(.pdf) - Updated 2 July 2012 - Family Court of Western Australia

Client IDFAMILY COURT OF WESTERN AUSTRALIAMAGISTRATES COURT OF WESTERN AUSTRALIAFile No (P)PTWFiled onFORM 1A – RESPONSE TOINITIATING APPLICATIONCOURT LOCATIONNEXT COURT DATETIMEam / pmApplicant’s family name(as used now)Given namesRespondent’s family name(as used now)Given namesRespondent’s address forservice of documents inAustraliaPrepared by *Lawyer’s Code *Name of law firm *Email ^TelephoneFax ^* Complete where filed by a law firm^ Please do not include email or fax details unless you are willing to receive documents from the Courtand other parties in that way.Part AOrders sought by you the Respondent1 Type of orders sought (mark all boxes that apply)Children (parenting)Child supportFinancial (property and/or maintenance)Other (specify)Page 1 of 5

2 Final orders agreedState the paragraph numbers of the final orders sought in the Initiating Application (at Part A) with which youagree. (Give each order the same paragraph number from the Initiating Application eg. 3, 6, 10)3 Final orders sought by you the respondentState precisely and briefly the final orders sought by you, the respondent.(Give a number to each order sought)1.Page 2 of 5

4 Interim or procedural orders agreedState the paragraph numbers of the interim or procedural orders sought in the Initiating Application (at Part A)with which you agree. (Give each order the same paragraph number from the Initiating Application eg. 3, 4, 6, 10)5 Interim or procedural orders sought by you the respondentState precisely and briefly any other interim or procedural orders sought by you the respondent.(Give a number to each order sought.)1.NOTE - Go to Part D where filing a Case Information Affidavit with this response.(Do not complete Part B and C)Page 3 of 5

Part B6 Family name asused now7 Given namesDetails of the PartiesApplicantRespondent8 Gender male female male female9 Residentialaddress(incl postcode)10 Telephonenumber (home andmobile)11 Date of birth(day / month / year)You do not have to state your residential address or your telephone number if you areconcerned about family violence. You can repeat your contact address for service ifyou wish./ / / /12 Occupation13. Mark box asapplicable for therespondent14 Is aninterpreterrequired?present in Australiaordinarily resident in AustraliaAustralian citizendomiciled in AustraliaAboriginal originNoYesIf Yes, state language & dialect:present in Australiaordinarily resident in AustraliaAustralian citizendomiciled in AustraliaAboriginal originNoYesIf Yes, state language & dialect:*If there is more than one respondent, just add a page with the same details on it for them.The information you provide may be shared with researchers approved by the Court, and may be included in publications instatistical form in a way that does not identify you.Part CSafety concerns15 Is there a current RestrainingOrder between you and/or theother party or the children?NoYesIf yes, who is restrained16 Are you concerned aboutyour safety while attendingCourt?NoYesPage 4 of 5

Part D Statement of Truth of the Contents of this document(If more than one respondent, attach a further page providing a full name and statement of truth in this form)17 Respondent’s name1. I believe the facts of which I have personal knowledge aretrue.2. All other facts are true to the best of my knowledge,information and belief and the orders sought in this responseare supported by evidence.3. I am aware that I have a duty to the Court and to each otherparty to give full and frank disclosure – in a timely manner - ofall information relevant to the issues in the case.I have read and understood this Statementof Truth (please tick)Signature of RespondentDate / /June2012 V2Page 5 of 5