based on that amount.

I, ................[name]................, of ...............[address for service]..............., SWEAR (OR AFFIRM) THAT:

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

[Check whichever of the following boxes is correct and complete any required information.]

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

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

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].... ,

(b) by adding the following after "PART 1 – INCOME":

You do not need to complete Part 1 if ALL of the following apply:

(a) the other party does not claim child support from you;

(b) there are no claims for special expenses under section 7 of the child support guidelines;

(c) the current parenting arrangement does not involve split or shared custody under section 8 or section 9 of the child support guidelines;

(d) there are no claims for split or shared custody;

(e) there are no claims for child support relating to stepchildren;

(f) there are no children 19 years or older for whom support is sought;

(g) the payor's child support guidelines income is less than $150 000 per year;

(h) there are no claims for undue hardship under section 10 of the child support guidelines;

(i) there are no claims for retroactive child support;

(j) there are no claims for spousal support. ,

(c) by adding the following after "[ ] I operate an unincorporated business, the name and address of which is ................[name and address of business]................":

[ ]I am unemployed ,

(d) by striking out "[if you are receiving social assistance] a statement confirming the amount of social assistance that I receive" and substituting "[if you are receiving income assistance] a statement confirming the amount of income assistance that I receive",

(e) by striking out "Social assistance income relating to self" and substituting "Income assistance relating to self",

(f) by striking out "the other party to the family law case" wherever it appears and substituting "the other party to this family law case",

(g) by striking out "Universal Child Care Benefits" and substituting "Canada Child Tax Benefit",

(h) by striking out "Social assistance received for other members of household" and substituting "Income assistance received for other members of household",

(i) by adding "Canada" before "Child Tax Benefit and BC Family Bonus",

(j) by adding the following after "PART 2 – MONTHLY EXPENSES":

You must complete Part 2 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 one or more of the following conditions applies:

• one or more of the children is a stepchild;

• one or more of the children for whom child support is claimed is 19 years of age or older;

• the current parenting arrangement involves split or shared custody under section 8 or 9 of the child support guidelines or there is an application for an order under section 9 of the child support guidelines;

• the income of the party being asked to pay child support is more than $150 000 per year

OR

(c) there is a claim against you for child support and you intend to make a hardship claim under the child support guidelines

OR

(d) there is a claim by you for child support and the opposite party has made a hardship claim under the child support guidelines

OR

(e) there is a claim, either by you or against you, for child support and there is a claim for special expenses under section 7 of the child support guidelines. ,

(k) by striking out the following:

MSP premiums   

(l) by striking out the following:

PART 3 – PROPERTY

ASSETS

and substituting the following:

PART 3 – PROPERTY

You must complete Part 3 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 one or more of the following conditions applies:

• one or more of the children is a stepchild;

• one or more of the children for whom child support is claimed is 19 years of age or older;

• there is an application for an order under section 9 of the child support guidelines;

• the income of the party being asked to pay child support is more than $150 000 per year

(c) there is a claim against you for child support and you intend to make a hardship claim under the child support guidelines

OR

(d) there is a claim by you for child support and the opposite party has made a hardship claim under the child support guidelines

OR

(e) there is a claim, either by you or against you, for child support and there is a claim for special expenses under section 7 of the child support guidelines

OR

(f) there is a property claim, either by you or against you, under Part 5 or 6 of the Family Law Act.

ASSETS

List all assets that you own, regardless of whether or not the other party has made a claim.  ,

(m) by adding the following before "DISPOSAL OF PROPERTY":

EXCLUDED PROPERTY

Of the assets listed above, list which ones are excluded property or form part of the excluded property claim.

Description   Date of Acquisition   Value at Acquisition or
Commencement 
Current Value 
       

(n) by adding the following after "PART 4 – SPECIAL OR EXTRAORDINARY EXPENSES":

You must complete Part 4 if there is a claim, either by you or against you, for child support and there is a claim for special expenses under section 7 of the child support guidelines. ,

(o) by adding the following after "PART 5 – UNDUE HARDSHIP":

You must complete Part 5 if there is a claim against you for child support and you intend to make an undue hardship claim under the child support guidelines. , and

(p) by adding the following after "PART 6 – INCOME OF OTHER PERSONS IN HOUSEHOLD":

You must complete Part 6 if

(a) there is a claim against you for child support and you intend to make an undue hardship claim under the child support guidelines

OR

(b) there is a claim by you for child support and the other party has made an undue hardship claim under the child support guidelines.

Schedule 2

1 Section 12 of the Schedule to B.C. Reg. 208/2020 is amended by repealing Form F102 and substituting the following:

Form F102 (Rule 15-2.2 (1) and (2) )

Court File No.: .........................

Court Registry: ..........................

In the Supreme Court of British Columbia

Claimant:

Respondent:

STATEMENT OF INFORMATION FOR
COROLLARY RELIEF PROCEEDINGS

[Rule 21-1 of the Supreme Court Family Rules applies to all forms.]

Filed by:................[party(ies)]................

1  Civil Protection Orders or Proceedings

[A civil protection order is any order made against a person for the purposes of protecting another person's safety]
A civil protection order may restrict or restrain a person from doing certain things, such as
  •  contacting another person,
  •  being a certain distance from another person or a specific place,
  •  harassing or threatening another person, or
  •  living in the family home 
  YES  NO 
Are you aware of any active protection order about you, or any other people involved in this family law case?  [ ]  [ ] 
Are you or others involved in this family law case also involved in any protection order matter?  [ ]  [ ] 
If you answered yes, provide more detail:

 

2 Child Protection Orders or Proceedings

[Child protection services ("child welfare") protect children from harm. Child protection services might use a supervision or custody order to protect children from harm. Child protection services may exist under a different name in another province.] 
  YES  NO 
Are you or others involved in this family law case also involved with child protection services?  [ ]  [ ] 
If you answered yes, provide more detail:

 

3 Criminal Proceedings

[Criminal offences are offences under the Criminal Code and other federal laws, including the Controlled Drugs and Substances Act (Canada). Criminal offences or matters do not include bylaw offences, traffic tickets, or consumer issues.] 
  YES  NO 
Are you or others involved in this family law case facing a criminal charge?  [ ]  [ ] 
Are you or others involved in this family law case required to follow a court order because of a criminal matter? (Such as release/bail order, probation order, peace bond/recognizance, parole order, warrant, or required to follow conditions)   [ ]  [ ] 
Are you or others involved in this family law case required to follow demands because of a criminal matter? (Such as a promise to appear or a summons)  [ ]  [ ] 
Are you or others involved in this family law case in prison?  [ ]  [ ] 
If you answered yes, provide more detail:

 

Date: ................[dd/mmm/yyyy]................. ..................................................................................
  Signature of
  [ ] filing party  [ ] lawyer for filing party(ies)

...........................[type or print name]..........................


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