Family Court Rules 2002

CS 1	Front page for certain documents filed in court under Child Support Act 1991
CS 2	Heading of certain documents issued by court or Registrar under Child Support Act 1991
CS 3	Application for declaration that another person is step-parent of child
CS 4	Application for declaration that applicant is step-parent of child
CS 5	Notice of appeal against Commissioner’s decision to accept application for formula assessment of child support
CS 6	Order upholding or disallowing appeal made under section 100 of Act
CS 7	Notice of appeal against Commissioner’s decision to refuse to accept application for formula assessment of child support
CS 8	Order upholding or disallowing appeal made under section 101 of Act
CS 9	Notice of appeal against other administrative decisions of Commissioner
CS 10	Order upholding or disallowing appeal made under section 102 of Act
CS 11	Notice of appeal against assessment
CS 12	Order upholding or disallowing appeal against assessment
CS 12A	Notice of appeal against Commissioner’s determination or decision under subpart 3 of Part 5A of Act
CS 12B	Order upholding or disallowing appeal made under section 103A of Act
CS 12C	Notice of appeal by respondent against Commissioner’s determination under Part 6A of Act
CS 12D	Order upholding or disallowing appeal made under section 103B of Act
CS 12E	Notice of appeal against Commissioner’s determination under Part 6B of Act
CS 12F	Order upholding or disallowing appeal made under section 103C of Act
CS 13	Application for departure from formula assessment in special circumstances
CS 14	Order for departure from formula assessment
CS 15	Application for order for provision of child support in form of lump sum
CS 16	Order for provision of child support in form of lump sum
CS 17	Application for order to discharge (or suspend or revive or vary) order made under section 106 or section 109 of Act
CS 18	Order to discharge (or suspend or revive or vary) order made under section 106 or section 109 of Act
CS 19	Application for order to set aside voluntary agreement
CS 20	Order to set aside voluntary agreement
CS 21	Application for urgent maintenance order [Revoked]
CS 22	Urgent maintenance order [Revoked]
CS 23	Application for suspension order
CS 24	Suspension order
CS 25	Notice of application to respondent
CS 26	Notice of application to respondent residing outside New Zealand
CS 27	Notice of intervention
CS 28	Affidavit of financial means and their sources
CS 29	Request for issue of warrant to seize property
CS 30	Warrant to seize property
CS 31	Charging order
CS 32	Receiving order
CS 33	Summons to attend examination as to means and default
CS 34	Warrant to arrest respondent for examination as to means and default
CS 35	Summons to witness to attend examination
CS 36	Warrant to arrest witness for attendance at examination of respondent
CS 37	Warrant to arrest respondent for attendance at contempt proceedings
CS 38	Application without notice for issue of warrant for arrest of respondent
CS 39	Warrant for arrest of absconding respondent

Form CS 1 Front page for certain documents filed in court under Child Support Act 1991

rr 72(1)(a), 225

In the Family Court
at [place]

CS No: .

Applicant

[full name, address, and occupation of objector]

Respondent(s)

[full name, address, and occupation of respondent(s)]

This document is filed by [name and address for service, and, if filed by lawyers, the name and telephone number of the acting lawyer].

Schedule 3 form CS 1: amended, on 7 August 2008, by rule 24 of the Family Courts Amendment Rules 2008 (SR 2008/207).

Form CS 2 Heading of certain documents issued by court or Registrar under Child Support Act 1991

rr 73(1)(a), 225

In the Family Court
at [place]

CS No: .

Applicant

[full name, address, and occupation of objector]

Respondent(s)

[full name, address, and occupation of respondent(s)]

Schedule 3 form CS 2: amended, on 7 August 2008, by rule 25 of the Family Courts Amendment Rules 2008 (SR 2008/207).

Form CS 3 Application for declaration that another person is step-parent of child

r 262(2)(a)

Section 99(1), Child Support Act 1991

(Front page—Form G 1)

I, [full name], declare that I am an eligible custodian of [full name of child].

I apply for a declaration that [full name of respondent] is a step-parent of the child for the purposes of the Act.

This application is made on the following ground(s):

[state the ground(s) on which the application is made, referring to any relevant circumstances set out in section 99(4) of the Act to which the court must have regard].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This application is filed by [full name], whose address for service is [address].

Form CS 4 Application for declaration that applicant is step-parent of child

r 262(2)(a)

Section 99(2), Child Support Act 1991

(Front page—Form G 1)

I, [full name], wish to be declared to be a step-parent of [full name of child] for the purposes of the Act.

I apply for a declaration to that effect.

This application is made on the following ground(s):

[state the ground(s) on which the application is made, referring to any relevant circumstances set out in section 99(4) of the Act to which the court must have regard].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This application is filed by [full name], whose address for service is [address].

Form CS 5 Notice of appeal against Commissioner’s decision to accept application for formula assessment of child support

Section 100, Child Support Act 1991

(Front page—Form CS 1)

I, [full name], object to the Commissioner’s decision under section 17(1) of the Act to accept an application for formula assessment of child support.

Attached is a copy of the Commissioner’s notification that the application has been accepted.

The name of each child in respect of whom the application sought payment of child support, and the name(s) of the eligible custodian(s) of that child (or those children), are as follows:

Full name of child	Full name of custodian
.	.
.	.
.	.
.	.

I objected to the Commissioner on [date] against the Commissioner’s decision to accept the application for formula assessment of child support.

The Commissioner disallowed the objection on [date].

Take notice that I intend to appeal to the Family Court against the Commissioner’s decision to accept the application for formula assessment of child support in respect of [full name(s) of child(ren)] and [full name(s) of custodian(s)] on the ground(s) that—

*the application was not made in respect of a qualifying child.

*the application was not made by an eligible applicant.

*the application required the payment of child support by a person who was not liable to pay child support under the Act in respect of the child.

*Delete if inapplicable.

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This notice of appeal is filed by [full name], whose address for service is [address].

Form CS 6 Order upholding or disallowing appeal made under section 100 of Act

Section 100, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s decision to accept an application for formula assessment of child support in respect of the following child(ren) and the following custodian(s):

Full name of child	Full name of custodian
.	.
.	.
.	.
.	.

.
Registrar
.
Date

Form CS 7 Notice of appeal against Commissioner’s decision to refuse to accept application for formula assessment of child support

Section 101, Child Support Act 1991

(Front page—Form CS 1)

I, [full name], object to the Commissioner’s decision under section 17(2) of the Act to refuse to accept an application for formula assessment of child support.

Attached is a copy of the Commissioner’s notification that the application has been refused.

The name of each child in respect of whom the application sought payment of child support, and the name(s) of the eligible custodian(s) of that child (or those children), are as follows:

Full name of child	Full name of custodian
.	.
.	.
.	.
.	.

I objected to the Commissioner on [date] against the Commissioner’s decision to refuse to accept the application for formula assessment of child support.

The Commissioner disallowed the objection on [date].

Take notice that I intend to appeal to the Family Court against the Commissioner’s decision to refuse to accept the application for formula assessment of child support in respect of [full name(s) of child(ren)] and [full name(s) of custodian(s)] on the ground(s) that—

*the application was made in respect of a qualifying child.

*the application was made by an eligible applicant.

*the application required the payment of child support by a person who was liable to pay child support under the Act in respect of the child.

*Delete if inapplicable.

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This notice of appeal is filed by [full name], whose address for service is [address].

Form CS 8 Order upholding or disallowing appeal made under section 101 of Act

Section 101, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s decision to refuse to accept an application for formula assessment of child support in respect of the following child(ren) and the following custodian(s):

Full name of child	Full name of custodian
.	.
.	.
.	.
.	.

.
Registrar
.
Date

Form CS 9 Notice of appeal against other administrative decisions of Commissioner

Section 102, Child Support Act 1991

(Front page—Form CS 1)

Take notice that I, [full name], intend to appeal to the Family Court against the Commissioner’s decision dated [date] to [give particulars of the decision appealed against].

I objected to the Commissioner on [date] against that decision.

The Commissioner disallowed the objection on [date].

The grounds of the appeal are as follows: [state the grounds on which the application is made].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application]

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This notice of appeal is filed by [full name], whose address for service is [address].

Form CS 10 Order upholding or disallowing appeal made under section 102 of Act

Section 102, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s decision dated [date] to [state decision appealed against].

*The court makes the following order: [specify any order made].

*Delete if inapplicable.

.
Registrar
.
Date

Form CS 11 Notice of appeal against assessment

Section 103, Child Support Act 1991

(Front page—Form CS 1)

Take notice that I, [full name], intend to appeal to the Family Court against the Commissioner’s assessment of child support. Attached is a copy of the assessment.

I objected to the Commissioner on [date] against that assessment.

The Commissioner disallowed the objection on [date].

The grounds of the appeal are as follows: [state the grounds on which the application is made].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This notice of appeal is filed by [full name], whose address for service is [address].

Form CS 12 Order upholding or disallowing appeal against assessment

Section 103, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s assessment of child support in respect of [state assessment appealed against].

*The assessment must be corrected as follows:

*Delete if inapplicable.

.
Registrar
.
Date

Form CS 12A Notice of appeal against Commissioner’s determination or decision under subpart 3 of Part 5A of Act

Section 103A, Child Support Act 1991

(Front page—Form CS 1)

Take notice that I, [full name], intend to appeal to the Family Court against—

*a determination of the Commissioner under subpart 3 of Part 5A of the Act.

*a decision of the Commissioner to refuse to make a determination made under subpart 3 of Part 5A of the Act.

Attached is a copy of the Commissioner’s *determination/*decision made on [date].

The grounds of the appeal are as follows:

[state the grounds on which the appeal is made].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the appeal].

*Delete if inapplicable.

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To [set out the names and addresses of the persons intended to be served with the notice of appeal]

This notice of appeal is filed by [full name], whose address for service is [address].

Schedule 3 form CS 12A: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 12B Order upholding or disallowing appeal made under section 103A of Act

Section 103A, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s *determination/*decision dated [date].

*The court makes the following order: [specify any order made].

*Delete if inapplicable.

.
Registrar
.
Date

Schedule 3 form CS 12B: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 12C Notice of appeal by respondent against Commissioner’s determination under Part 6A of Act

Section 103B, Child Support Act 1991

(Front page—Form CS 1)

Take notice that I, [full name], intend to appeal to the Family Court against a determination of the Commissioner under Part 6A of the Act.

I am—

*a qualifying custodian and did not apply for the determination under Part 6A of the Act.

*a liable parent and did not apply for the determination under Part 6A of the Act.

Attached is a copy of the Commissioner’s determination made on [date].

The grounds of the appeal are as follows:

[state the grounds on which the application is made].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the appeal].

*Delete if inapplicable.

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To [set out the names and addresses of the persons intended to be served with the notice of appeal]

This notice of appeal is filed by [full name], whose address for service is [address].

Schedule 3 form CS 12C: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 12D Order upholding or disallowing appeal made under section 103B of Act

Section 103B, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s determination dated [date].

*The court makes the following order: [specify any order made].

*Delete if inapplicable.

.
Registrar
.
Date

Schedule 3 form CS 12D: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 12E Notice of appeal against Commissioner’s determination under Part 6B of Act

Section 103C, Child Support Act 1991

(Front page—Form CS 1)

Take notice that I, [full name], intend to appeal to the Family Court against a determination of the Commissioner under Part 6B of the Act.

Attached is a copy of the Commissioner’s determination made on [date].

The grounds of the appeal are as follows: [state the grounds on which the application is made].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the appeal].

.
Signature of appellant
.
Date

To the Registrar

Family Court at [place]

and

To [set out the names and addresses of the persons intended to be served with the application]

This notice of appeal is filed by [full name], whose address for service is [address].

Schedule 3 form CS 12E: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 12F Order upholding or disallowing appeal made under section 103C of Act

Section 103C, Child Support Act 1991

(Heading—Form CS 2)

On appeal to it, the court upholds (or dismisses) the appellant’s appeal against the Commissioner’s determination dated [date].

*The court makes the following order: [specify any order made].

*Delete if inapplicable.

.
Registrar
.
Date

Schedule 3 form CS 12F: inserted, on 23 October 2006, by rule 4(2) of the Family Courts Amendment Rules 2006 (SR 2006/325).

Form CS 13 Application for departure from formula assessment in special circumstances

Section 104, Child Support Act 1991

(Front page—Form G 1)

I, [full name], declare that I am—

*a qualifying custodian of [full name(s) of child(ren)].

*a liable parent in relation to [full name(s) of child(ren)].

*Delete if inapplicable.

A formula assessment of child support is in force in relation to the child(ren), the applicant, and the respondent. Attached is a copy of the assessment.

Take notice that I intend to apply to the Family Court for an order that all or some of the provisions of the Act relating to formula assessment of child support be departed from in relation to [full name(s) of child(ren)]. I apply for an order [state precisely the nature of the order sought, referring to the relevant provision of section 106 of the Act].

This application is made on the ground(s) that—

[state the ground(s) on which the application is made, referring to—

(a)

any relevant grounds for departure set out in section 105(2) of the Act that exist; and

(b)

the reasons why it would be—

(i)

just and equitable as regards the child(ren), the applicant, and the respondent; and

(ii)

otherwise proper,—

to make a particular order of the type specified in section 106 of the Act].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This notice of appeal is filed by [full name], whose address for service is [address].

Form CS 14 Order for departure from formula assessment

Section 106, Child Support Act 1991

(General heading—Form G 2)

On application made to it under section 104 of the Act, the court orders that the provisions of the Act relating to formula assessment of child support be departed from in relation to [full name of child(ren)].

The order(s) made is (or are) as follows:

The order—

*applies for the period of time beginning on [date] and ending with [date].

*terminates when [specify the event that will cause the order to terminate].

*Delete if inapplicable.

.
Registrar
.
Date

Form CS 15 Application for order for provision of child support in form of lump sum

Section 108, Child Support Act 1991

(Front page—Form G 1)

I, [full name], declare that I am—

*a qualifying custodian of [full name(s) of child(ren)].

*a liable parent in relation to [full name(s) of child(ren)].

*Delete if inapplicable.

A formula assessment of child support is in force in relation to the child(ren), the applicant, and the respondent. Attached is a copy of the assessment.

Take notice that I intend to apply to the Family Court for an order that the respondent (or applicant) provide child support for the child(ren) otherwise than in the form of periodic amounts paid to the applicant (or respondent). I apply for an order [state precisely the nature of the order sought].

This application is made on the ground(s) that—

[state the ground(s) on which the application is made, referring to the reasons why it would be—

(a)

just and equitable as regards the child(ren), the applicant, and the respondent; and

(b)

otherwise proper,—

to make a particular order of the type specified in section 109(2) of the Act].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

*There is (or There is not) a pending application made to the court under section 104 of the Act in relation to the child(ren), the applicant, and the respondent to be heard and determined.

*Attached is a copy of an order in force under section 106 of the Act in relation to the child(ren), the appellant, and the respondent.

*Delete if inapplicable.

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This application is filed by [full name], whose address for service is [address].

Form CS 16 Order for provision of child support in form of lump sum

Section 109(2), Child Support Act 1991

(General heading—Form G 2)

On application made to it under section 108 of the Act, the court orders that the respondent (or applicant) provide child support for [full name(s) of child(ren)] otherwise than in the form of periodic amounts paid to the applicant (or respondent).

The order(s) made is (or are) as follows:

*The child support ordered to be paid under this order must be credited against the respondent’s (or applicant’s) liability to pay child support under the formula assessment for any period for which this order relates, and, for that purpose,—

*(a)

the child support ordered to be paid under this order has an annual value of $[specify], and the annual rate of child support payable under any relevant formula assessment must be reduced by that amount (but not in a child support year below the minimum annual rate for that year under section 72(1)(a) of the Act).

*(b)

the child support ordered to be paid under this order must count for [specify]% of the annual rate of child support payable under any relevant formula assessment.

*The child support ordered to be paid under this order must not be credited against the respondent’s (or applicant’s) liability to pay child support under the formula assessment.

*Delete if inapplicable.

The period to which this order relates begins on [date] and ends with [date].

.
Registrar
.
Date

Schedule 3 form CS 16 paragraph (a): amended, on 27 May 2010, by rule 12 of the Family Courts Amendment Rules 2010 (SR 2010/97).

Form CS 17 Application for order to discharge (or suspend or revive or vary) order made under section 106 or section 109 of Act

Section 112, Child Support Act 1991

(Front page—Form G 1)

I, [full name], declare that I am—

*a qualifying custodian of [full name(s) of child(ren)].

*a liable parent in relation to [full name(s) of child(ren)].

*the Commissioner of Inland Revenue (or an employee of the Crown appearing for the Commissioner of Inland Revenue).

*Delete if inapplicable.

An order dated [date] made under section 106 (or section 109) of the Act is in force in relation to [full name(s) of child(ren)]. Attached is a copy of the order.

Take notice that I intend to apply to the Family Court for an order to discharge (or suspend or revive or vary) the order.

This application is made on the ground(s) that—

[state the ground(s) on which the application is made, referring to—

(a)

the reasons why it would be—

(i)

just and equitable as regards the child(ren), the qualifying custodian, and the liable parent concerned; and

(ii)

otherwise proper,—

to make the order; and

(b)

in the case of an application for variation, the matters as to which the court must be satisfied under section 112(4) of the Act].

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This application is filed by [full name], whose address for service is [address].

Form CS 18 Order to discharge (or suspend or revive or vary) order made under section 106 or section 109 of Act

Section 112, Child Support Act 1991

(General heading—Form G 2)

On application made to it under section 112 of the Act, the court orders that the order of the court dated [date], made under section 106 (or section 109) of the Act in relation to [full name(s) of child(ren)],—

*(a)

be discharged.

*(b)

be suspended wholly (or in part) until a further order (or until [specify date] or until [specify the happening of a future event]).

*(c)

be revived wholly (or in part).

*(d)

be varied in the following way:

*Delete if inapplicable.

.
Registrar
.
Date

Form CS 19 Application for order to set aside voluntary agreement

Section 113, Child Support Act 1991

(Front page—Form G 1)

I, [full name], declare that I am a party to an agreement dated [date].

Attached is a copy of the agreement.

Take notice that I intend to apply to the Family Court for an order to set aside the agreement on the ground that—

*(a)

my concurrence was obtained by fraud (or undue influence).

*(b)

I was influenced in my decision to enter into the agreement by a mistake that was material to me.

*Delete if inapplicable.

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

*I also apply for an order [state precisely the nature of any order sought that the court is empowered to make under section 113(3) of the Act].

*Delete if inapplicable.

.
Signature of applicant
.
Date

To the Registrar

Family Court at [place]

and

To the respondent

This application is filed by [full name], whose address for service is [address].

Note

If the application may, in accordance with section 117(5) of the Act, be made and dealt with without notice, amend the form accordingly.

Form CS 24 Suspension order

Section 117, Child Support Act 1991

(General heading—Form G 2)

On application to it, the court orders that the liability of [full name] to make payments under the Act be suspended (or be varied as follows: [state variation]) pending the hearing and final determination of the proceeding for [specify order sought] instituted in the Family Court on [date] (or of the objection by [full name of objector] made under Part 6 of the Act on [date]).

This order is subject to the following terms and conditions:

[specify any terms and conditions].

*This order operates for the period beginning on [date] and ending with [date].

*This order operates until the decision of the court determining the proceeding becomes final.

*Delete if inapplicable.

.
Registrar
.
Date

Form CS 25 Notice of application to respondent

rr 32(2)(b), 268(1)(a)

(General heading—Form G 2)

Notification of application for order

[Full name], the applicant, has filed an application in this court. A copy of the application is attached.

The order (or orders) sought by the applicant are specified in the application.

Notice of defence

If you wish to defend the application, you must, within 21 days after the date on which you receive this notice,—

(a)

file a notice of defence and an accompanying affidavit in this office of the court; and

(b)

serve a copy of the notice of defence and a copy of the accompanying affidavit on the other party (or parties) to the proceedings. Those copies may be delivered to the address for service given by the applicant (or by other parties).

You should note that if you do not file and serve a notice of defence and accompanying affidavit within that time you may not be able to defend the application. On the day of the hearing of the application, should you appear, the court may—

(a)

allow you to take part in the hearing of the application only on such terms as the court thinks fit; or

(b)

decline to allow you to take part.

You should also note that the court may make an order against you for costs properly incurred as a consequence of your failure to file and serve a notice of defence and accompanying affidavit within time.

If you do not file and serve a notice of defence and accompanying affidavit, the case may proceed without further notice to you.

Address for service

If you do not wish to defend the application but you do wish to know what is happening, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the other party (or parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or by other parties).

Assistance

A lawyer will prepare a notice of defence for you. If you want a lawyer but think you cannot afford one, contact an office of the Family Court immediately. You may also see a specimen form of the notice of defence at any office of the Family Court.

Liability as a witness

Even if you take no action, the court may summon you as a witness to help it deal with the application.

Copies of orders

You will get a copy of any orders made against you. However, any order will probably be in force from the time it is made. The fact that you have not got a copy of the order will not be an excuse for not obeying it.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Schedule 3 form CS 25: amended, on 2 May 2024, by rule 135(1) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 3 form CS 25: amended, on 3 August 2009, by rule 12(1) of the Family Courts Amendment Rules 2009 (SR 2009/185).

Form CS 26 Notice of application to respondent residing outside New Zealand

(General heading—Form G 2)

Notification of application for order

[Full name], the applicant, has filed an application in this court. A copy of the application is attached.

The order (or orders) sought by the applicant are specified in the application.

Jurisdiction of court

(b)

serve a copy of the notice on the other party (or parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or other parties).

Copies of orders

Advice

If you need help, consult a lawyer in the place where you are immediately.

If you intend to employ a lawyer in New Zealand, you should ask about your eligibility for legal aid in this country.

.
Registrar
.
Date

Schedule 3 form CS 26: amended, on 2 May 2024, by rule 135(2) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 3 form CS 26: amended, on 3 August 2009, by rule 12(2) of the Family Courts Amendment Rules 2009 (SR 2009/185).

Form CS 27 Notice of intervention

r 269(a)

Section 125, Child Support Act 1991

(Front page—Form G 1)

I, [full name], of [address], [occupation], intervene in the above proceedings.

I am—

*the Commissioner of Inland Revenue.

*the custodian of [full name(s) of child(ren)] who is (or are) the child(ren) in respect of whom child support is sought.

*a person by whom (or from whom) financial support is sought.

*Delete if inapplicable.

.
Signature of person intervening
.
Date

To the Registrar

Family Court at [place]

and

To the applicant

and

To the respondent

This notice is filed by [full name], whose address for service is [address].

Note

The person intervening now becomes a party to the proceedings.

Form CS 28 Affidavit of financial means and their sources

rr 139(3)(c), 266(1)(a)

Section 234(2)(d), Child Support Act 1991

(Front page—Form G 1)

I, [full name], of [address], [occupation], swear (or affirm) that my financial means and their sources are set out below.

1

My income for the 52 weeks immediately preceding the date of this affidavit was as follows: [use “Nil” if applicable].

Item Particulars		$
(a) salary, wages, or other personal earnings from [state employer]: (b) gross income from business: (c) amount received from boarders (including children over 16 years of age): (d) rents from property (including rooms let): (e) compensation or damages received: (f) superannuation, pension, or benefit (including any from overseas): (g) dividends and interest: (h) all other sources of income [specify]:
Total income in the 52 weeks:		$

2

My assets (both in New Zealand and elsewhere) are as follows:

Item Particulars		$
(a) land and buildings [state address and capital value]: (b) money in bank accounts [specify banks]: (c) money not in bank or invested: (d) money lent or in hands of any person [name and address]: (e) Government stock, shares, debentures, or bonds [state details]: (f) plant and machinery [state details]: (g) livestock [state details]: (h) interest in business, stock in trade, or venture of any kind [state details]: (i) motor vehicles [state details]: (j) any other property or assets not specified above, including interest in any estate [state details]:
Total assets:		$

3

The property specified in items [specify] of clause 2 of this affidavit is mortgaged, or otherwise secured to [full name] of [address], for the sum of: $ .

4

My expenses for the 52 weeks specified in clause 1 of this affidavit were as follows:

Item Particulars		$
(a) income tax: (b) insurance and superannuation: (c) medical and hospital benefits: (d) rent: (e) rates: (f) mortgage payments: (g) repairs on home: (h) food and household supplies: (i) electricity, gas, and fuel: (j) telephone: (k) laundry and cleaning: (l) clothing: (m) child maintenance, care, and education: (n) maintenance for former spouse or former de facto partner: (o) entertainment: (p) fares: (q) car maintenance, running, and registration: (r) hire purchase payments: (s) other expenses [specify]:
Total expenses in the 52 weeks:		$

5

Separate income for the 52 weeks of members of household whose expenses are included:

(a)

[list full names, ages, and relationship of all members of household]:

(b)

[list details of separate income of any member of household]:

.
Signature of deponent

Sworn (or Affirmed) at [place], [date], before me:

.
Registrar
(or Justice of the Peace
or Solicitor of the High Court)

Schedule 3 form CS 28 heading: amended, on 1 July 2023, by section 28(2) of the Child Support (Pass On) Acts Amendment Act 2023 (2023 No 27).

Schedule 3 form CS 28: amended, on 1 July 2004, by rule 7(1) of the Family Courts Amendment Rules 2004 (SR 2004/165).

Form CS 29 Request for issue of warrant to seize property

Section 183, Child Support Act 1991

(Front page—Form G 1)

To the Registrar

District Court at [place]

I, [full name], of [address], [occupation], request the issue of a warrant to seize property under section 183 of the Act against the respondent.

[Set out details of the financial support that is payable by the person under the Act.]

I certify—

(a)

that payments of financial support are in arrears and unpaid for not less than 14 days; and

(b)

that there is now due and owing by way of financial support the sum of [state amount] up to [date].

.
Signature
.
Date

	Date	Time	Initials
Request filed:	.	.	.
Warrant issued:	.	.	.

Schedule 3 form CS 29 heading: replaced, on 14 April 2014, by rule 8(1) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Schedule 3 form CS 29: amended, on 14 April 2014, by rule 8(2) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Form CS 30 Warrant to seize property

Section 183, Child Support Act 1991

(General heading—Form G 2)

To every bailiff and constable

Financial support due by the respondent, [full name], under the Act is, at the time of the issue of this warrant, in arrears and unpaid for not less than 14 days.

I direct you to immediately levy or cause to be levied the sum of [specify amount], and the costs of the execution of this warrant, by seizure and sale of any of the respondent’s goods and chattels, except the respondent’s necessary tools of trade, to a value not exceeding $500 and the respondent’s necessary household furniture and effects, including the wearing apparel of the respondent and any members of the respondent’s family, to a value not exceeding $2,000.

In pursuance of that direction, you are also authorised to seize and take away, and deliver to the Registrar of this court, any money, bank notes, bills of exchange, promissory notes, bonds, specialities, or other securities for money belonging to the respondent.

You are directed to pay what you levy to the Registrar of this court (or to the Registrar of the court at [place]) and to make return of what you do by virtue of this warrant immediately on its execution.

If no sufficient goods or money can be found or if the respondent cannot be found, you are required to report back to this court and to state what your inquiries have shown.

.
Judge
.
Date

Notes

Sale by auction

Goods seized in execution under this warrant must be sold by public auction unless the court otherwise orders.

Restriction on sale

Goods seized in execution under this warrant must not be sold until the expiration of a period of at least 7 days following the day on which the goods were seized unless—

(a)

the goods are of a perishable nature; or

(b)

the person whose goods have been seized so requests in writing.

Power of entry

For the purpose of executing this warrant, you may, at any time, enter on any premises, by force if necessary, if you have reasonable cause to believe that the property in respect of which this warrant is issued is on those premises. If any person in actual occupation of the premises requires you to produce evidence of your authority, you must produce this warrant before entering on the premises.

Endorsements

A request was made to the court for the issue of this warrant at [specify minutes] minutes past the hour of [specify hour] on [date] by [full name].

.
Registrar

This warrant was received by me on [date] at [time].

.
Bailiff (or Constable)

[Form 74 in the District Court Rules 2014 must be endorsed on this form if necessary.]

Schedule 3 form CS 30 heading: replaced, on 14 April 2014, by rule 9(1) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Schedule 3 form CS 30: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 3 form CS 30: amended, on 14 April 2014, by rule 9(2) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Form CS 31 Charging order

Section 184, Child Support Act 1991

(General heading—Form G 2)

The court is satisfied that the respondent, [full name], has a liability to pay financial support under the Act.

The court is satisfied that the respondent is entitled to the following property: [describe property to be charged and, if the order is to bind the Crown, the particulars required by section 186 of the Act].

The court orders that the money payable or to become payable by the respondent by way of financial support must be a charge on the property described above and, subject in the case of any real property to registration of a duplicate or copy of this order under the seal of the court against the appropriate title to the land (or as the case may require), the property is charged in favour of [full name] to whom for the time being and from time to time the money is or becomes payable.

.
Registrar
.
Date

Schedule 3 form CS 31: amended, on 1 July 2004, by rule 7(2) of the Family Courts Amendment Rules 2004 (SR 2004/165).

Form CS 32 Receiving order

Section 187, Child Support Act 1991

(General heading—Form G 2)

On [date], an order was made that money payable or to become payable by the respondent by way of financial support must be a charge on the following property to which the respondent is entitled: [describe the property charged].

That charge is in favour of [full name], being the person to whom, for the time being and from time to time, the money is or becomes payable.

The court is satisfied that payments of financial support under the Act that are due by the respondent are in arrears and unpaid and that there is due and payable the sum of $[specify]—

*and is satisfied that a copy of the charging order has been registered against the appropriate title to the land described above [or as the case may be].

†and is satisfied that a copy of the charging order has been served on the respondent.

‡and that the proposed receiver has entered into and filed a bond to the satisfaction of the Registrar for the due administration of his or her receivership.

The court orders that [full name and description of receiver] be the receiver of [describe terms of order].

Subject to the provisions of the Act, all money received by the receiver in the exercise of his or her powers must, after payment of all expenses incurred by him or her and of the remuneration (if any) that may be allowed by the court (or where Public Trust is the receiver, as provided by under the Public Trust Act 2001), be held by the receiver in trust—

(a)

to pay and satisfy all money from time to time accruing due, by way of financial support:

(b)

to hold the residue of the money so received until the charging order or this receiving order is discharged, or the court sooner directs, and then to pay it to the person who would be entitled to the money if no such charging or receiving order was in force.

.
Registrar
.
Date

*Delete if charging order does not include a charge over any real property.
†Delete if order is not made on an application.
‡Delete if the receiver is Public Trust, the Maori Trustee, or a trustee company within the meaning of the Trustee Companies Act 1967.

Note

The receiving order will expire on the payment of all arrears due under the Act, together with the payment in advance of all money that will become payable under the Act during the following 6-month period.

Form CS 33 Summons to attend examination as to means and default

Section 190, Child Support Act 1991

(General heading—Form G 2)

You are liable to pay financial support under the Act.

The amount of $[specify] was in arrears and unpaid on [date].

You are summoned to appear at [time] on [date] at the Family Court at [place] to be examined orally as to your means and as to the reasons for your failure to pay the financial support in arrears. If you pay the above amount before the above date, you need not appear for examination.

You must bring to the hearing any books, papers, and documents relating to your debts and to your failure to pay.

.
Registrar
.
Date

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Notes

Representation by a lawyer

You may be represented at the examination by a lawyer if you wish.

Failure to appear

If you fail to appear in answer to this summons, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Form CS 34 Warrant to arrest respondent for examination as to means and default

Section 190(4), Child Support Act 1991

(General heading—Form G 2)

To every constable

A summons was issued requiring the respondent, [full name], to appear on [date] at the Family Court at [place] to be examined as to the respondent’s means and as to the reasons for the respondent’s failure to pay financial support due under the Act.

*The examination was adjourned to [place].

*Delete if inapplicable.

The summons could not be served (or The respondent did not appear).

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

If you believe that the respondent cannot be brought before the court within 72 hours after the arrest of the respondent, you need not execute the warrant immediately.

.
Judge
.
Date

Form CS 35 Summons to witness to attend examination

Section 192(1), Child Support Act 1991

(General heading—Form G 2)

[Full name] has been summoned to appear to be examined orally as to his (or her) means and as to his (or her) reasons for failure to pay financial support due under the Act.

I believe—

*that you have possession of books, papers, or documents relating to the affairs or property of the respondent.

*that you are capable of giving information concerning the respondent’s income from any sources or concerning the respondent’s expenditure.

You are summoned to appear as a witness at the examination at [time] on [date] at the Family Court at [place].

*You are required to bring with you and produce [set out details of the book, paper, or document].

*Delete if inapplicable.

.
Registrar
.
Date

Notes

Travelling expenses

If you are required to travel more than 20 kilometres to attend the examination, you are entitled to a sum for expenses.

Failure to appear

If you fail to appear in answer to this summons, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Form CS 36 Warrant to arrest witness for attendance at examination of respondent

Section 192(4), Child Support Act 1991

(General heading—Form G 2)

To every constable

[Full name], of [address], [occupation], was summoned to appear on [date] at [place] as a witness at an examination as to the means of the respondent, [full name], and as to the reasons for the respondent’s failure to pay financial support due under the Act.

The witness failed to appear.

I am satisfied—

(a)

that the summons was duly served on the witness; and

(b)

that the witness was not required to travel more than 20 kilometres to attend the examination (or that expenses in accordance with the prescribed scale were tendered to the witness).

I direct you to arrest the witness, [full name], and bring him (or her) before the court as soon as possible.

If you believe that the witness cannot be brought before the court within 72 hours after the arrest of the witness, you need not execute the warrant immediately.

.
Judge
.
Date

Form CS 37 Warrant to arrest respondent for attendance at contempt proceedings

Section 196(5), Child Support Act 1991

(General heading—Form G 2)

To every constable

It is alleged that—

(a)

the respondent has or has had sufficient means to pay money payable under the Act but has refused or failed to do so; and

(b)

other methods of enforcing payment have been considered or tried and that they are inappropriate or have been unsuccessful.

As a result, an application has been made under section 196(2) of the Act.

*The application (with its supporting affidavit) was served on the respondent, but the respondent did not attend the hearing of the application on [date] at [place].

*The application (with its supporting affidavit) could not be served on the respondent.

*Delete if inapplicable.

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

If you believe that the respondent cannot be brought before the court within 72 hours after the respondent’s arrest, you need not execute the warrant immediately.

.
Judge
.
Date

Note

The warrant will cease to have effect if the amount due under the Act is paid.

Form CS 38 Application without notice for issue of warrant for arrest of respondent

Section 199, Child Support Act 1991

In the Family Court
at [place]

CS No: .

Applicant

The Commissioner of Inland Revenue

Respondent

[full name, address, and occupation]

I—

*am the Commissioner of Inland Revenue.

*[full name], am an employee of the Crown and am appearing for the Commissioner of Inland Revenue.

*Delete if inapplicable.

I make oath and say that—

1

the respondent has a liability to pay financial support under the Act.

2

I have reasonable cause to believe that the respondent is about to leave New Zealand with intent to avoid payment of that liability.

I apply for the issue of a warrant for the arrest of the respondent.

.
Signature of applicant

Sworn (or Affirmed) at [place], [date], before me:

.
Registrar
(or Justice of the Peace
or Solicitor)

To the Registrar

District Court at [place]

This application is filed by [full name], whose address for service is [address].

Form CS 39 Warrant for arrest of absconding respondent

Section 199, Child Support Act 1991

In the Family Court
at [place]

CS No: .

Applicant

The Commissioner of Inland Revenue

Respondent

[full name, address, and occupation]

To every constable

I am satisfied that—

1

the respondent has a liability to pay financial support under the Act.

2

the respondent is about to leave New Zealand with intent to avoid payment of that liability.

(*There being no District Court Judge available and the case appearing to be one of urgency,) I direct you to arrest the respondent and bring the respondent before the District Court as soon as possible.

*Delete if inapplicable.

.
Judge
(or Registrar (not being
a constable))
.
Date

Schedule 3 form CS 39: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 4 Forms for proceedings under Oranga Tamariki Act 1989

Schedule 4 heading: amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

OT 1	Front page for documents filed in court under Oranga Tamariki Act 1989
OT 2	Heading of documents issued by court or Registrar under Oranga Tamariki Act 1989
OT 3	Certificate as to holding of family group conference
OT 4	Information sheet to accompany applications under Oranga Tamariki Act 1989
OT 5	Notice of application
OT 6	Statement of consent
OT 7	Notice of proposal to make order
OT 8	Summons to attend mediation conference (or hearing)
OT 9	Summons for attendance of child or young person at hearing
OT 10	Warrant to arrest party for attendance at hearing
OT 11	Warrant to bring child or young person before court
OT 12	Warrant to deliver child or young person to person entitled to access
OT 13	Summons, by way of recall, to appear before Family Court
OT 14	Application relating to secure care
OT 15	Notice of application relating to detention in secure care

Form OT 1 Front page for documents filed in court under Oranga Tamariki Act 1989

rr 72(1)(a), 275

In the Family Court
at [place]

FAM No: .

Child or young person the application is about

[Full name of child or young person the application is about], born on [date of birth].

This document is filed by [name and address for service, and, if filed by lawyers, the name and telephone number of the acting lawyer].

Schedule 4 form OT 1 heading (formerly titled form CYPF 1): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 1 heading (formerly titled form CYPF 1): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 1 (formerly titled form CYPF 1): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Form OT 2 Heading of documents issued by court or Registrar under Oranga Tamariki Act 1989

rr 73(1)(a), 275

In the Family Court
at [place]

FAM No: .

Child or young person the application is about

[Full name of child or young person the application is about], born on [date of birth].

Schedule 4 form OT 2 heading (formerly titled form CYPF 2): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 2 heading (formerly titled form CYPF 2): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 2 (formerly titled form CYPF 2): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Form OT 3 Certificate as to holding of family group conference

r 279(1)(a)

(Heading—Form OT 2)

*I certify that—

*(a)

a family group conference has been held in relation to [full name of child or young person]; and

*(b)

the members of the conference were unable to agree on what decisions, recommendations, or plans should be made or formulated in relation to that child (or young person); or

*(c)

agreement on the decisions, recommendations, and plans made or formulated by that conference has been secured under section 30 of the Oranga Tamariki Act 1989; or

*(d)

the members of the conference agreed on what decisions, recommendations, and plans should be made or formulated in relation to the child (or young person), but [full name], acting in his (or her) capacity as [state capacity], did not agree to those decisions, recommendations, and plans.

*I certify that reasonable enquiries have been made to ascertain the whereabouts of a member of the family, whanau, or family group of [full name of child or young person], and that it has not been possible to ascertain the whereabouts of any such person.

*Delete if inapplicable.

.
Care and Protection Co-ordinator
(or Youth Justice Co-ordinator)
.
Date

Schedule 4 form OT 3 heading (formerly titled form CYPF 3): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 3 (formerly titled form CYPF 3): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 3 (formerly titled form CYPF 3): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Form OT 4 Information sheet to accompany applications under Oranga Tamariki Act 1989

r 20(1)(b)

In the Family Court
at [place]

FAM No: .

Particulars of child or young person that the application is about

This information sheet accompanies application(s) about [full name of child or young person that the application is about].

*Home address:

*Work address:

*Contact telephone number(s):

.[home] .[work]

Age: . Date of birth: ././.

Gender: .

Ethnic group: [please mark the space or spaces which apply]

□
New Zealand European
□
Maori
□
Samoan
□
Cook Island Maori
□
Tongan
□
Niuean
□
Chinese
□
Indian
□
Other [Dutch, Japanese, Tokelauan, etc]
Please state: .

Interpreter required: Yes/No

If yes, specify language:

The child (or young person) that the application is about is living with the following person(s):

Full name:

*Home address:

*Work address:

*Contact telephone number(s):

.[home] . [work]

Relationship or status in relation to the child (or young person):

The child (or young person) has lived with that person for [state period].

The living parent(s) of the child (or young person) are as follows:

Full name:

*Home address:

*Work address:

*Contact telephone number(s):

. [home] .[work]

The guardians of the child (or young person) are as follows:

Full name:

*Home address:

*Work address:

*Contact telephone number(s):

. [home] .[work]

*These details may be omitted from the copy to be served with the application.

The child (or young person) is in the legal custody of [if the child or young person is in the legal custody of the Director-General or an Iwi Authority or a Cultural Authority or the Director of a Child and Family Support Service or the controlling authority of a home registered under the Disabled Persons Community Welfare Act 1975, state the name and address of the person or organisation that has legal custody].

The child (or young person) is in that custody by reason of [state the legal authority for that custody, eg, place of safety warrant under section 39 of the Act, and give details of that legal authority, including the date of commencement and, if that authority was granted by a court, the location of that court and the file number of the proceedings (if known)].

The following court orders are in force in respect of the child (or young person): [state the nature of the order, the date on which it was made, the court that made the order, the location of that court, and the file number of the proceedings (if known)].

*The barrister or solicitor representing the child (or young person) in these proceedings is [full name], of [address].

*Delete if inapplicable.

Previous applications: [give the file number of, or sufficient information to identify, any previous applications relating to the child or young person that the application is about, and the courts where those applications were filed].

Nature of applications

The applications are:

A family group conference has (or has not) been held in respect of the matter that forms the ground of the application(s).

A medical examination of the child or young person has (or has not) been carried out under section 50 or section 53 of the Act.

Particulars of applicant

The applicant is [full name], of [address], [occupation].

Home address:

Work address:

Contact telephone number(s):

.[home] .[work]

Relationship or status in relation to the child (or young person):

Capacity in which the application is made:

Address for service

The accompanying applications are filed by [full name], whose address for service¹ is [address].

¹This address must be a place in New Zealand where any document may be left for the applicant. It may not be the address of a Post Office box, document exchange, or rural delivery.

For court use:

Date stamp:

Schedule 4 form OT 4 heading (formerly titled form CYPF 4): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 4 heading (formerly titled form CYPF 4): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 4 (formerly titled form CYPF 4): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Form OT 5 Notice of application

(Heading—Form OT 2)

[Repeat if more than 1 respondent.]

Notification of application for order

[Full name], the applicant, has filed an application at this court.

A copy of the application is attached. The order(s) or declaration(s) sought by the applicant is (or are) specified in the application.

Notice of intention to appear

If you wish to appear at the hearing of the application, either to support or to oppose the application, you must, within 7 days after the service of this notice on you, file a notice of intention to appear in this office of the court.

If you file a notice of intention to appear, you must serve a copy of the notice on the applicant or the applicant’s solicitor. The copy may be delivered to the address for service given by the applicant. You must also serve a copy of the notice on the barrister or solicitor representing the child (or young person) that the application is about, who is [full name], of [address].

You should note that if you do not file and serve a notice of intention to appear within 7 days after receiving service of this notice you may not be able to defend the application. On the day of the hearing of the application, should you appear, the Judge may—

(a)

allow you to take part in the hearing of the application only on such terms as the Judge thinks fit; or

(b)

decline to allow you to take part.

You should also note that the Judge may make an order against you for costs properly incurred as a consequence of your failure to file and serve a notice of intention to appear within time.

If you do not file and serve a notice of intention to appear, the case may proceed without further notice to you.

If you do not wish to appear either to support or to oppose the application, but you do wish to be kept informed of what is happening in respect of the application, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the other party (or parties) to the proceedings. That copy may be delivered to the address for service given by the other party (or parties).

If you do not appear at the hearing of the application, and the court considers that your presence is necessary to enable the court to hear and determine the application, a summons may be issued requiring you to attend. If you do not obey the summons, you may be arrested and brought before the court.

A mediation conference may be held to discuss the application. You will be given notice of the time and place at which the conference will be held. You will be requested to attend that conference.

Assistance

You may instruct a lawyer to prepare on your behalf a notice of intention to appear. If you want a lawyer but think you cannot afford one, contact an office of the Family Court immediately. You may also see a specimen form of the notice of intention to appear at any office of the Family Court.

Copies of orders

You will get copies of any orders made pursuant to this application.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Schedule 4 form OT 5 heading (formerly titled form CYPF 5): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 5 (formerly titled form CYPF 5): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 5 (formerly titled form CYPF 5): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 5 (formerly titled form CYPF 5): amended, on 3 August 2009, by rule 13 of the Family Courts Amendment Rules 2009 (SR 2009/185).

Form OT 6 Statement of consent

r 300(2)

(Front page—OT 1)

I, [full name], of [address], [occupation], consent to the making of the following order (or the imposing of the following condition) under the Oranga Tamariki Act 1989: [state order or condition consented to].

This consent is given subject to the following conditions: [state any conditions on which this consent is given].

My relationship or status in relation to the child (or young person) that the application is about is

Dated [date].

.
Signed by the above-named,

[full name of person giving the consent],

in the presence of—

Signature of witness:

Address:

Occupation:

Schedule 4 form OT 6 heading (formerly titled form CYPF 6): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 6 (formerly titled form CYPF 6): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 6 (formerly titled form CYPF 6): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Form OT 7 Notice of proposal to make order

r 300(4)

(Heading—Form OT 2)

The court proposes to make the following order under the Oranga Tamariki Act 1989: [state order proposed to be made].

*The order may not be made without your consent.

*The order may not be made unless you have been given the opportunity to make representations to the court.

*The order may not be made unless you have been given the opportunity to appear and be heard.

*Delete if inapplicable.

The court will consider making the order at the time and place stated below. You may make representations to the court about the order then. If you wish to consent to the making of the order, you may file in the court a statement of consent in form OT 6.

Time and place of hearing

Date of hearing: . Time: . am/pm

Place of hearing:

.
Registrar
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Schedule 4 form OT 7 heading (formerly titled form CYPF 7): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 7 (formerly titled form CYPF 7): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 7 (formerly titled form CYPF 7): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Form OT 8 Summons to attend mediation conference (or hearing)

Section 156 (or section 175), Oranga Tamariki Act 1989

(Heading—Form OT 2)

To [full name], of [address]

either

[In the case of a summons to attend a mediation conference]

You have failed to comply with a letter sent to you by post requesting you to attend a mediation conference at [time] on [date] at [place].

You are summoned to attend a mediation conference at [time] on [date] at [place].

*You are required to bring with you and produce [specify what must be produced].

*Delete if inapplicable.

If, without sufficient cause, you refuse or neglect to attend or to produce anything that you are required to produce, you may be prosecuted and fined.

[In the case of a summons to attend a hearing]

You are summoned to appear before the Family Court at [time] on [date] at [place].

Your presence is required to enable the court to hear and determine an application by [full name of applicant] in respect of [full name of child or young person to whom the proceedings relate].

If, without sufficient cause, you refuse or neglect to attend, you may be prosecuted and fined.

.
Judge (or Registrar)
.
Date

Schedule 4 form OT 8 heading (formerly titled form CYPF 8): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 8 (formerly titled form CYPF 8): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 8 (formerly titled form CYPF 8): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Form OT 9 Summons for attendance of child or young person at hearing

Section 157, Oranga Tamariki Act 1989

(Heading—Form OT 2)

(Heading—Form OT 2)

To every constable and every social worker

and

To [full name], [occupation]

I am satisfied on the application of [full name], of [address], [occupation], that he (or she) is entitled to access to [full name of child or young person], aged [specify] years, under an order made under section 121 of the Oranga Tamariki Act 1989.

The child (or young person) is in the care of [full name], of [address].

I authorise you to take possession of [full name of child or young person] and deliver him (or her) to [full name].

.
Judge
.
Date

Schedule 4 form OT 12 heading (formerly titled form CYPF 12): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 12 (formerly titled form CYPF 12): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 12 (formerly titled form CYPF 12): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 12 (formerly titled form CYPF 12): amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).

Form OT 13 Summons, by way of recall, to appear before Family Court

Section 85, Oranga Tamariki Act 1989

(Heading—Form OT 2)

To [full name], of [address], [occupation]

By order of the Family Court at [place] made on [date], you were ordered to come before that court if called on within 2 years after that order was made.

That court has now directed, on the application of a social worker (or a constable or [full name], the applicant in the proceedings in which the order was made), that this summons recalling you before that court be issued. That application was made on the grounds that [specify grounds].

You are summoned to appear at [time] on [date] at the Family Court at [place].

The court will then inquire into the circumstances of the case and your conduct since the order was made for the purpose of deciding whether it should exercise any of its powers.

Dated at [place], [date].

.
Judge
(or Justice of the Peace
or Registrar (not being
a constable))

Notice to person summoned

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Schedule 4 form OT 13 heading (formerly titled form CYPF 13): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 13 (formerly titled form CYPF 13): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 13 (formerly titled form CYPF 13): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 13 (formerly titled form CYPF 13): amended, on 1 October 2008, pursuant to section 116(a)(ii) of the Policing Act 2008 (2008 No 72).

Form OT 14 Application relating to secure care

Section 371 (or section 372(1) or section 377 or section 379 or section 380), Oranga Tamariki Act 1989

(Front page—Form OT 1)

I, [full name], apply—

*(a)

under section 371 of the Oranga Tamariki Act 1989 for an approval authorising the continued detention of [full name] in secure care.

*(b)

without notice under section 372(1) of the Oranga Tamariki Act 1989 for an order authorising the continued detention of [full name] in secure care.

*(c)

under section 377 of the Oranga Tamariki Act 1989 for the renewal of an approval granted under section 376(1) of that Act authorising the continued detention of [full name] in secure care.

*(d)

under section 379 of the Oranga Tamariki Act 1989 for a review of the decision of the Family Court (or Youth Court or District Court)—

*(i)

to grant an approval under section 376 of that Act authorising the continued detention of [full name] in secure care.

*(ii)

to grant a renewal of an approval under section 376 of that Act authorising the continued detention of [full name] in secure care.

*(iii)

to impose conditions under section 376 (or section 377) of that Act relating to the continued detention of [full name] in secure care.

*(e)

on notice (or without notice) under section 380 of the Oranga Tamariki Act 1989 for a review of the decision of the Director-General to place [full name] in secure care.

*Delete if inapplicable.

I am making this application because [state the reasons for the application].

I say:

[set out sufficient information to inform the court of the facts relied on to support the application].

.
Signature of applicant
.
Date

To the Registrar,

Family Court at [place]

and

To the other parties

This application is filed by [full name], whose address for service is [address].

Date of hearing

I appoint [date] at [time] at the Family (or Youth or District) Court (or the [name of responsible department residence]) at [place] for the hearing of this application.

.
Registrar
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

If this is an application under section 371 of the Act, a duly completed information sheet (in form CYPF 4) must accompany this application.

Schedule 4 form OT 14 heading (formerly titled form CYPF 14): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 14 (formerly titled form CYPF 14): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 14 (formerly titled form CYPF 14): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 4 form OT 14 (formerly titled form CYPF 14): amended, on 21 October 2002, pursuant to section 11(5) of the Department of Child, Youth and Family Services Act 1999 (1999 No 82).

Form OT 15 Notice of application relating to detention in secure care

Section 371(2) (or section 377(3) or section 381), Oranga Tamariki Act 1989

(Heading—Form OT 2)

Notification of application for order

[Full name], the applicant, has filed an application in this court.

A copy of the application is attached. The order(s) or approval(s) sought by the applicant is (or are) specified in the application.

Notice of intention to appear

If you wish to appear at the hearing of the application, either to support or to oppose the application, you must appear when the application is to be heard. The date, time, and place of the hearing is stated in the application.

At any hearing of the matter, you are entitled to appear and be heard as a party to the application, and you may have a barrister or solicitor acting for you. You may be entitled to legal aid in the proceedings. You must contact a lawyer as soon as possible if you wish to have legal representation.

.
Registrar
.
Date

Schedule 4 form OT 15 heading (formerly titled form CYPF 15): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 15 (formerly titled form CYPF 15): amended, on 13 August 2020, by rule 18 of the Family Court Amendment Rules (No 2) 2020 (LI 2020/150).

Schedule 4 form OT 15 (formerly titled form CYPF 15): amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 5 Forms for proceedings under Family Violence Act 2018

Schedule 5: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 1 Heading of documents issued by court or Registrar under Family Violence Act 2018

rr 73(1)(a), 305

In the Family Court at [place]
FV No: [number of proceeding]

[full name, address, and occupation]
(Applicant)

[full name, address, and occupation]
(Respondent)

*[full name, address, and occupation]
(Associated Respondent)

*Delete if it does not apply.

Note

Rule 311 of the Family Court Rules 2002 permits the applicant’s address to be omitted from the heading.

Schedule 5 form FV 1: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 2 Notice to respondent or associated respondent

Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

To [name of respondent/associated respondent*]

*Select one.

Notification of application for order

An application (see the attached copy) has been made by [full name] (the applicant).

The order or orders* sought is or are* specified in the application.

*Select one.

The applicant’s address for service is: [address].

A lawyer may prepare a notice of defence and an affidavit for you. If you want a lawyer but think you cannot afford one, you can find information about what assistance may be available on the Ministry of Justice website (see below), or by contacting a lawyer, the Ministry of Justice call centre (see below), or an office of the Family Court.

Copies of order

You will receive a copy of any orders made against you by the court. However, any order will normally be in force from the time it is made. The fact that you have not got a copy of the order will not be an excuse for not obeying it.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

Date:

Signature:

(Registrar)

Schedule 5 form FV 2: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 5 form FV 2: amended, on 2 May 2024, by rule 136(1) of the Family Court Amendment Rules 2024 (SL 2024/35).

Form FV 3 Summons to appear as witness (or appear before court)

rr 305, 322(1)

Section 169, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

To [full name], of [address], [occupation]

*Summons to appear as witness

*An application has been made by [full name], the applicant, against [full name], the respondent, for the following order(s): [specify nature of order(s) sought].

*On application by [full name], the applicant, against [full name], the respondent, the court has made the following temporary order: [specify order made].

*A hearing is to be held to decide—

*(a)

whether the order(s) sought should be made:

*(b)

whether a final order should be substituted for the temporary order:

*(c)

whether specified parts of the order made or sought should be part of a final order.

I believe that you are capable of giving evidence that may assist the court.

*Summons to appear before court

*On [date], the court directed you to undertake an assessment for a non-violence programme and attend a non-violence programme/‡undertake an assessment for prescribed services and engage with any prescribed standard service, provided by a service provider, that an assessor determines may be appropriate for and may benefit you.

‡Select one.

The service provider to whom you have been referred has notified the Registrar that you have failed to comply with that direction [set out nature of non-compliance].

You are summoned to appear (*as a witness) at the hearing at [time] on [date] at the Family Court at [place].

*Delete if it does not apply.

Date:

Signature:

Judge (or Family Court Associate or Registrar)

Notes

Failure to appear

If (*, having been tendered or paid allowances and travelling expenses at the appropriate rate,) you fail to attend, the court may issue a warrant to arrest you and bring you before the court.

If, without sufficient cause, you refuse or fail to attend, you may be prosecuted and fined.

*Delete if it does not apply.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

Schedule 5 form FV 3: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 5 form FV 3: amended, on 2 May 2024, by rule 136(2) of the Family Court Amendment Rules 2024 (SL 2024/35).

Form FV 4 Temporary protection order

Section 79, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

On application without notice, the court makes a temporary protection order against [full name], the respondent.

*Order to apply against other person(s) (or associated respondent(s))

*The court also directs that the order apply against the following person(s):

[full name of each person in respect of whom the court makes a direction under section 89(1) of the Family Violence Act 2018].

Person(s) protected by order

This order protects the following person(s) (the protected person(s)):

[full name of applicant]:

*[full name of each child of the applicant’s family], and any other child of the applicant’s family.

*The court also directs that the order applies for the benefit of the following person(s):

[full name of each person in respect of whom the court makes a direction under section 87(1) of the Family Violence Act 2018].

*Delete if it does not apply.

1 Conditions of order

(i)

any weapon in their possession or under their control, whether or not any such weapon is lawfully in their possession or under their control; and

(ii)

any firearms licence held by them.

On the making of this temporary protection order, any firearms licence held by the respondent, and any associated respondent, is deemed to be suspended.

Note: The Family Violence Act 2018 defines a weapon as any firearm, airgun, pistol, prohibited magazine, prohibited part, restricted weapon, ammunition, or explosive, as those terms are defined in the Arms Act 1983.

E Special conditions

The court also imposes the following special conditions on the respondent, associated respondent, or both [set out any special conditions imposed]:

*Special conditions to protect the protected person from further violence by the respondent, associated respondent, or both:

*Special conditions to address the inflicting of family violence against protected people who are particularly vulnerable (for example, due to age, disability, or health condition):

*Special conditions for the manner in which arrangements for access to a child are to be implemented:

*Special conditions for the manner and circumstances in which the respondent or the associated respondent, or both, may make contact with the protected person:

* Person who may consent to contact on behalf of the protected person and to withdraw such consent [name of person who may consent]:

*Other [insert any other special condition]:

Unless otherwise stated, these conditions last for the duration of this order.

*Omit if it does not apply.

2 Assessment for, and attendance at, non-violence programme/Assessment for prescribed services and engagement with prescribed standard service*

The court directs [full name of respondent/associated respondent] (the specified person) to undertake an assessment for a non-violence programme, and attend a non-violence programme, provided by a service provider, that an assessor determines is an appropriate non-violence programme for the specified person to attend.*

The court directs [full name of respondent/associated respondent] (the specified person) to undertake an assessment for prescribed services, and engage with any prescribed standard service, provided by a service provider, that an assessor determines may be appropriate for and may benefit the specified person.*

The Registrar of the court will arrange for the specified person to be referred to an assessor, and the specified person must meet with the assessor so that the assessor may—

(a)

undertake an assessment of the specified person; and

(b)

determine, if the direction in the notification is that the specified person undertake an assessment for a non-violence programme, whether there is an appropriate non-violence programme, provided by a service provider, for the specified person to attend; and

(c)

determine, if the direction in the notification is that the specified person undertake an assessment for prescribed services, whether (and, if so, which of) the types of services specified in regulations made under section 249(a) of the Family Violence Act 2018 (if any), provided by a service provider, may be appropriate for and may benefit the specified person.

If there is an appropriate non-violence programme for the specified person to attend, the service provider of that programme will settle in writing with the specified person the terms of attendance, which must include—

(a)

the number of programme sessions that the specified person must attend; and

(b)

details and arrangements about the programme venue, sessions, and times.

Before providing a prescribed standard service to a specified person directed to engage with the service, the service provider must settle in writing with the specified person the terms of the specified person’s engagement with the service.*

*Omit if it does not apply.

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to the whole of this order (or the following parts of this order: [specify parts]).

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Delete if it does not apply.

*Review of contact arrangements

Although no application has been made to it, the court, on its own initiative, has decided to direct that there be a review of the arrangements for contact between the respondent and [full name of each child of the applicant’s family in respect of whom contact arrangements are to be reviewed].

Date of review

I appoint [date] at [time] at the Family Court at [place] for this review.

*Omit if court does not direct that there be a review.

Date:

Signature:

(Registrar)

Effect of temporary protection order

This order is a temporary order.

*If you do nothing after being served, this order will automatically become a final order 3 months after the date on which it was made. The final order will come into effect immediately. If you wish to dispute this temporary protection order, you must notify the court as soon as possible.

*The court has directed that a hearing be held in relation to the whole of this order (or specified parts of this order).

This hearing will take place whether or not you wish to appear. If you wish to dispute any part of the order, you must notify the court as soon as possible.

If you do nothing, the court may make a final order in your absence (or the parts of the order in relation to which a hearing is not required will become final 3 months after the date on which this order was made, and the court may confirm the other parts of the order at the hearing).

*Delete if it does not apply.

Modification or discharge of order

You or the protected person may apply to the Family Court at any time—

(a)

for the modification or discharge of the standard condition about weapons. (The Family Court may make a change to this standard condition only if it is satisfied that the condition, or a term of the condition, is not needed to protect the persons for whose benefit this order applies from further family violence.):

(b)

for a variation or discharge of any special conditions of this order, or for the imposition of a new special condition:

(c)

for this order to be discharged.

You or the protected person may apply to the Family Court for a variation or discharge of a direction to undertake an assessment and attend a non-violence programme or engage with a prescribed standard service, or for such a direction to be made.

Consequences of breach of order

You commit an offence if you breach this order by—

(a)

doing an act in contravention of this order; or

(b)

failing to comply with any condition of this order; or

(c)

contravening, or failing to comply with any term and condition of, a related occupation order (for example, by failing to leave the dwellinghouse to which the order relates); or

(d)

contravening a related tenancy order (for example, by failing to leave the dwellinghouse to which the order relates); or

(e)

contravening, or failing to comply with any term and condition of, a related ancillary furniture order (for example, by preventing possession and use of all or any items to which the order relates); or

(f)

contravening, or failing to comply with any term and condition of, a related furniture order (for example, by preventing possession and use of all or any items to which the order relates).

You have a defence to proceedings for this offence if you can prove that you had a reasonable excuse for breaching the order.

The maximum penalty for this offence is 3 years’ imprisonment.

If a constable has good cause to suspect that you have breached this order, you may be arrested without warrant. Police bail is not available during the 24 hours immediately following an arrest. During that period, any bail application must be made to a Judge.

*Consequences of failing to comply with direction

You commit an offence if, without reasonable excuse, you fail on any occasion to comply with a direction made under section 188 or 198 of the Family Violence Act 2018—

(a)

to undertake an assessment for, and attend, a programme; or

(b)

to undertake an assessment for, or engage with, a prescribed service.

The maximum penalty for this offence is 6 months’ imprisonment or a fine not exceeding $5,000.

*Omit if it does not apply.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 4: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 5 Interim parenting order

Section 105, Family Violence Act 2018

(Complete and insert the general heading set out in form G 2)

On application made to it for a protection order, the court orders that—

(a)

the following person has/people have* the role of providing day-to-day care for the child(ren) listed below, during the times stated:

*Select one.

Full name of child and date of birth		Full name of person		Times when person has role of providing day-to-day care
[state]		[state]		[specify]

(b)

the following person has/people have* contact with the child(ren) listed below, during the times and in the ways stated:

*Select one.

Full name of child and date of birth		Full name of person		Times, location, and nature of contact
[state]		[state]		[specify, eg, face-to-face contact, letters, telephone, email, supervised by a person other than an approved provider]

Effect of interim parenting order

List of all existing relevant orders (if any) made under the Care of Children Act 2004, with statement in this order making clear, as required by section 105(5) of the Family Violence Act 2018, how this order operates with, overrides, or replaces all, or any parts, of those existing relevant orders: [insert list and statement].

The role of providing day-to-day care for a child may continue until the child turns 16 years old (see sections 48 to 50 of the Care of Children Act 2004).

While exercising the role of providing day-to-day care for a child, you have exclusive responsibility for the child’s day-to-day living arrangements, subject to any court order and the following conditions (if any): [specify any conditions to which the interim parenting order is subject that have been imposed by the court].

If you are a guardian, unless your role or another guardian’s role is modified by a court order, you must act jointly (for example, consulting whenever practicable with the aim of reaching agreement) when making guardianship decisions for a child.

Duration of interim parenting order

Select the statement that applies

This order continues in effect until [state specific date or specific event] or until it is replaced by another interim order or final order, as the case may be.

The court has directed that this order is to become a final parenting order on [date] unless, before that date,—

you notify the court that you wish to be heard; or
if a lawyer has been appointed to represent the child/children*, that lawyer has notified the court that that lawyer wishes to be heard.

*Select one.

If parent has neither role of providing day-to-day care nor contact

If, under this order, a parent of a child has neither the role of providing day-to-day care for, nor contact with, the child, there must be a hearing within 3 months on whether a further interim order or a final order should replace this order.

Select the statement that applies

I appoint [date within 3 months] at [time] at the Family Court at [place] for this hearing.

I will advise you of the date, time, and place of the hearing as soon as practicable.

Application to vary or discharge

If the order was made on an application without notice to you, you may make an application to the court to vary or discharge this order.

*Monitoring and review

This order is subject to the following monitoring and review requirements: [specify details of any monitoring or review requirements relating to this order, including any dates or processes by which the order is to be reviewed or monitored, and any requirements for parties to report back to the court on progress].

*Omit if it does not apply.

Variation or discharge of order

Any person affected by this order, or a person acting for a child who is the subject of this order, may apply to the court to vary or discharge this order.

Consequences of non-compliance

You must comply with the conditions of this parenting order. If you do not, another party may apply to the court to enforce the order. The Family Court may choose from a variety of tools to remedy the non-compliance. For example, you may be required to pay a bond to ensure you do not contravene the parenting order again, or to meet the reasonable costs incurred by the other party because of your contravention. The court may admonish you, or vary the order, for example, by reducing the amount of time you have with the child. The court takes non-compliance very seriously.

It is also an offence, without reasonable excuse and with the intention of preventing compliance with a parenting order, to contravene a parenting order. The penalty for this offence is imprisonment for a term not exceeding 3 months or a fine not exceeding $2,500.

*Because of the history of your case, the following actions are likely to be taken in the event of one or other of the parties to the order not complying: [specify any particular actions (eg, summonses, variation of order, bond, warrant) that are more likely to be considered because of the parties’ previous behaviour in relation to the order].

*Omit if it does not apply.

*Bond

This order requires [full name of person required to enter into the bond] to enter into a bond for the purpose of [state purpose of the bond].

[Full name of person required to enter into the bond] is required to deposit the sum of $[specify] with the Family Court at [place] by [date for payment of bond].

The bond may be forfeited to the Crown if [full name of person required to enter into the bond] does not meet the purpose of the bond or in the following circumstances: [specify circumstances that may result in forfeiture of the bond].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

General information to accompany parenting orders (as required by section 55(1)(b) of the Care of Children Act 2004)

See also the general information, set out above, about—

the effect of a parenting order; and
the processes for the monitoring and review of the order; and
the means by which the order can be varied or discharged; and
the consequences that may follow if the order is not complied with.

Schedule 5 form FV 5: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 6 Protection order

Sections 79 and 148, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

*On application, the court makes a protection order against [full name], the respondent.

*On application without notice, the court made a temporary protection order against [full name], the respondent, on [date], which order is now final in whole (or in part or with modifications or without modification).

*The temporary protection order made against [full name], the respondent, on [date] by the District Court after the court had been satisfied that the respondent had refused or failed to comply with a Police safety order, is now final in whole (or in part or with modifications or without modifications).

*Order to apply against other person(s) (or associated respondent(s))

*The court also directs that the order applies against the following person(s):

[full name of each person in respect of whom the court makes a direction under section 89(1) of the Family Violence Act 2018].

Person(s) protected by order

This order protects the following person(s) (the protected person(s)):

[full name of applicant]:

*[full name of each child of the applicant’s family], and any other child of the applicant’s family.

*The court also directs that the order applies for the benefit of the following person(s):

[full name of each person in respect of whom the court makes a direction under section 87(1) of the Family Violence Act 2018].

*Delete if it does not apply.

1 Conditions of order

A Standard conditions: no family violence, no contact, no having others breach order

The respondent, and any associated respondent, must not—

(a)

engage in behaviour that amounts to any form of family violence against the protected person (whether physical abuse, sexual abuse, or psychological abuse); or

(b)

make any unauthorised contact with the protected person; or

(c)

B Exceptions to standard no-contact condition, with consent

The protected person can suspend or reinstate the no-contact condition by giving or cancelling consent to contact.

The protected person’s consent is only valid if given in writing or in a digital communication but the protected person may withdraw consent at any time and in any way.

The protected person cannot consent to any contact inconsistent with—

(a)

any order for supervised contact in relation to a child; or

(b)

no-contact conditions imposed by a direction under section 168A of the Criminal Procedure Act 2011.

C Other exceptions to standard no-contact condition

Contact by the respondent, or associated respondent, with the protected person is authorised, and not in breach of the no-contact condition, if the contact is—

(a)

reasonably necessary in any emergency; or

(b)

permitted under any order or written agreement relating to the role of providing day-to-day care for, or contact with, or custody of—

(i)

any child (within the meaning of section 8 of the Care of Children Act 2004); or

(ii)

any child or young person (within the meaning of section 2 of the Oranga Tamariki Act 1989); or

(c)

permitted under any special condition of this protection order; or

(d)

necessary for the purposes of attending a family group conference (within the meaning of section 2 of the Oranga Tamariki Act 1989); or

(e)

D Standard conditions about weapons

The respondent and any associated respondent—

(a)

must not possess, or have under their control, any weapon; and

(b)

must not hold a firearms licence; and

(c)

(i)

any weapon in their possession or under their control, whether or not any such weapon is lawfully in their possession or under their control; and

(ii)

any firearms licence held by them.

On the making of this protection order, any firearms licence held by the respondent, and any associated respondent, is deemed to be revoked.

[Note: If the court has modified the terms of the standard condition relating to weapons, or directed that the standard condition relating to weapons is not a condition of the order (whether absolutely or only in so far as the order relates to the respondent or associated respondent), set out the terms of the court’s decision.]

E Special conditions

The court also imposes the following special conditions on the respondent, associated respondent, or both [set out any special conditions imposed]:

*Special conditions to protect the protected person from further violence by the respondent, associated respondent, or both:

*Special conditions to address the inflicting of family violence against protected people who are particularly vulnerable (for example, due to age, disability, or health condition):

*Special conditions for the manner in which arrangements for access to a child are to be implemented:

*Special conditions for the manner and circumstances in which the respondent or the associated respondent, or both, may make contact with the protected person:

* Person who may consent to contact on behalf of the protected person and to withdraw such consent [name of person who may consent]:

*Other [insert any other special condition]:

Unless otherwise stated, these conditions last for the duration of this order.

*Omit if it does not apply.

2 Assessment for, and attendance at, non-violence programme/Assessment for prescribed services and engagement with prescribed standard service*

The court directs [full name of respondent/associated respondent] (the specified person) to undertake an assessment for a non-violence programme, and attend a non-violence programme, provided by a service provider, that an assessor determines is an appropriate non-violence programme for the specified person to attend.*

The court directs [full name of respondent/associated respondent] (the specified person) to undertake an assessment for prescribed services, and engage with any prescribed standard service, provided by a service provider, that an assessor determines may be appropriate for and may benefit the specified person.*

The Registrar of the court will arrange for the specified person to be referred to an assessor, and the specified person must meet with the assessor so that the assessor may—

(a)

undertake an assessment of the specified person; and

(b)

(c)

determine, if the direction in the notification is that the specified person undertake an assessment for prescribed services, whether (and, if so, which of) the types of services specified in regulations made under section 249(a) of the Act (if any), provided by a service provider, may be appropriate for and may benefit the specified person.

(a)

the number of programme sessions that the specified person must attend; and

(b)

details and arrangements about the programme venue, sessions, and times.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to the whole of this order (or the following parts of this order: [specify parts]).

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of protection order

This order is a final protection order that lasts indefinitely. Certain conditions of this order may have a limited duration.

Modification or discharge of order

You or the protected person may apply to the Family Court at any time—

(a)

(b)

for a variation or discharge of any special conditions of this order, or for the imposition of a new special condition:

(c)

for this order to be discharged.

Consequences of breach of order

You commit an offence if you breach this order by—

(a)

doing an act in contravention of this order; or

(b)

failing to comply with any condition of this order; or

(c)

contravening, or failing to comply with any term and condition of, a related occupation order (for example, by failing to leave the dwellinghouse to which the order relates); or

(d)

contravening a related tenancy order (for example, by failing to leave the dwellinghouse to which the order relates); or

(e)

(f)

contravening, or failing to comply with any term and condition of, a related furniture order (for example, by preventing possession and use of all or any items to which the order relates).

You have a defence to proceedings for this offence if you can prove that you had a reasonable excuse for breaching the order.

The maximum penalty for this offence is 3 years’ imprisonment.

*Consequences of failing to comply with direction

You commit an offence if, without reasonable excuse, you fail on any occasion to comply with a direction made under section 188 or 198 of the Family Violence Act 2018—

(a)

to undertake an assessment for, and attend, a programme; or

(b)

to undertake an assessment for, or engage with, a prescribed service.

The maximum penalty for this offence is 6 months’ imprisonment or a fine not exceeding $5,000.

*Omit if it does not apply.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 6: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 7 Temporary occupation order

Section 116, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

On or after making a protection order on [date], in favour of [full name], the applicant, against [full name], the respondent, the court, on an application without notice for an occupation order, makes a temporary occupation order against the respondent.

The court orders that [full name], the applicant, be entitled, to the exclusion of the respondent, to personally occupy the dwellinghouse at [full address], together with any land, buildings, or improvements related to the dwellinghouse that are used, or ordinarily would be used, for the purposes of a household.

*The court directs that the applicant be entitled to occupy the dwellinghouse for the period from [date] to [date].

*The court also imposes the following terms and conditions relating to the occupation of the dwellinghouse: [set out any terms and conditions imposed].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to the whole of this order (or the following parts of this order: [specify parts]).

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of temporary occupation order

This order is a temporary order.

*If you do nothing after being served, this order will automatically become a final order 3 months after the date on which it was made. The final order will come into effect immediately. If you wish to dispute this temporary occupation order, you must notify the court as soon as possible.

*The court has directed that a hearing be held in relation to the whole of this order (or specified parts of this order).

This hearing will take place whether or not you wish to appear. If you wish to dispute any part of the order, you must notify the court as soon as possible.

*If another person who has an interest in the property and who has been given notice wishes to be heard, a hearing will be required even if you do not wish to be heard. In that case, you will be notified of the hearing date.

*If this order is made while you and the applicant are living in the same dwellinghouse, this order will expire—

(a)

on its discharge by the court (although the order may still become final, or be confirmed by the court, as set out above); or

(b)

on the discharge of a temporary protection order made in conjunction with this order.

*Omit if it does not apply.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce the period for which this order is in force; or

(b)

to vary or discharge any terms and conditions imposed by the court; or

(c)

to discharge this order.

Consequences of breach of order

You commit an offence if you contravene or fail to comply with any term and condition of this order (for example by failing to leave the dwellinghouse to which the order relates). You have a defence to proceedings for this offence if you can prove that you had a reasonable excuse for breaching the order. The maximum penalty for this offence is 3 years’ imprisonment. If a constable has good cause to suspect that you have breached this order, you may be arrested without warrant. Police bail is not available during the 24 hours immediately following an arrest. During that period, any bail application must be made to a Judge.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 7: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 8 Occupation order

Section 116, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

*On or after making a protection order on [date], in favour of [full name], the applicant, against [full name], the respondent, the court, on an application for an occupation order, makes an occupation order against the respondent.

*On application without notice, the court made a temporary occupation order against [full name], the respondent, on [date], which order is now final in whole (or in part or with modifications or without modifications).

The court orders that [full name], the applicant, is entitled, to the exclusion of the respondent, to personally occupy the dwellinghouse at [full address], together with any land, buildings, or improvements related to the dwellinghouse that are used, or ordinarily would be used, for the purposes of a household.

*The court directs that the applicant is entitled to occupy the dwellinghouse for the period from [date] to [date].

*The court also imposes the following terms and conditions relating to the occupation of the dwellinghouse: [set out any terms and conditions imposed].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of occupation order

This order is a final occupation order that lasts for the period specified in the order or, if no period is specified, indefinitely.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce the period for which this order is in force; or

(b)

to vary or discharge any terms and conditions imposed by the court; or

(c)

to discharge this order.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 8: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 9 Temporary tenancy order

Section 122, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

On or after making a protection order on [date], in favour of [full name], the applicant, against [full name], the respondent, the court, on application without notice for a tenancy order, makes a temporary tenancy order against the respondent.

The court orders—

(a)

that the tenancy of the dwellinghouse at [full address] be vested in [full name], the applicant, on and subject to the terms and conditions of the tenancy in force on [date on which order is made]; and

(b)

that the respondent cease to be a tenant.

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to this order.

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of temporary tenancy order

This order is a temporary order.

*If you do nothing after being served, this order will automatically become a final order 3 months after the date on which it was made. The final order will come into effect immediately. If you wish to dispute this temporary tenancy order, you must notify the court as soon as possible.

*The court has directed that a hearing be held in relation to this order.

This hearing will take place whether or not you wish to appear. If you wish to dispute any part of the order, you must notify the court as soon as possible.

If you do nothing, the court may make a final order in your absence.

*If this order is made while you and the applicant are living in the same dwellinghouse, this order will expire—

(a)

on its discharge by the court (although the order may still become final, or be substituted by a final order, as set out above); or

(b)

on the discharge of a temporary protection order made in conjunction with this order.

*Omit if it does not apply.

Discharge of order

You (or any other party) may apply to the court at any time to discharge this order and revest the tenancy. The court cannot vary the terms and conditions of the tenancy itself.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 9: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 10 Tenancy order

Section 122, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

*On or after making a protection order on [date], in favour of [full name], the applicant, against [full name], the respondent, the court, on an application for a tenancy order, makes a tenancy order against the respondent.

*On application without notice, the court made a temporary tenancy order against [full name], the respondent, on [date], which order is now final.

*Omit if it does not apply.

The court orders—

(a)

(b)

that the respondent cease to be a tenant.

Date:

Signature:

(Registrar)

Effect of tenancy order

This order is a final tenancy order that lasts indefinitely. The applicant becomes the tenant of the dwellinghouse to which this order relates, subject to the terms and conditions of the tenancy in force at the time this order is made. You cease to be a tenant.

Discharge of order

You (or any other party) may apply to the court at any time to discharge this order and revest the tenancy. The court cannot vary the terms and conditions of the tenancy itself.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 10: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 11 Temporary ancillary furniture order

Section 128, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

Having made—

*(a)

an occupation order:

*(b)

a tenancy order—

on [date] in favour of [full name], the applicant, against [full name], the respondent, the court, on application without notice, makes a temporary ancillary furniture order.

The court orders that the applicant be entitled, to the exclusion of the respondent, to the possession of—

*(a)

all the furniture, household appliances, and household effects in the dwellinghouse to which the occupation order (or tenancy order) relates, which is situated at [full address].

*(b)

the following furniture, household appliances, and household effects in the dwellinghouse to which the occupation order (or tenancy order) relates, which is situated at [full address]: [specify the items. It is not necessary to specify every item as long as the items to which the order relates are readily ascertainable from the terms of this order].

*The court also imposes the following terms and conditions relating to the furniture, household appliances, and household effects to which this order relates: [set out any terms and conditions imposed].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to the whole of this order (or the following parts of this order: [specify parts]).

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of temporary ancillary furniture order

This order is a temporary order.

*If you do nothing after being served, this order will automatically become a final order 3 months after the date on which it was made. The final order will come into effect immediately. If you wish to dispute this temporary ancillary furniture order, you must notify the court as soon as possible.

*The court has directed that a hearing be held in relation to the whole of this order (or specified parts of this order).

This hearing will take place whether or not you wish to appear. If you wish to dispute any part of the order, you must notify the court as soon as possible.

*Omit if it does not apply.

This order expires if the occupation order (or tenancy order) to which this order relates expires or is discharged.

*If this order is made while you and the applicant are living in the same dwellinghouse, this order will expire—

(a)

on its discharge by the court (although the order may still become final, or be confirmed by the court, as set out above); or

(b)

on the discharge of the occupation order (or tenancy order) to which this order relates.

*Omit if it does not apply.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce any period specified by the court as the period for which this order is in force; or

(b)

to vary the furniture, household appliances, and household effects to which this order relates; or

(c)

to vary or discharge any terms and conditions imposed by the court; or

(d)

to discharge this order.

Consequences of breach of order

You commit an offence if you contravene or fail to comply with any term and condition of this order (for example by preventing possession and use of all or any items to which the order relates). You have a defence to proceedings for this offence if you can prove that you had a reasonable excuse for breaching the order. The maximum penalty for this offence is 3 years’ imprisonment. If a constable has good cause to suspect that you have breached this order, you may be arrested without warrant. Police bail is not available during the 24 hours immediately following an arrest. During that period, any bail application must be made to a Judge.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 11: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 12 Ancillary furniture order

Section 128, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

*Having made—

*(a)

an occupation order:

*(b)

a tenancy order—

on [date] in favour of [full name], the applicant, against [full name], the respondent, the court, on application, makes an ancillary furniture order.

*On application without notice, the court made a temporary ancillary furniture order in favour of [full name], the applicant, against [full name], the respondent, on [date], which order is now final in whole (or in part or with modifications or without modification).

The court orders that the applicant be entitled, to the exclusion of the respondent, to the possession of—

*(a)

all the furniture, household appliances, and household effects in the dwellinghouse to which the occupation order (or tenancy order) relates, which is situated at [full address] (or the dwellinghouse situated at [full address]).

*(b)

the following furniture, household appliances, and household effects in the dwellinghouse to which the occupation order (or tenancy order) relates, which is situated at [full address] (or the dwellinghouse situated at [full address]): [specify the items. It is not necessary to specify every item as long as the items to which the order relates are readily ascertainable from the terms of this order].

*The court directs that this order continue in force for [specify duration if order made for specific period].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of ancillary furniture order

This is a final order that gives the applicant possession of the furniture, household appliances, and household effects to which it relates. While this order remains in force, you are not entitled to possession of these items.

Duration of order

This order continues in force for—

*(a)

6 months from the date on which it is made.

*(b)

[as directed by the court].

This order expires if the occupation order (or tenancy order) to which this order relates expires or is discharged.

*Omit if it does not apply.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce any period specified by the court as the period for which this order is in force; or

(b)

to vary the furniture, household appliances, and household effects to which this order relates; or

(c)

to vary or discharge any terms and conditions imposed by the court; or

(d)

to discharge this order.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 12: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 13 Temporary furniture order

Section 134, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

On or after making a protection order on [date] in favour of [full name], the applicant, against [full name], the respondent, the court, on application without notice, makes a temporary furniture order.

The court orders that the applicant be entitled, to the exclusion of the respondent, to the possession of—

*(a)

all the furniture, household appliances, and household effects in the dwellinghouse situated at [full address].

*(b)

the following furniture, household appliances, and household effects in the dwellinghouse situated at [full address]: [specify the items. It is not necessary to specify every item as long as the items to which the order relates are readily ascertainable from the terms of this order].

Date:

Signature:

(Registrar)

*Direction that hearing be held

The court directs that there be a hearing in relation to the whole of this order (or the following parts of this order: [specify parts]).

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for this hearing.

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of temporary furniture order

This order is a temporary order.

*If you do nothing after being served, this order will automatically become a final order 3 months after the date on which it was made. The final order will come into effect immediately. If you wish to dispute this temporary furniture order, you must notify the court as soon as possible.

*The court has directed that a hearing be held in relation to the whole of this order (or specified parts of this order).

This hearing will take place whether or not you wish to appear. If you wish to dispute any part of the order, you must notify the court as soon as possible.

*Omit if it does not apply.

This order expires if the protection order to which this order relates expires or is discharged.

*If this order is made while you and the applicant are living in the same dwellinghouse, this order will expire—

(a)

on its discharge by the court (although the order may still become final, or be confirmed by the court, as set out above); or

(b)

on the discharge of the protection order to which this order relates.

*Omit if it does not apply.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce any period specified by the court as the period for which this order is in force; or

(b)

to vary the furniture, household appliances, and household effects to which this order relates; or

(c)

to vary or discharge any terms and conditions imposed by the court; or

(d)

to discharge this order.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 13: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 14 Furniture order

Section 134, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

*Having made a protection order on [date] in favour of [full name], the applicant, against [full name], the respondent, the court, on application, makes a furniture order.

*On application without notice, the court made a temporary furniture order in favour of [full name], the applicant, against [full name], the respondent, on [date], which order is now final in whole (or in part or with modifications or without modification).

The court orders that the applicant be entitled, to the exclusion of the respondent, to the possession of—

*(a)

all the furniture, household appliances, and household effects in the dwellinghouse situated at [full address].

*(b)

*The court directs that this order continue in force for [specify duration if order made for specific period].

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Effect of furniture order

Duration of order

This order continues in force for—

*(a)

6 months from the date on which it is made.

*(b)

[as directed by the court].

This order expires if the protection order to which this order relates expires or is discharged.

*Omit if it does not apply.

Variation or discharge of order

You (or any other party) may apply to the court at any time—

(a)

to extend or reduce any period specified by the court as the period for which this order is in force; or

(b)

to vary the furniture, household appliances, and household effects to which this order relates; or

(c)

to vary or discharge any terms and conditions imposed by the court; or

(d)

to discharge this order.

Consequences of breach of order

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 14: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 15 Notice of result of objection to direction for assessment, non-violence programme, or prescribed standard services

r 321(a)

Section 190(1), Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

The objector [full name] is the respondent (or the associated respondent) under a temporary protection order made on [date] in favour of [full name], the applicant.

The objector has made an objection under section 189 of the Family Violence Act 2018 to—

(a)

a direction made under section 188(1) of the Act that the objector undertake an assessment for a non-violence programme, and attend a non-violence programme, provided by a service provider, that an assessor determines is an appropriate non-violence programme for the objector to attend:

*(b)

a direction made under section 188(3) of the Act that the objector undertake an assessment for prescribed services, and engage with any prescribed standard service, provided by a service provider, that an assessor determines may be appropriate for and may benefit the objector.

After considering the objection, the court—

*(a)

confirms the direction(s). The terms of the direction(s) are as follows: [set out terms of the direction(s) confirmed].

*(b)

confirms the direction(s) but varies the terms of the direction(s) as follows: [set out terms of the variation]. The terms of the direction(s), as varied, are as follows: [set out terms of the direction(s), as varied].

*(c)

discharges the direction(s).

*Omit if it does not apply.

Date:

Signature:

(Registrar)

Important information for respondent (or associated respondent) if direction confirmed or varied

Consequences of failure to comply with direction

If, without reasonable excuse, you fail to comply with a direction made under section 188 of the Family Violence Act 2018, you commit an offence. The maximum penalty for this offence is 6 months’ imprisonment or a fine not exceeding $5,000, or both (see section 211 of the Act).

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

See also the information sheet accompanying this order.

Schedule 5 form FV 15: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FV 16 Notice of registration of foreign protection order

r 328(1)

Section 219, Family Violence Act 2018

(Complete and insert the heading as set out in form FV 1)

To [name of respondent]

[address]

An order was made for [full name of applicant] at [place where foreign order made] on [date].

I have registered the order today, in this court.

The order protects the following people: [full names of protected persons].

Now that this order has been registered in New Zealand, it will be treated like a protection order made by a court here. A copy of a New Zealand protection order is attached to this notice. While you are in New Zealand, you must comply with the conditions set out in that order.

Date:

Signature:

(Registrar)

[Attach copy of New Zealand protection order, and relevant information sheet.]

Notes

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

Schedule 5 form FV 16: inserted, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 5 Forms for proceedings under Domestic Violence Act 1995

[Revoked]

Schedule 5: revoked, on 1 July 2019, by rule 46 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

DV 1	Front page for documents filed in court under Domestic Violence Act 1995 [Revoked]
DV 2	Heading of documents issued by court or Registrar under Domestic Violence Act 1995 [Revoked]
DV 3	Application for protection order/property orders [Revoked]
DV 4	Affidavit in support of application for protection order/property orders [Revoked]
DV 4A	Information sheet to accompany applications under the Domestic Violence Act 1995 (including application made without notice) [Revoked]
DV 5	Notice of residential address and request for confidentiality [Revoked]
DV 6	Information for Police if application made for protection order [Revoked]
DV 7	Application for appointment as representative [Revoked]
DV 8	Application for modification, discharge, or imposition of standard condition relating to weapons [Revoked]
DV 9	Notice to respondent or associated respondent [Revoked]
DV 10	Notice of defence [Revoked]
DV 11	Notice of intention to appear [Revoked]
DV 12	Affidavit of service [Revoked]
DV 13	Summons to appear as witness (or appear before court) [Revoked]
DV 14	Temporary protection order [Revoked]
DV 14A	Interim parenting order [Revoked]
DV 15	Protection order [Revoked]
DV 16	Temporary occupation order [Revoked]
DV 17	Occupation order [Revoked]
DV 18	Temporary tenancy order [Revoked]
DV 19	Tenancy order [Revoked]
DV 20	Temporary ancillary furniture order [Revoked]
DV 21	Ancillary furniture order [Revoked]
DV 22	Temporary furniture order [Revoked]
DV 23	Furniture order [Revoked]
DV 24	Objection to direction to undertake assessment and attend non-violence programme [Revoked]
DV 25	Notice of result of objection to direction to undertake assessment and attend non-violence programme [Revoked]
DV 26	Request by programme provider for variation of direction to attend programme [Revoked]
DV 27	Notice of registration of foreign protection order [Revoked]

FP 1	Request for counselling [Revoked]
FP 2	Notice to respondent of reference to counselling [Revoked]
FP 3	Request (and application without notice) to dispense with reference to counselling [Revoked]
FP 4	Report of counsellor [Revoked]
FP 5	Notice to respondent of resumption of proceedings [Revoked]
FP 6	Summons to party to attend counselling or mediation conference [Revoked]
FP 7	Application for separation order
FP 8	Application for declaration as to validity of marriage or civil union
FP 9	Application for order declaring marriage or civil union to be void ab initio
FP 10	Application for declaration of presumption of death and order dissolving marriage or civil union
FP 11	Application by one party for order dissolving marriage or civil union on ground of irreconcilable breakdown
FP 12	Affidavit to accompany application by one party for order dissolving marriage or civil union on ground of irreconcilable breakdown
FP 13	Joint application for order dissolving marriage or civil union on ground of irreconcilable breakdown
FP 14	Affidavit to accompany joint application for order dissolving marriage or civil union on ground of irreconcilable breakdown
FP 14A	Application by one party for dissolution order: protected person under protection order
FP 14B	Affidavit to accompany application by one party for dissolution order: protected person under protection order
FP 14C	Joint application for dissolution order: protected person under protection order
FP 14D	Affidavit to accompany joint application for dissolution order: protected person under protection order
FP 15	Application for paternity order
FP 15A	Application for declaration of paternity
FP 16	Notice to respondent of application under Family Proceedings Act 1980 or subpart 4 of Part 2 of Care of Children Act 2004
FP 17	Notice to respondent residing outside New Zealand of application under Family Proceedings Act 1980 or subpart 4 of Part 2 of Care of Children Act 2004
FP 18	Affidavit of financial means and their sources
FP 19	Request for appearance
FP 20	Request for hearing in relation to dissolution order: irreconcilable breakdown
FP 21	Notice of registration of order from commonwealth or designated country
FP 22	Provisional order for confirmation overseas
FP 23	Summons for hearing of proceedings for confirmation of overseas maintenance order
FP 24	Warrant to arrest respondent for hearing of proceedings for confirmation of maintenance order
FP 25	Summons for hearing of overseas maintenance application
FP 26	Warrant to arrest respondent for hearing of application for maintenance made by applicant residing overseas
FP 27	Order confirming provisional order for maintenance
FP 28	Maintenance order (child in convention country)
FP 29	Warrant of commitment on adjournment where respondent remanded in custody or does not immediately enter into bond
FP 30	Bail bond
FP 31	Warrant of deliverance on execution of bail bond
FP 32	Warrant to enforce role of providing day-to-day care for, or order for contact with, child [Revoked]
FP 33	Warrant to take child to prevent removal from New Zealand
FP 34	Separation order
FP 35	Maintenance order (spouse or civil union partner, former spouse or civil union partner, or former de facto partner)
FP 35A	Application for parenting order [Revoked]
FP 36	Parenting order(s) [Revoked]
FP 36A	Bond to ensure compliance with parenting order [Revoked]
FP 36B	Notice of intention to appear in relation to interim parenting order or other interim order [Revoked]
FP 37	Paternity order (and maintenance order)
FP 38	Order dissolving marriage or civil union
FP 39	Order declaring that other party to marriage or civil union is presumed to be dead and that marriage or civil union is dissolved
FP 40	Order declaring marriage or civil union to be void
FP 41	Application without notice for issue of warrant for arrest of respondent
FP 42	Request for issue of warrant to seize property
FP 43	Warrant to seize property
FP 44	Summons to attend examination as to means and default
FP 45	Warrant to arrest respondent for examination as to means and default
FP 46	Summons to witness to attend examination
FP 47	Warrant to arrest witness for attendance at examination of respondent
FP 48	Warrant to arrest respondent for attendance at contempt proceedings
FP 49	Warrant for arrest of absconding respondent
FP 49A	Warrant to prevent concealment of whereabouts of child
FP 49B	Warrant to enforce order for return of child
FP 50	Attachment order
FP 51	Charging order
FP 52	Receiving order

Form FP 7 Application for separation order

Section 20, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for a separation order.

This application is made on the ground that there is a state of disharmony between my husband (or wife) and me of a nature that it makes it unreasonable to require us to live together.

I say—

1

The state of disharmony arose between my husband (or wife) and me about [year].

2

The general nature of the disharmony is [describe in broad terms. Do not give details].

3

My husband (or wife) and I are living together at the time of making this application.

3

My husband (or wife) and I are not living together at the time of making this application.

(a)

We stopped living together on or about [date].

(b)

We agreed to separate by a written (or oral) agreement.

or

(b)

We did not agree to separate.

.
Signature of applicant
.
Date

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

*Counselling

As a result of this application, you and your husband (or wife) will be referred for counselling. Counselling may be dispensed with only for some good reason. See section 10 of the Family Proceedings Act 1980 and form FP 3.

*Delete if counselling has been dispensed with.

Form FP 8 Application for declaration as to validity of marriage or civil union

Section 27, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply to the court for a declaration whether, according to the law of New Zealand, the marriage or civil union between [full name] and [full name] is valid (or has been validly dissolved).

I say:

[set out sufficient information to inform the court of the facts relied on in support of the application].

.
Signature of applicant
.
Date

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Marriage or civil union certificate

A marriage or civil union certificate must, at the time of filing this application, be lodged in the office of the court unless the Registrar otherwise directs.

Schedule 6 form FP 8 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 8: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 9 Application for order declaring marriage or civil union to be void ab initio

Section 29, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for an order declaring the purported marriage or civil union between the respondent and me to be void ab initio.

This application is made on the following ground: [state the ground on which the application is made, following closely the wording of section 31 of the Family Proceedings Act 1980, and referring to the part of section 31(1) relied on].

I say—

*1

I am domiciled in New Zealand.

*1

The respondent is domiciled in New Zealand.

*1

The respondent and I are both domiciled in New Zealand.

*2

The purported marriage or civil union was solemnised in New Zealand.

3

I went through a form of ceremony of marriage or civil union with the respondent on [date] at [place].

4

[Set out sufficient information to inform the court of the facts relied on in support of the application.]

*Delete if inapplicable.

.
Signature of applicant
.
Date

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Marriage or civil union certificate

A marriage or civil union certificate must, at the time of filing this application, be lodged in the office of the court unless the Registrar otherwise directs.

Schedule 6 form FP 9 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 9: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 10 Application for declaration of presumption of death and order dissolving marriage or civil union

Section 32, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for an order declaring that my spouse (or partner) is presumed to be dead and that the marriage or civil union between us is dissolved.

This application is made on the ground that reasonable grounds exist for believing that my spouse (or partner) is dead.

Date of hearing

I appoint [date] at [time] at the Family Court at [place] for the hearing of this application.

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Marriage or civil union certificate

A marriage or civil union certificate must, at the time of filing this application, be lodged in the office of the court unless the Registrar otherwise directs.

Schedule 6 form FP 10 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 10: amended, on 1 July 2005, by rule 37(3) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 10: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 10: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 11 Application by one party for order dissolving marriage or civil union on ground of irreconcilable breakdown

rr 337(2)(b), 355(1)(a)(ii)

Section 37, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for an order dissolving the marriage or civil union between my spouse (or partner) and me.

This application is made on the ground that the marriage or civil union has broken down irreconcilably.

I say:

1

*Delete if inapplicable.

.
Registrar
.
Date

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Consent to order being made in absence

If you consent to the order being made in your absence (see paragraph 1), you must file an affidavit in form FP 12 with your application. Your application is then entered on the Registrar’s list of applications for dissolution orders. This allows the Registrar to make an order dissolving the marriage or civil union, if the requirements of the Family Proceedings Act 1980 and these rules are satisfied, without your having to appear before the Family Court.

Documents to be lodged

If you do not consent to the order being made in your absence (see paragraph 1), you must, at the time of filing this application, lodge in the office of the court, unless the Registrar otherwise directs,—

(a)

the original or a certified copy of your marriage or civil union certificate; and

(b)

a copy of any separation order or separation agreement to be used as evidence of living apart.

When order takes effect as final order

If an order dissolving a marriage or civil union is made by the Family Court in undefended proceedings, it takes effect as a final order on being made.

If an order dissolving a marriage or civil union is made by the Family Court in defended proceedings, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

However, one party may appeal to the High Court against the making of the order. If that happens, the order does not take effect while the appeal is pending. If, before the expiration of 1 month from the date on which the order is made, the appeal is withdrawn, abandoned, or dismissed, or the order is confirmed by the High Court, the order takes effect as a final order at the expiration of 1 month from the date on which it is made. If, after the expiration of 1 month from the date on which the order is made, the appeal is withdrawn, abandoned, or dismissed, or the order is confirmed by the High Court, the order takes effect as a final order on the withdrawal, abandonment, or dismissal of the appeal, or on the confirmation of the order of the High Court. If the order is set aside or quashed by the High Court, the order does not take effect as a final order.

If an order dissolving a marriage or civil union is made by the Family Court in defended proceedings and one party dies within 1 month of the order being made, the order does not take effect as a final order.

If an order dissolving a marriage or civil union is made by the Registrar, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

Schedule 6 form FP 11 heading: amended, on 17 October 2025, by rule 22(1)(a) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 11 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 11: amended, on 17 October 2025, by rule 22(1)(b) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 11: amended, on 17 October 2025, by rule 22(1)(c) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 11: amended, on 1 July 2005, by rule 37(4)(a) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 11: amended, on 1 July 2005, by rule 37(4)(b) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 11: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 11: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 12 Affidavit to accompany application by one party for order dissolving marriage or civil union on ground of irreconcilable breakdown

6

We will, at the filing of the application, have been living apart for the period of 2 years immediately preceding the filing of this application.

7

We ceased living together on [date].

8	(a)	A separation order was made on [date].
	(b)	A copy of the separation order is annexed to this affidavit and marked with the letter B.

8	(a)	A written separation agreement was made on [date].
	(b)	A copy of the written separation agreement is annexed to this affidavit and marked with the letter B.

8

We made an oral agreement to separate on [date].

8

No separation order was made and we did not agree to separate.

9

Our marriage or civil union has broken down irreconcilably.

*10

Satisfactory arrangements, or arrangements that are the best that can be devised in the circumstances, have been made for the day-to-day care, maintenance, and other aspects of the welfare of every child of the marriage or civil union. The arrangements relate to every child who is under 16 years. They also relate to every child who is 16 years or over and, because of special circumstances, requires arrangements to be made.

*11

The arrangements referred to in paragraph 10 of this affidavit are as follows:

Day-to-day care: [give details]:

Maintenance: [give details]:

Other aspects of welfare, such as schooling or any special needs [give details].

*Include if there are children of the marriage or civil union.

.
Signature of deponent

*Sworn (or Affirmed) at [place], [date], before me:

.
Registrar
(or Justice of the Peace
or Solicitor of the High Court)

Notes

Living apart

Section 40 of the Family Proceedings Act 1980 allows you to say that you have lived apart for 2 years even if you have come together as a married couple, or as civil union partners, for some periods within that 2 years. This section applies if you have come together as a married couple, or as civil union partners, for up to 3 months in total and if your purpose in coming together was to try to resume your marriage or civil union.

Documents

When you have completed this affidavit, these are the documents you must file:

an application by one party for an order dissolving a marriage or civil union (form FP 11)
an information sheet (form G 7)
this affidavit (form FP 12)
your marriage or civil union certificate (the original or a certified copy), annexed to this affidavit and marked with the letter A
your separation order, if any, annexed to this affidavit and marked with the letter B.

your written separation agreement, if any, annexed to this affidavit and marked with letter B.

Schedule 6 form FP 12 heading: amended, on 17 October 2025, by rule 22(2)(a) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 12 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 12: amended, on 17 October 2025, by rule 22(2)(b) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 12: amended, on 17 October 2025, by rule 22(2)(c) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 12: amended, on 19 August 2013, by rule 5(1) of the Family Courts Amendment Rules (No 2) 2013 (SR 2013/300).

Schedule 6 form FP 12: amended, on 1 July 2005, by rule 37(5)(a) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 12: amended, on 1 July 2005, by rule 37(5)(b) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 12: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 12: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 13 Joint application for order dissolving marriage or civil union on ground of irreconcilable breakdown

r 337(2)(b)

Section 37, Family Proceedings Act 1980

(Front page—Form G 1)

We, [full name] and [full name], jointly apply for an order dissolving our marriage or civil union.

This application is made on the ground that the marriage or civil union has broken down irreconcilably.

We say:

1

.
Registrar
.
Date

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Consent to order being made in absence

If you consent to the order being made in your absence (see paragraph 1), you must file an affidavit in form FP 14 with your application. Your application is then entered on the Registrar’s list of applications for dissolution orders. This allows the Registrar to make an order dissolving the marriage or civil union, if the requirements of the Family Proceedings Act 1980 and these rules are satisfied, without your having to appear before the Family Court.

Documents to be lodged

(a)

the original or a certified copy of your marriage or civil union certificate; and

(b)

a copy of any separation order or separation agreement to be used as evidence of living apart.

When order takes effect as final order

If an order dissolving a marriage or civil union is made by the Family Court on this application, it takes effect as a final order on being made.

If an order dissolving a marriage or civil union is made by the Registrar on this application, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

However, if there is a change of circumstances between the time of the filing of the application and the date on which the order takes effect, either party may seek a hearing at any time before the order takes effect as a final order. If that happens, the order does not take effect while the hearing is pending. If the order is then confirmed by the Family Court, the order takes effect as a final order on the confirmation of the order by the Family Court. If the order is quashed or set aside by the Family Court, the order does not take effect as a final order.

Schedule 6 form FP 13 heading: amended, on 17 October 2025, by rule 22(3)(a) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 13 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 13: amended, on 17 October 2025, by rule 22(3)(b) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 13: amended, on 17 October 2025, by rule 22(3)(c) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 13: amended, on 1 July 2005, by rule 37(6)(a) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 13: amended, on 1 July 2005, by rule 37(6)(b) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 13: amended, on 1 July 2005, by rule 37(6)(c) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 13: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 14 Affidavit to accompany joint application for order dissolving marriage or civil union on ground of irreconcilable breakdown

Section 38(2)(d), Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], of [address], [occupation], and I, [full name], of [address], [occupation], swear (or affirm) that:

1

We are the applicants for an order dissolving a marriage or civil union on the ground that the marriage or civil union has broken down irreconcilably.

2

[Full name of one of the marriage or civil union partners] is domiciled in New Zealand.

2

We are both domiciled in New Zealand.

3

We were married or entered into a civil union on [date] at [place], [name of city or town etc].

4

A copy of our marriage or civil union certificate is annexed to this affidavit and marked with the letter A.

5

We are living apart.

6

We will, at the filing of the application, have been living apart for the period of 2 years immediately preceding the filing of this application.

7

We ceased living together on [date].

8	(a)	A separation order was made on [date].
	(b)	A copy of the separation order is annexed to this affidavit and marked with the letter B.

8	(a)	A written separation agreement was made on [date].
	(b)	A copy of the written separation agreement is annexed to this affidavit and marked with the letter B.

8

We made an oral agreement to separate on [date].

8

No separation order was made and we did not agree to separate.

9

Our marriage or civil union has broken down irreconcilably.

*10

Satisfactory arrangements, or arrangements that are the best that may be devised in the circumstances, have been made for the day-to-day care, maintenance, and other aspects of the welfare of every child of the marriage or civil union. The arrangements relate to every child who is under 16 years. They also relate to every child who is 16 years or over and who, because of special circumstances, requires arrangements to be made.

*11

The arrangements referred to in paragraph 10 of this affidavit are as follows:

Day-to-day care: [give details]:

Maintenance: [give details]:

Other aspects of welfare, such as schooling or any special needs: [give details].

*Include if there are children of the marriage or civil union.

.
Signatures of deponents

Severally sworn (or affirmed) at [place] by both the above-named deponents this [date] before me:

.
Registrar
(or Justice of the Peace
or Solicitor of the High Court)

Notes

Living apart

Documents

When you have completed this affidavit, these are the documents you must file:

a joint application for an order dissolving a marriage or civil union (form FP 13)
an information sheet (form G 7)
this affidavit (form FP 14)
your marriage or civil union certificate (the original or a certified copy), annexed to this affidavit and marked with the letter A.
your separation order, if any, annexed to this affidavit and marked with the letter B.

your written separation agreement, if any, annexed to this affidavit and marked with the letter B.

Schedule 6 form FP 14 heading: amended, on 17 October 2025, by rule 22(4)(a) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 14 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 14: amended, on 17 October 2025, by rule 22(4)(b) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 14: amended, on 17 October 2025, by rule 22(4)(c) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 14: amended, on 19 August 2013, by rule 5(2) of the Family Courts Amendment Rules (No 2) 2013 (SR 2013/300).

Schedule 6 form FP 14: amended, on 1 July 2005, by rule 37(7)(a) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 14: amended, on 1 July 2005, by rule 37(7)(b) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 14: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 14: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 14A Application by one party for dissolution order: protected person under protection order

r 337(4)(a)

Section 39A, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for an order dissolving the marriage or civil union between my spouse (or partner) and me.

This application is made on the ground that I am a protected person under a protection order made against my spouse or civil union partner that is in force at the date of filing this application.

I say—

1

I am domiciled in New Zealand.

1

My spouse (or partner) is domiciled in New Zealand.

1

My spouse (or partner) and I are both domiciled in New Zealand.

2

I am a protected person under a protection order made against my spouse (or partner) and the protection order is in force at the date of filing this application.

3

There are no children of the marriage or civil union.

3

Day-to-day care: [give details]:

Maintenance: [give details]:

Other aspects of welfare, such as schooling or any special needs: [give details].

3

It is impracticable for me to make any arrangements for the day-to-day care, maintenance, and welfare of the children of the marriage or civil union because [give reasons].

Date:

Signature:

(Applicant)

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for the hearing of this application.

*Registrar’s list of applications for dissolution orders

*Delete if inapplicable.

Date:

Signature:

(Registrar)

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Documents to be filed

You must file an affidavit in form FP 14B. Your application is then entered on the Registrar’s list of applications for dissolution orders. This allows the Registrar to make an order dissolving the marriage or civil union, if the requirements of the Family Proceedings Act 1980 and these rules are satisfied, without your having to appear before the Family Court.

When order takes effect as final order

If an order dissolving a marriage or civil union is made by the Family Court in undefended proceedings, it takes effect as a final order on being made.

If an order dissolving a marriage or civil union is made by the Family Court in defended proceedings, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

However, one party may appeal to the High Court against the making of the order. If that happens, the order does not take effect while the appeal is pending. If, before the expiration of 1 month from the date on which the order is made, the appeal is withdrawn, abandoned, or dismissed, or the order is confirmed by the High Court, the order takes effect as a final order at the expiration of 1 month from the date on which it is made. If, after the expiration of 1 month from the date on which the order is made, the appeal is withdrawn, abandoned, or dismissed or the order is confirmed by the High Court, the order takes effect as a final order on the withdrawal, abandonment, or dismissal of the appeal or on the confirmation of the order of the High Court. If the order is set aside or quashed by the High Court, the order does not take effect as a final order.

If an order dissolving a marriage or civil union is made by the Registrar, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

Schedule 6 form FP 14A: inserted, on 17 October 2025, by rule 22(5) of the Family Court Amendment Rules 2025 (SL 2025/205).

Form FP 14B Affidavit to accompany application by one party for dissolution order: protected person under protection order

*8

Satisfactory arrangements, or arrangements that are the best that can be devised in the circumstances, have been made for the day-to-day care, maintenance, and other aspects of the welfare of every child of the marriage or civil union. The arrangements relate to every child who is under 16 years. They also relate to every child who is 16 years or over and who, because of special circumstances, requires arrangements to be made.

*9

The arrangements referred to in paragraph 8 of this affidavit are as follows:

Day-to-day care: [give details]:

Maintenance: [give details]:

Other aspects of welfare, such as schooling or any special needs [give details].

*Include if there are children of the marriage or civil union.

Signature:

(Deponent)

*Sworn (or Affirmed) at [place], [date], before me:

Signature:

(Registrar/Justice of the Peace/Solicitor of the High Court*)

*Select one.

Notes

Documents

When you have completed this affidavit, you must file the following documents:

an application by one party for an order dissolving a marriage or civil union: protected person under protection order (form FP 14A):
an information sheet (form G 7):
your marriage or civil union certificate (the original or a certified copy), annexed to this affidavit and marked with the letter A:
a copy of the protection order annexed to this affidavit and marked with the letter B and, if it is a foreign protection order, evidence of registration annexed to this affidavit and marked with the letter C.

Schedule 6 form FP 14B: inserted, on 17 October 2025, by rule 22(5) of the Family Court Amendment Rules 2025 (SL 2025/205).

Form FP 14C Joint application for dissolution order: protected person under protection order

r 337(4)(b)

Section 39A, Family Proceedings Act 1980

(Front page—Form G 1)

(Applicant(s))

*Date of hearing

I appoint [date] at [time] at the Family Court at [place] for the hearing of this application.

*Registrar’s list of applications for dissolution orders

*Delete if inapplicable.

Date:

Signature:

(Registrar)

Notes

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Documents to be filed

You must file an affidavit in form FP 14D. Your application is then entered on the Registrar’s list of applications for dissolution orders. This allows the Registrar to make an order dissolving the marriage or civil union, if the requirements of the Family Proceedings Act 1980 and these rules are satisfied, without your having to appear before the Family Court.

When order takes effect as final order

If an order dissolving a marriage or civil union is made by the Family Court on this application, it takes effect as a final order on being made.

If an order dissolving a marriage or civil union is made by the Registrar on this application, it takes effect as a final order at the expiration of 1 month from the date on which it is made.

Schedule 6 form FP 14C: inserted, on 17 October 2025, by rule 22(5) of the Family Court Amendment Rules 2025 (SL 2025/205).

Form FP 14D Affidavit to accompany joint application for dissolution order: protected person under protection order

rr 337(4)(b), 337A(2), 339(1)(b), 355A(1)(a)

Section 39A, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], of [address], [occupation], and I, [full name], of [address], [occupation], swear (or affirm) that—

1

We are the applicants for an order dissolving a marriage or civil union.

2

[Full name of one of the marriage or civil union partners] is domiciled in New Zealand.

2

We are both domiciled in New Zealand.

3

We were married or entered into a civil union on [date] at [place], [name of city or town, etc].

4

A copy of our marriage or civil union certificate is annexed to this affidavit and marked with the letter A.

5

[Full name of one of the marriage or civil union partners] is a protected person under a final protection order made on [date].

5

[Full name of one of the marriage or civil union partners] is a protected person under a foreign protection order registered on [date].

6

Any appeal rights in respect of the protection order have been exhausted or have expired.

7

A copy of the final protection order is annexed to this affidavit and marked with the letter B.

7

A copy of the foreign protection order and evidence of its registration is annexed to this affidavit and marked with the letter B.

8

[Full name of the other of the marriage or civil union partners] is a protected person under a final protection order made on [date].

8

[Full name of the other of the marriage or civil union partners] is a protected person under a foreign protection order registered on [date].

9

Any appeal rights in respect of the protection order have been exhausted or have expired.

10

A copy of the final protection order is annexed to this affidavit and marked with the letter C.

10

A copy of the foreign protection order and evidence of its registration is annexed to this affidavit and marked with the letter C.

*11

*12

The arrangements referred to in paragraph 11 of this affidavit are as follows:

Day-to-day care: [give details]:

Maintenance: [give details]:

Other aspects of welfare, such as schooling or any special needs: [give details].

Signature:

(Deponent)

Signature:

(Deponent)

Severally sworn (or affirmed) at [place] by both the above-named deponents this [date] before me:

Signature:

(Registrar/Justice of the Peace/Solicitor of the High Court*)

*Select one

Notes

Documents

When you have completed this affidavit, you must file the following documents:

a joint application for an order dissolving a marriage or civil union (form FP 14C):
an information sheet (form G 7):
this affidavit (form FP 14D):
your marriage or civil union certificate (the original or a certified copy), annexed to this affidavit and marked with the letter A:
a copy of the first party to the application’s protection order (and, if that protection order is a foreign protection order, evidence of registration of that protection order) annexed to this affidavit and marked with the letter B and the second party to the application’s protection order (and, if that protection order is a foreign protection order, evidence of registration of that protection order) annexed to this affidavit and marked with the letter C.

Schedule 6 form FP 14D: inserted, on 17 October 2025, by rule 22(5) of the Family Court Amendment Rules 2025 (SL 2025/205).

Form FP 15 Application for paternity order

Section 47, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], apply for a paternity order against [full name] on the ground that he is the father of a child called [full name of child] born on [date of birth of child] (or is the father of a child expected to be born on [expected date of birth of child]).

I say:

1

[If the application is made by a person other than the mother of the child, that person must state in what capacity and for what reason he or she is making the application. See section 47(1)(b) to (d) of the Family Proceedings Act 1980.]

2

[If section 49(2) of the Family Proceedings Act 1980 is relied on to bring the application within the period of limitation, the facts must be stated here.]

3

[Set out sufficient information to inform the court of the facts relied on in support of the application.]

.
Signature of applicant
.
Date

Note

Information sheet

A duly completed information sheet (form G 7) must accompany this application.

Form FP 15A Application for declaration of paternity

Family Proceedings Act 1980; Section 10(5)(a), Status of Children Act 1969

(Front page—Form G 1)

I, [full name], apply in relation to [full name of child or alleged child], [date of birth], for—

*a declaration of paternity

*a declaration of non-paternity.

*Delete whichever is inapplicable.

I am—

[tick whichever applies]

□
the mother of the child and I allege that [full name] of [address, if known] is the father of the child:

□
a person who alleges that the relationship of father and child exists between me and [full name] of [address, if known]:

□
a person who wishes to have it determined whether the relationship of father and child exists between the child or alleged child and [full name] of [address, if known] and I have a proper interest in the result [specify the nature of the interest].

.
Signature of applicant
.
Date

Note

Information sheet

A completed information sheet (form G 7) must accompany this application.

Schedule 6 form FP 15A: inserted, on 1 July 2005, by rule 36 of the Family Courts Amendment Rules 2005 (SR 2005/101).

Form FP 16 Notice to respondent of application under Family Proceedings Act 1980 or subpart 4 of Part 2 of Care of Children Act 2004

rr 32(2)(b), 341(2)(b), 367(1)(a)

(General heading—Form G 2)

An application (see the attached copy) has been filed in this court by [full name]. The order or orders sought by the applicant are specified in the application.

*Interim maintenance order

*On [date] at [time] at [place], there will be a hearing to decide whether interim maintenance should be paid.

*If you do not appear at this hearing, the court may make an interim maintenance order in your absence.

*Include these paragraphs only if a maintenance order is applied for.

Notice of defence

If you wish to defend the application, you must, within 21 days after the date on which you receive this notice,—

(a)

file a notice of defence in this office of the court; and

(b)

serve a copy of the notice of defence on the other party (or parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or other parties).

You should note that if you do not file and serve a notice of defence within that time you may not be able to defend the application. On the day of the hearing of the application, should you appear, the court may—

(a)

allow you to take part in the hearing of the application only on such terms as the court thinks fit; or

(b)

decline to allow you to take part.

You should also note that the court may make an order against you for costs properly incurred as a consequence of your failure to file and serve a notice of defence within time.

If you do not file and serve a notice of defence, the case may proceed without further notice to you.

*Request for an appearance or request for hearing

This note applies if—

(a)

the application is for an order dissolving the marriage or civil union on the ground that the marriage or civil union has broken down irreconcilably; and

(b)

the applicant has indicated in the application that the applicant consents to the order being made in his or her absence.

If you do not consent to the order being made in your absence, you may file, in this office of the court, a request for an appearance.

You may file a request for an appearance instead of, or in addition to, a notice of defence.

If you file a request for an appearance, you must serve a copy on the applicant. That copy may be delivered to the address for service given by the applicant.

If there is a change of circumstances after the application is filed and before the order takes effect as a final order, so that you want to appear before the Family Court, you may seek a hearing by filing, in this office of the court, a request for a hearing in form FP 20.

If you do not file and serve a notice of defence or a request for an appearance or a request for a hearing, an order dissolving the marriage or civil union may be made by the Registrar in your absence.

A lawyer will prepare a request for an appearance or a request for a hearing for you. If you want a lawyer but think you cannot afford one, you should contact an office of the Family Court immediately. You may also see a specimen form of the request for an appearance and request for a hearing at any office of the Family Court.

Address for service

If you do not wish to defend the application (*or appear before the Family Court at the hearing of the application) but you do wish to know what is happening, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the other party to the proceedings. That copy may be delivered to the address for service given by the applicant.

*Include only if an order dissolving a marriage or civil union is applied for.

Liability as witness

Even if you take no action, the court may summon you as a witness to help it deal with the application.

Copies of orders

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Schedule 6 form FP 16 heading: amended, on 31 March 2014, by rule 44(3) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 6 form FP 16: amended, on 17 October 2025, by rule 22(6) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 16: amended, on 2 May 2024, by rule 137(1) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 6 form FP 16: amended, on 3 August 2009, by rule 15(1) of the Family Courts Amendment Rules 2009 (SR 2009/185).

Schedule 6 form FP 16: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 17 Notice to respondent residing outside New Zealand of application under Family Proceedings Act 1980 or subpart 4 of Part 2 of Care of Children Act 2004

rr 32(2)(b), 341(2)(b)

(General heading—Form G 2)

An application (see the attached copy) has been filed in this court by [full name]. The order or orders sought by the applicant are described in the application.

Jurisdiction of court

The court may make an order if [set out bases for jurisdiction in respect of each order sought, following closely the relevant provisions of the Family Proceedings Act 1980 or subpart 4 of Part 2 of the Care of Children Act 2004 or of both].

Notice of defence

If you wish to defend the application or be heard on it, you must, either directly or through a lawyer in the place where you are, send authority to a lawyer in New Zealand instructing him or her to act for you.

You may file a request for an appearance instead of, or in addition to, a notice of defence.

If you file a request for an appearance, you must serve a copy on the applicant. That copy may be delivered to the address for service given by the applicant.

Address for service

If you do not wish to defend the application (*or appear before the Family Court at the hearing of the application) but you do wish to know what is happening, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the other party to the proceedings. That copy may be delivered to the address for service given by the applicant.

*Include only if an order dissolving a marriage or civil union is applied for.

Copies of orders

*Warning

If you are not domiciled in New Zealand, you are warned that a dissolution of marriage or civil union granted on the application of your marriage or civil union partner may not be recognised as valid outside New Zealand. The dissolution will be valid for all purposes within New Zealand.

If you wish to marry or enter into a civil union in a country outside New Zealand, you should take legal advice on whether you are legally free to do so.

*Include if an order dissolving a marriage or civil union is applied for.

Advice

If you need help, consult a lawyer in the place where you are immediately. If you intend to employ a lawyer in New Zealand, you should ask about your eligibility for legal aid in this country.

Respondents served in Australia under Trans-Tasman Proceedings Act 2010

If you are served in Australia and under section 13 of the Trans-Tasman Proceedings Act 2010 of New Zealand, this notice is affected by that Act and the information that section 15 of that Act requires to be served on you. By virtue of that Act you may, for example,—

respond to the application by taking steps yourself or by using an Australian lawyer (rather than by instructing a New Zealand lawyer to act for you); and
respond within a period that is at least 30 working days after the day on which you were served; and
give an address for service that is an address of a place in Australia or New Zealand.

Note: An initiating document for a civil proceeding that relates wholly or partly to a matter that, under sections 4(1) and 12(2)(a) of the Trans-Tasman Proceedings Act 2010, is an excluded matter (for example, the dissolution of a marriage) cannot be served in Australia and under section 13 of that Act.

.
Registrar
.
Date

Schedule 6 form FP 17 heading: amended, on 31 March 2014, by rule 44(4) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 6 form FP 17: amended, on 17 October 2025, by rule 22(7) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 17: amended, on 2 May 2024, by rule 137(2) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 6 form FP 17: amended, on 31 March 2014, by rule 44(5) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 6 form FP 17: amended, on 11 October 2013, by rule 20 of the Family Courts (Trans-Tasman Proceedings Act 2010) Amendment Rules 2013 (SR 2013/347).

Schedule 6 form FP 17: amended, on 3 August 2009, by rule 15(2) of the Family Courts Amendment Rules 2009 (SR 2009/185).

Schedule 6 form FP 17: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 17: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 18 Affidavit of financial means and their sources

r 344(1)(a)

Section 188(2)(d), Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], of [address], [occupation], swear (or affirm) that my financial means and their sources are as set out below.

1

My income for the 52 weeks immediately preceding the date of this affidavit was as follows: [use Nil if applicable]

Item Particulars		$
(a) salary, wages, or other personal earnings from [state employer]: (b) gross income from business: (c) amount received from boarders (including children over 16 years of age): (d) rents from property (including rooms let): (e) compensation or damages received: (f) superannuation, pension, or benefit (including any from overseas): (g) dividends and interest: (h) all other sources of income [specify]:
Total income in the 52 weeks:		$

2

My assets (both in New Zealand and elsewhere) are as follows:

Item Particulars		$
(a) land and buildings [state address and capital value]: (b) money in bank accounts [specify banks]: (c) money not in bank or invested: (d) money lent or in hands of any person [name and address]: (e) government stock, shares, debentures, or bonds [state details]: (f) plant and machinery [state details]: (g) livestock [state details]: (h) interest in business, stock in trade, or venture of any kind [state details]: (i) motor vehicles [state details]: (j) any other property or assets not specified above, including interest in any estate [state details]:
Total assets:		$

3

The property specified in items [specify] of clause 2 of this affidavit is mortgaged, or otherwise secured to [full name], of [address], for the sum of $.

4

My expenses for the 52 weeks specified in clause 1 of this affidavit were as follows:

Item Particulars		$
(a) income tax: (b) insurance and superannuation: (c) medical and hospital benefits: (d) rent: (e) rates: (f) mortgage payments: (g) repairs on home: (h) food and household supplies: (i) electricity, gas, and fuel: (j) telephone: (k) laundry and cleaning: (l) clothing: (m) child maintenance, care, and education: (n) maintenance for former spouse or partner: (o) entertainment: (p) fares: (q) car maintenance, running, and registration: (r) hire purchase payments: (s) other expenses [specify]:
Total expenses in the 52 weeks:		$

5

Separate income for the 52 weeks of members of household whose expenses are included:

(a)

[list full names, ages, and relationship of all members of household]:

(b)

[list details of separate income of any member of household].

.
Signature of deponent

Sworn (or Affirmed) at [place], [date], before me:

.
Registrar
(or Justice of the Peace
or Solicitor of the High Court)

Schedule 6 form FP 18: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 18: amended, on 1 July 2004, by rule 8(2) of the Family Courts Amendment Rules 2004 (SR 2004/165).

Form FP 19 Request for appearance

r 346

Section 38(2)(c), Family Proceedings Act 1980

(Front page—Form G 1)

To the Registrar

Family Court at [place]

I, [full name], am the respondent to the application for an order dissolving a marriage or civil union made by [name of applicant] on [date].

I request an appearance when the application is heard by the Family Court.

.
Signature of respondent
.
Date

Schedule 6 form FP 19: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 6 form FP 19: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 20 Request for hearing in relation to dissolution order: irreconcilable breakdown

rr 347, 356(1)

Section 38(3), Family Proceedings Act 1980

(Front page—Form G 1)

To the Registrar

Family Court at [place]

1

I, [full name], am a party to a marriage or civil union in relation to which an application for a dissolution order: irreconcilable breakdown was filed on [date]. The order has not been made.

1

I, [full name], am a party to a marriage or civil union that was dissolved by a dissolution order: irreconcilable breakdown made by the Registrar on [date]. The order will take effect on [date].

2

I request a hearing.

3

This request is made on the ground that there has been the following change of circumstances since the time of the filing of the application for the order: [set out sufficient information to inform the court of the facts relied on in support of the request].

4

I estimate that the duration of the hearing will be [specify period] because [set out all available information affecting the estimated length of the hearing].

.
Signature of party
.
Date

Date of hearing

I appoint [date] at [time] at the Family Court at [place] for the hearing.

.
Registrar
.
Date

Schedule 6 form FP 20 heading: amended, on 17 October 2025, by rule 22(8)(a) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 20: amended, on 17 October 2025, by rule 22(8)(b) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 20: amended, on 17 October 2025, by rule 22(8)(c) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 20: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 21 Notice of registration of order from commonwealth or designated country

r 364(1)

Section 136, Family Proceedings Act 1980

(General heading—Form G 2)

I have today registered in this court an order for maintenance made between the above-named parties at [place] on [date]. The order provides for the payment of maintenance by you in the following terms: [set out the terms of the order].

Now that this order has been registered in New Zealand, it will be treated like a maintenance order made by a court here.

According to a certificate given by [full name] and filed in the court, you owe, under the order, the sum of [specify] up to [specify].

Unless you are notified to the contrary by the Commissioner of Inland Revenue, all payments under the order must be paid to the Commissioner of Inland Revenue in accordance with the Child Support Act 1991. It is the Commissioner’s duty to enforce the order.

.
Registrar
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office or an office of the Ministry of Social Development immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Schedule 6 form FP21: amended, on 1 October 2003, pursuant to section 14(1) of the State Sector Amendment Act 2003 (2003 No 41).

Form FP 22 Provisional order for confirmation overseas

r 368(1)

Section 147, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it for the making against the respondent of—

*a maintenance order in respect of a spouse or civil union partner or a former spouse or civil union partner,—

*a provisional maintenance order in respect of a child,—

this court makes a provisional maintenance order (or provisional maintenance orders) against the respondent.

*Delete if inapplicable.

By this provisional maintenance order (or these provisional maintenance orders), this court orders that the respondent—

(a)

pay towards the future maintenance of the applicant the sum of $[specify] per [specify] until [specify period] (or during the joint lives of [full name] and [full name] [or as the case may be]):

(b)

pay towards the future maintenance of [full name], a child born on [date of birth], the sum of $[specify] per [specify] until the child reaches the age of 16 years [or as the court otherwise directs].

This order is (or These orders are) provisional only and have no effect unless and until confirmed by a competent court in a place outside New Zealand.

.
Registrar
.
Date

Note

Accompanying documents

When transmitted by the Secretary for Justice to the country in which the respondent resides, this order must be accompanied by the documents specified in section 147(6) of the Family Proceedings Act 1980. The statement of the grounds on which the making of the order might have been opposed may be in the form of a certificate signed by the Judge hearing the application.

Schedule 6 form FP 22: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 22: amended, on 1 July 2004, by rule 8(3) of the Family Courts Amendment Rules 2004 (SR 2004/165).

Form FP 23 Summons for hearing of proceedings for confirmation of overseas maintenance order

Section 138(3)(a) (or section 139(3)), Family Proceedings Act 1980

(General heading—Form G 2)

On the application of [full name], a provisional order was made against you in the [specify court] Court at [place] on [date] under [state the Act or other authority of the country where the order was made].

The provisional order provides [set out the relevant terms of the provisional order].

Proceedings for the confirmation of the provisional order are now to be heard in New Zealand in court.

In connection with those proceedings, this court has received, in relation to the provisional order, the following documents:

(a)

a certified copy of that order:

(b)

the depositions of the witnesses:

(c)

a statement of the grounds on which the order might have been opposed [delete if the provisional order, being an order to which section 139 or section 139A of the Family Proceedings Act 1980 applies, affects a New Zealand maintenance order or a New Zealand maintenance agreement].

Copies of these documents may be obtained from this office of this court.

You are summoned to appear at [time] on [date] in the District Court at [place] to show reasons why the provisional order (or orders) should not be confirmed.

At the hearing, it will be open to you to raise any defence that you might have raised in the original proceedings had you been present but no other defence (except [if the provisional order is made in or consequent on an affiliation order] the defence—

(a)

that you are not the father of the child; and

(b)

that the proceedings in which the affiliation order was made were not brought to your notice (either by the service of a summons on you or by any other method permitted by the law of the country in which the affiliation order was made)).

If you do not appear at the hearing, or if on appearing you do not satisfy the court that the order ought not to be confirmed, the court may confirm the order either with or without modifications.

*If the court confirms the order, it may also, if it is satisfied that you are of sufficient ability, order you to pay a sum for maintenance between the date of the making of the order and its confirmation.

*Include only if section 138(1)(a) of the Family Proceedings Act 1980 applies.

*If the court confirms the order, it will become a maintenance order for the purposes of the Family Proceedings Act 1980 and may be enforced in New Zealand under the Child Support Act 1991.

*Include only if section 138(1)(a) of the Family Proceedings Act 1980 applies.

.
Registrar
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Form FP 24 Warrant to arrest respondent for hearing of proceedings for confirmation of maintenance order

Section 138(3)(b), Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

On the application of [full name], a provisional order was made against the respondent in the [specify court] Court at [place] on [date] under [state the Act or other authority of the country where the order was made].

The provisional order provides [set out the terms of the provisional order].

A certified copy of that order, together with the other necessary documents, has now been sent to this court for the hearing of proceedings for the confirmation of the order.

I am satisfied that the address of the respondent is unknown (or a summons has been issued for the attendance of the respondent at this court, but has not been served because the respondent cannot be found).

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

.
Judge
(or Registrar)
.
Date

Schedule 6 form FP 24: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FP 25 Summons for hearing of overseas maintenance application

Section 145J(1)(b), Family Proceedings Act 1980

(General heading—Form G 2)

An application by [full name] of [address] for an order against you has been received by this court.

The applicant seeks [set out the terms of the order(s) sought].

Copies of the application and of the accompanying documents sent by the applicant are attached to this summons.

You are summoned to appear at [time] on [date] in the District Court at [place] for the hearing of the application.

Notice of defence

If you wish to defend the application, you must, within 21 days after the date on which you receive this notice, file a notice of defence in this office of the court. If you do not file and serve a notice of defence, the case may proceed without further notice to you.

Address for service

If you do not wish to defend the application but you do wish to know what is happening, you must file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you.

Assistance

Liability as a witness

Even if you take no action, the court may summon you as a witness to help it deal with the application.

Copies of orders

Enforcement

If the court makes an order, the order will be enforced under the Child Support Act 1991.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Form FP 26 Warrant to arrest respondent for hearing of application for maintenance made by applicant residing overseas

Section 145J(2), Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

An application by [full name] of [address] for an order has been received by this court.

The applicant seeks [set out the terms of the order(s) sought].

The application, together with the other necessary documents, has now been sent to the court to be dealt with.

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

.
Judge
.
Date

Schedule 6 form FP 26: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FP 27 Order confirming provisional order for maintenance

Section 138 (or section 139 or section 139A), Family Proceedings Act 1980

(General heading—Form G 2)

On [date], a provisional order was made by the [specify court] Court at [place and country] under [set out the Act or other authority].

The provisional order provides [set out the relevant terms of the provisional order].

A summons was duly served on the respondent to appear on [date] at the District Court at [place] (or The respondent was arrested and brought before the District Court at [place]) to show reasons why the provisional order should not be confirmed.

On appearing, the respondent failed to satisfy the court that the order should not be confirmed (or did not appear).

This court orders that the order be confirmed without modification (or with the following modifications: [specify]).

*Unless you are notified to the contrary by the Commissioner of Inland Revenue, all payments under the order must be paid to the Commissioner of Inland Revenue in accordance with the Child Support Act 1991. It is the Commissioner’s duty to enforce the order.

*The first payment must be made on [date].

*Delete—

(a)

if the order does not require payments, as in the case of the cancellation or suspension of a maintenance order; or

(b)

if the person ordered to pay maintenance under the order is outside New Zealand.

.
Registrar
.
Date

Note

Copies of order

Copies of this order must be forwarded to—

(a)

the Head Office, Ministry of Justice; and

(b)

the court making the provisional order; and

(c)

if the order was made under section 138 of the Family Proceedings Act 1980, the Commissioner of Inland Revenue.

Schedule 6 form FP 27: amended, on 1 July 2004, by rule 8(4) of the Family Courts Amendment Rules 2004 (SR 2004/165).

Form FP 28 Maintenance order (child in convention country)

Family Proceedings Act 1980

Section 145G, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court orders that the respondent pay, in respect of the maintenance of [full name], a child born on [date],—

(a)

the sum of $[specify] per [specify period] towards the future maintenance of the child until the child reaches the age of [specify] years [or as the court otherwise directs]. The first payment is to be made on [date]:

(b)

the sum of $[specify] towards the future maintenance of the child. The sum is payable [specify arrangements for payment and any conditions]:

(c)

the sum of $[specify] towards the past maintenance of the child. The sum is payable [specify arrangements for payment and any conditions].

.
Registrar
.
Date

Note

Payments

Form FP 29 Warrant of commitment on adjournment where respondent remanded in custody or does not immediately enter into bond

r 369(4)

(General heading—Form G 2)

To every constable

and

To the Manager of [name of prison]

The respondent was arrested on a warrant issued under section 138(3)(b) (or section 145J(2)) of the Family Proceedings Act 1980 [or as the case may be]).

The further hearing of the application between the above-named parties has been adjourned, and the respondent has been remanded in custody for the period of the adjournment (or granted bail in terms certified on the back of this warrant) but has not yet entered into a bail bond.

You, the constables, are directed to deliver the respondent to the prison at [place] and you, the Manager, to receive the respondent into your custody and to detain the respondent until [date], when you are required to bring the respondent to the Family Court at [place] at [time] for the further hearing of the application.

.
Registrar
.
Date

Certificate of consent to bail

I certify that the respondent named in this warrant may be released on bail bond being entered into on the following terms: [specify terms].

.
Registrar
.
Date

Schedule 6 form FP 29: amended, on 1 July 2005, by rule 37(10)(a) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 29: amended, on 1 July 2005, by rule 37(10)(b) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 29: amended, on 1 July 2005, by rule 37(10)(c) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Form FP 30 Bail bond

r 369(5)

Family Proceedings Act 1980

(General heading—Form G 2)

The respondent was arrested on a warrant issued under section 138(3)(b) (or section 145J(2)) of the Family Proceedings Act 1980 [or as the case may be]).

The further hearing of the application between the above-named parties has been adjourned, and the court has directed that the respondent be released on bail during the period of the adjournment.

I, [full name], bind myself to attend personally at the Family Court at [place] at [time] on [date], which is the date to which the hearing of the application between the parties has been adjourned.

I acknowledge myself bound to forfeit to the Crown the sum of $[specify] and I (or we) [full name, address, and occupation of each surety] acknowledge myself (or ourselves) bound to forfeit to the Crown the sum of $[specify] (each) if the respondent fails to attend at the time and place to which the hearing has been adjourned.

.
Respondent

.
Surety (or Sureties)

Taken before me at [place] on [date]:

.
Judge
(or Family Court Associate or Registrar)

Schedule 6 form FP 30: amended, on 2 May 2024, by rule 137(3) of the Family Court Amendment Rules 2024 (SL 2024/35).

Form FP 31 Warrant of deliverance on execution of bail bond

r 369(6)

Family Proceedings Act 1980

(General heading—Form G 2)

To the Manager of [name of prison]

The respondent, who was remanded into your custody after the respondent’s arrest and on the adjournment of an application between the above-named parties, was granted bail on the following terms: [specify terms].

The respondent has now entered into a bail bond with (or without) surety (or sureties) in the required amount(s), and you are now directed, if the respondent is detained on the warrant and no other, to release the respondent immediately.

.
Judge
(or Family Court Associate or Registrar)
.
Date

Schedule 6 form FP 31: amended, on 2 May 2024, by rule 137(4) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 6 form FP 31: amended, on 1 July 2005, by rule 37(11) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Form FP 32 Warrant to enforce role of providing day-to-day care for, or order for contact with, child

[Revoked]

Schedule 6 form FP 32: revoked, on 31 March 2014, by rule 44(2) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form FP 33 Warrant to take child to prevent removal from New Zealand

Section 118, Care of Children Act 2004

(General heading—Form G 2)

To every constable (or social worker)

I have reason to believe that [full name], a child aged [specify] years, may be taken out of New Zealand with intent to, or in circumstances where the taking of the child would be likely to,—

*defeat the claim of [full name], of [address], [occupation], who has applied for (or is about to apply for) the role of providing day-to-day care for, or an order for contact with, the child; or

*prevent an order made in the [court] at [place] on [date] (or registered under section 81 of the Care of Children Act 2004) about the role of providing day-to-day care for, or about contact with, the child, from being complied with.

The child is said to be in the care of [full name] of [address].

(*There being no High Court Judge or District Court Judge or Family Court Judge available,) I direct you to take the child (using reasonable force if necessary) and place the child in the care of some suitable person pending the order or further order of the court having jurisdiction in the case.

When you have executed this warrant in accordance with the direction, you must advise this court immediately of the name and address of the person with whom you have placed the child.

*Delete if inapplicable.

.
Judge
(or Family Court Associate or Registrar (not being
a constable))
.
Date

Notes

Arrest of person resisting execution of warrant

Under section 79 of the Care of Children Act 2004, you commit an offence for which you may be sentenced to imprisonment if you knowingly resist or obstruct a person executing this warrant, or knowingly fail or refuse to afford a person of that kind immediate entrance to (all or a part of) any premises. Under section 315(2) of the Crimes Act 1961, a constable (and persons the constable calls to his or her assistance) may arrest and take into custody without a warrant a person whom the constable finds committing, or has good cause to suspect of having committed, an offence punishable by imprisonment.

Use of a faxed copy of warrant

If use of a faxed copy of this warrant is authorised by an authority to prevent delay in execution of the warrant, the authority must, under section 76 of the Care of Children Act 2004, write and sign a note on the front of the warrant stating—

(a)

the fact that a faxed copy of the warrant may be used for the purposes of executing the warrant; and

(b)

the date and time at which the authorisation expires, which must be the close of the third day after the day on which the authorisation is granted.

Schedule 6 form FP 33: replaced, on 1 July 2005, by rule 35(d) of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 33 heading: amended, on 31 March 2014, by rule 44(6) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 6 form FP 33: amended, on 2 May 2024, by rule 137(5) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 6 form FP 33: amended, on 17 November 2011, by rule 11 of the Family Courts Amendment Rules 2011 (SR 2011/349).

Form FP 34 Separation order

Part 3, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court makes a separation order.

The effect of this order is that, so long as the order remains in force, neither the applicant nor the respondent is under an obligation to cohabit with each other, but, except as provided by the Family Proceedings Act 1980 or any other enactment, the order does not otherwise affect the marriage or civil union or the status, rights, and obligations of the parties to the marriage or civil union.

.
Registrar
.
Date

Schedule 6 form FP 34: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 35 Maintenance order (spouse or civil union partner, former spouse or civil union partner, or former de facto partner)

Section 69 (or section 70), Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court orders that the respondent must pay, in respect of the maintenance of the applicant,—

(a)

the sum of $[specify] per [specify] towards the future maintenance of the applicant until [specify period] (or during the joint lives of the parties or during the life of the applicant). The first payment must be made on [date]:

(b)

the sum of $[specify] towards the future maintenance of the applicant. The sum is payable [specify arrangements for payment, and any conditions]:

(c)

the sum of $[specify] towards the past maintenance of the applicant. The sum is payable [specify arrangements for payment, and any conditions].

The court orders that the respondent pay to the applicant the costs of these proceedings amounting to $[specify].

.
Registrar
.
Date

Notes

Payments

*Effect of new marriage or civil union or de facto relationship

An order for future maintenance ceases to have effect if the party in whose favour it is made marries, or enters into a civil union or a de facto relationship with, someone other than the party against whom the order is made. See section 70A(2) to (4) of the Family Proceedings Act 1980.

*Delete if the order makes no provision for future maintenance.

Schedule 6 form FP 35 heading: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 35: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 35: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 35A Application for parenting order

[Revoked]

Schedule 6 form FP 35A: revoked, on 31 March 2014, by rule 44(2) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form FP 36 Parenting order(s)

[Revoked]

Schedule 6 form FP 36: revoked, on 31 March 2014, by rule 44(2) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form FP 36A Bond to ensure compliance with parenting order

[Revoked]

Schedule 6 form FP 36A: revoked, on 31 March 2014, by rule 44(2) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form FP 36B Notice of intention to appear in relation to interim parenting order or other interim order

[Revoked]

Schedule 6 form FP 36B: revoked, on 31 March 2014, by rule 44(2) of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form FP 37 Paternity order (and maintenance order)

Sections 51 and 78 to 81, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court, by this order, declares the respondent to be the father of a child called [full name] born on [date of birth of child] (or a child expected to be born on [expected date of birth of child]).

The court orders that—

*(a)

the respondent must pay to the applicant in respect of expenses reasonably incurred by reason of her pregnancy and the birth of the child, and towards her support during and after pregnancy, the sum of $[specify] (in the following manner: [specify]).

*(b)

the respondent must pay to the applicant the sum of $[specify] in respect of the funeral expenses of the child (in the following manner: [specify]).

*(c)

the respondent must pay towards the future maintenance of the applicant the sum of $[specify] per [specify] until [date], and the first payment must be made on [date] (or the sum of $[specify]).

*(d)

the respondent must pay towards the past maintenance of the applicant the sum of $[specify].

*(e)

the respondent must pay to the applicant the costs of these proceedings amounting to $[specify].

*Delete if inapplicable.

.
Registrar
.
Date

Notes

Payments

Effect of applicant marrying or entering a civil union or a* de facto relationship

To the extent that this order relates to the maintenance of the applicant and has not expired earlier, it ceases to have effect if, after it is made, the applicant marries or enters into a civil union or de facto relationship. See section 81(3) of the Family Proceedings Act 1980.

*Delete if this order makes no provision for the maintenance of the applicant.

Schedule 6 form FP 37: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 38 Order dissolving marriage or civil union

Section 39 or 39A, Family Proceedings Act 1980

(General heading—Form G 2)

The Family Court (or The Registrar of the Family Court), by this order, dissolves the marriage or civil union that took place on [date] at [church, registry office, or other place at which the marriage or civil union took place] in [name of city or town, etc] between the applicant and the respondent (or the joint applicants).

.
Registrar
.
Date order made
.
Date order sealed

Schedule 6 form FP 38 heading: amended, on 17 October 2025, by rule 22(9) of the Family Court Amendment Rules 2025 (SL 2025/205).

Schedule 6 form FP 38 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 38: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 39 Order declaring that other party to marriage or civil union is presumed to be dead and that marriage or civil union is dissolved

Section 34, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court, by this order, declares that the respondent is presumed to be dead and that the marriage or civil union that took place on [date] at [church, registry office, or other place at which the marriage or civil union took place] in [name of city or town, etc] between the applicant and the respondent is dissolved.

.
Registrar
.
Date

Schedule 6 form FP 39 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 39: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 40 Order declaring marriage or civil union to be void

Sections 30 and 31, Family Proceedings Act 1980

(General heading—Form G 2)

On application made to it, the court, by this order, declares that the purported marriage or civil union that took place between the applicant and the respondent on [date] at [church, registry office, or other place at which the marriage or civil union took place] in [name of city or town, etc] to be void ab initio on the ground that [specify].

.
Registrar
.
Date

Schedule 6 form FP 40 heading: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 6 form FP 40: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form FP 41 Application without notice for issue of warrant for arrest of respondent

r 373(2)

Section 259, Child Support Act 1991; Section 134, Family Proceedings Act 1980

(Front page—Form G 1)

I, [full name], of [address], [occupation], swear (or affirm) that—

1

a maintenance order was made on [date] against the respondent (and subsequently varied) in the following terms:

[set out the terms of the maintenance order together with any variations and date(s)].

1

a maintenance agreement between me and the respondent in the following terms (and subsequently varied) was registered on [date]: [set out the terms of agreement together with any registered variations and the date(s) of registration].

2

I have reasonable cause to believe that the respondent is about to leave New Zealand with intent to avoid payment of maintenance in that [set out facts supporting the application, including the present whereabouts of the respondent, if known].

I apply for the issue of a warrant for the arrest of the respondent.

.
Signature of applicant

Sworn (or Affirmed) before me at [place], [date].

.
Judge
(or Solicitor
or Registrar (not being a constable))

To the Registrar

District Court at [place]

This application is filed by [name], whose address for service is [address].

Form FP 42 Request for issue of warrant to seize property

r 374

Section 259, Child Support Act 1991; Section 103, Family Proceedings Act 1980

(Front page—Form G 1)

To the Registrar

District Court at [place]

I, [full name], of [address], the Maintenance Officer at [place] [or as the case may be], request the issue of a warrant to seize property under section 103 of the Family Proceedings Act 1980 against the respondent.

[Set out details of the maintenance order (or maintenance agreement) and any variations.]

I certify—

(a)

that payments under the order (or agreement) are in arrears and unpaid for not less than 14 days; and

(b)

that there is now due and owing under the order (or agreement) the sum of $[specify] up to [date].

.
Signature
.
Date

Schedule 6 form FP 42 heading: replaced, on 14 April 2014, by rule 10(1) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Schedule 6 form FP 42: amended, on 14 April 2014, by rule 10(2) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Form FP 43 Warrant to seize property

r 374

Section 259, Child Support Act 1991; Section 103, Family Proceedings Act 1980

(General heading—Form G 2)

To every bailiff and constable

Under a maintenance order (or maintenance agreement) dated [date], payments due by the respondent are, at the time of the issue of this warrant, in arrears and unpaid for not less than 14 days.

I direct you to immediately levy or cause to be levied the sum of $[specify], and the costs of the execution of this warrant, by seizure and sale of any of the respondent’s goods and chattels, except the respondent’s necessary tools of trade, to a value not exceeding $500 and the respondent’s necessary household furniture and effects, including the wearing apparel of the respondent and any members of the respondent’s family, to a value not exceeding $2,000.

Under that direction, you are also authorised to seize and take away, and deliver to the Registrar of this court, any money, bank notes, bills of exchange, promissory notes, bonds, specialities, or other securities for money belonging to the respondent.

You are directed to pay what you levy to the Registrar of this court and to make return of what you do by virtue of this warrant immediately on its execution.

If insufficient goods or money can be found or if the respondent cannot be found, you are required to report back to this court and to state what your inquiries have shown.

.
Judge
.
Date

Notes

Sale by auction

Goods seized in execution under this warrant may be sold by public auction unless the court otherwise orders.

Restriction on sale

No goods seized in execution under this warrant may be sold until the expiration of a period of at least 7 days next following the day on which the goods were seized unless—

(a)

the goods are of a perishable nature; or

(b)

the person whose goods have been seized so requests in writing.

Power of entry

For the purpose of executing this warrant, you may, at any time, enter on any premises, by force if necessary, if you have reasonable cause to believe that the property in respect of which it is issued is on those premises. If any person in actual occupation of the premises requires you to produce evidence of your authority, you must produce this warrant before entering on the premises.

Endorsements

A request was made to the court for the issue of this warrant at [specify minutes] minutes past the hour of [specify hour] on [date] by [full name].

.
Registrar

This warrant was received by me on [date] at [time].

.
Bailiff (or Constable)

[Form 74 in the District Court Rules 2014 must be endorsed on this form if necessary.]

Schedule 6 form FP 43 heading: replaced, on 14 April 2014, by rule 11(1) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Schedule 6 form FP 43: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 6 form FP 43: amended, on 14 April 2014, by rule 11(2) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Schedule 6 form FP 43: amended, on 14 April 2014, by rule 11(3) of the Family Courts Amendment Rules (No 3) 2013 (SR 2013/414).

Form FP 44 Summons to attend examination as to means and default

Section 259, Child Support Act 1991; Section 124(1), Family Proceedings Act 1980

(General heading—Form G 2)

*A maintenance order was made against you on [date].

*The terms of the order are [set out the terms of the maintenance order].

*A maintenance agreement between [full name] and you was registered on [date]. The terms of the agreement are [set out terms of the agreement].

*Delete if inapplicable.

The amount of $[specify] was in arrears and unpaid under the order (or agreement) on [date].

You are summoned to appear at [time] on [date] at the District Court at [place] to be examined orally as to your means and as to the reasons for your failure to pay the maintenance in arrears. If you pay the above amount before the above date you need not appear for examination.

You must bring to the hearing any books, papers, and documents relating to your debts and to your failure to pay.

.
Registrar
.
Date

Notes

Representation by a lawyer

You may be represented at the examination by a lawyer if you wish.

Failure to appear

If you fail to appear in answer to this summons, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Form FP 45 Warrant to arrest respondent for examination as to means and default

Section 259, Child Support Act 1991; Section 124(4), Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

A summons was issued requiring the respondent to appear on [date] at the District Court at [place] to be examined as to the respondent’s means and as to the reasons for the respondent’s failure to pay maintenance under a maintenance order (or agreement).

*The examination was adjourned to [place].

*Delete if inapplicable.

The summons could not be served (or The respondent did not appear).

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

If you believe the respondent cannot be brought before the court within 72 hours after the arrest of the respondent, you need not execute the warrant immediately.

.
Registrar
.
Date

Form FP 46 Summons to witness to attend examination

Section 259, Child Support Act 1991; Section 126(1), Family Proceedings Act 1980

(General heading—Form G 2)

[Full name] has been summoned to appear to be examined orally as to his (or her) means and as to his (or her) reasons for failure to pay maintenance under a maintenance order (or agreement).

I believe—

*that you have possession of books, papers, or documents relating to the affairs or property of the respondent.

*that you are capable of giving information concerning the respondent’s income from any sources or concerning the respondent’s expenditure.

You are summoned to appear as a witness at the examination at [time] on [date] at the District Court at [place].

*You are required to bring with you and produce [set out details of the books, papers, or documents].

*Delete if inapplicable.

.
Registrar
.
Date

Notes

Travelling expenses

If you are required to travel more than 20 kilometres to attend the examination, you are entitled to a sum for expenses.

Failure to appear

If you fail to appear in answer to this summons, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Form FP 47 Warrant to arrest witness for attendance at examination of respondent

Section 259, Child Support Act 1991; Section 126(4), Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

[Full name], of [address], [occupation], was summoned to appear on [date] at [place] as a witness at an examination as to the means of the respondent and as to the reasons for the respondent’s failure to pay maintenance under a maintenance order (or agreement).

The witness failed to appear.

I am satisfied—

(a)

that the summons was duly served on the witness; and

(b)

that the witness was not required to travel more than 20 kilometres to attend the examination (or that expenses in accordance with the prescribed scale were tendered to the witness).

I direct you to arrest the witness, [full name], and bring him (or her) before the court as soon as possible.

If you believe that the witness cannot be brought before the court within 72 hours after the arrest of the witness, you need not execute the warrant immediately.

.
Registrar
.
Date

Form FP 48 Warrant to arrest respondent for attendance at contempt proceedings

Section 259, Child Support Act 1991; Section 130(5), Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

It is alleged that the respondent has wilfully disobeyed a maintenance order (or agreement). As a result, an application has been made under section 130(2) of the Family Proceedings Act 1980.

The application (with its supporting affidavit) was served on the respondent but the respondent did not attend the hearing of the application on [date] at [place].

The application (with its supporting affidavit) could not be served on the respondent.

I direct you to arrest the respondent and bring the respondent before the court as soon as possible.

If you believe that the respondent cannot be brought before the court within 72 hours after the respondent’s arrest, you need not execute the warrant immediately.

.
Registrar
.
Date

Form FP 49 Warrant for arrest of absconding respondent

Section 259, Child Support Act 1991; Section 134, Family Proceedings Act 1980

(General heading—Form G 2)

To every constable

*A maintenance order was made on [date] against the respondent (and subsequently varied) in the following terms: [set out the terms of the maintenance order together with any variations and the date(s) thereof].

*A maintenance agreement between the applicant and the respondent in the following terms (and subsequently varied) was registered on [date]: [set out terms of agreement together with any registered variations and the date(s) of registration].

*The applicant has applied (or is entitled to apply) for a maintenance order against the respondent in respect of [set out].

I am satisfied that there is reasonable cause to believe the respondent is about to leave New Zealand with intent to avoid payment of maintenance.

*Delete if inapplicable.

.
Judge
(or Registrar (not being a constable))
.
Date

Schedule 6 form FP 49: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FP 49A Warrant to prevent concealment of whereabouts of child

Section 117, Care of Children Act 2004

(General heading—Form G 2)

To every constable (or social worker).

I am satisfied on the application made on oath of [full name], of [address], [occupation], that with regard to [full name], a child aged [specify] years,—

(a)

an application under section 103 of the Care of Children Act 2004 (which relates to a child abducted to New Zealand) has been made to, and received by, the Authority; and

(b)

there are reasonable grounds for believing that a person will attempt to conceal the whereabouts of the child with intent to, or in circumstances where the concealment would be likely to, defeat the claim of the applicant.

The child is said to be in the care of [full name] of [address].

(*There being no District Court Judge or Family Court Judge available,) I direct you to take possession of the child and place the child in the care of some suitable person pending the order or further order of the court having jurisdiction in the case.

For the purpose of executing this warrant, you are authorised by section 75(1) of the Care of Children Act 2004 to enter and search any building, aircraft, ship, vehicle, premises, or place, with or without assistance, and by force if necessary.

You are required to have this warrant with you when executing it and to produce it on initial entry and, if requested, at any later time.

You must also comply with any other applicable requirements of section 75(2) of the Care of Children Act 2004.

When you have executed this warrant in accordance with the direction, you must advise this court immediately of the name and address of the person with whom you have placed the child.

*Delete if inapplicable.

.
Judge
(or Family Court Associate or Registrar of the District Court
(not being a constable))
.
Date

Notes

Arrest of person resisting execution of warrant

Under section 79 of the Care of Children Act 2004, you commit an offence for which you may be sentenced to imprisonment if you knowingly resist or obstruct a person executing this warrant, or knowingly fail or refuse to afford a person of that kind immediate entrance to (all or a part of) any premises. Under section 315(2) of the Crimes Act 1961, a constable (and persons the constable calls to his or her assistance) may arrest and take into custody without a warrant a person whom the constable finds committing or has good cause to suspect of having committed an offence punishable by imprisonment.

Use of a faxed copy of warrant

(a)

the fact that a faxed copy of the warrant may be used for the purpose of executing the warrant; and

(b)

the date and time at which the authorisation expires, which must be the close of the third day after the day on which the authorisation is granted.

Schedule 6 form FP 49A: inserted, on 1 July 2005, by rule 36 of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 6 form FP 49A: amended, on 2 May 2024, by rule 137(6) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 6 form FP 49A: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form FP 49B Warrant to enforce order for return of child

Section 119, Care of Children Act 2004

(General heading—Form G 2)

To every constable (or social worker).

(*On the application of [full name], of [address], [occupation],) I authorise you to take possession of [full name], a child aged [specify] years, and to deliver him (or her) to [full name], of [address], for the purpose of returning the child in accordance with an order made in the [court] at [place] on [date] under section 105(2) of the Care of Children Act 2004 (which relates to the return of a child abducted to New Zealand).

The child is said to be in the care of [full name] of [address].

You are required to have this warrant with you when executing it and to produce it on initial entry and, if requested, at any later time.

You must also comply with any other applicable requirements of section 75(2) of the Care of Children Act 2004.

*Delete if inapplicable.

.
Judge
.
Date

Notes

Arrest of person resisting execution of warrant

Use of a faxed copy of warrant

(a)

the fact that a faxed copy of the warrant may be used for the purpose of executing the warrant; and

(b)

the date and time at which the authorisation expires, which must be the close of the third day after the day on which the authorisation is granted.

Schedule 6 form FP 49B: inserted, on 1 July 2005, by rule 36 of the Family Courts Amendment Rules 2005 (SR 2005/101).

Form FP 50 Attachment order

Section 259, Child Support Act 1991; Section 105, Family Proceedings Act 1980

(General heading—Form G 2)

By a maintenance order made (or maintenance agreement registered) on [date] (and subsequently varied), the respondent was ordered (or agreed) to pay towards the future support of [set out terms of order or agreement and any variations].

The court is satisfied that [full name] is the employer of the respondent.

The court orders that money due and payable, or at any time becoming due and payable, under the maintenance order (or agreement) must, by way of weekly payments of $[specify] per week, be a charge on any salary or wages that from time to time while this attachment order remains in force, become due and payable by the employer to the respondent.

The protected earnings rate, below which the net earnings paid to the respondent shall not be reduced by reason of compliance with the order, is $[specify] per week.

The charge created attaches to all wages or salary that become due and payable by the employer to the respondent at any time while this attachment order remains in force, whether or not the contract of employment in respect of which the salary became due existed at the date of this order, and provides over and priority to any assignment made or charge created by the respondent, whether before or after the making of this order.

While this order remains in force, the employer must from time to time, whenever any money becomes due and payable by the employer to the respondent by way of wages or salary, deduct from it the sum of $[specify] per week. In any week, the employer must not deduct an amount that reduces the net earnings paid to the respondent below the protected earnings rate.

The first deduction must be made on the pay day following the date on which a copy of this order is served on the employer. A deduction must be made on every subsequent pay day. The money deducted must be paid to a maintenance officer at any office of the Ministry of Social Development [or as the court may direct] within 14 days.

.
Registrar
.
Date

Notice to employer

1

An employer, in making any deduction or payment under this order, is not required to inquire whether any money is due and payable under the maintenance order (or agreement).

2

Every employer commits an offence and is liable to a fine not exceeding $200 who, without reasonable excuse, fails to deduct from any money due and payable to the employee the sum that is sufficient to satisfy the charge on the money so far as the same has accrued before the day on which the salary or wages become due and payable.

3

Every employer commits an offence and is liable to a fine not exceeding $200 who, without reasonable excuse, fails within 14 days after deducting any sum from the wages or salary of an employee to pay the sum deducted to the person specified in the order.

4

Every employer commits an offence and is liable to a fine not exceeding $500 who dismisses any employee or alters any employee’s position in the employer’s business or undertaking to the employee’s prejudice by reason of an attachment order having been served on the employer.

5

If a respondent in respect of whom an attachment order is in force leaves or is dismissed from the respondent’s employment, the employer is required, within 7 days from that date, to notify a maintenance officer at any office of the Ministry of Social Development.

6

If you need help, consult a lawyer or contact a Family Court office or an office of the Ministry of Social Development immediately.

Schedule 6 form FP 50: amended, on 1 October 2003, pursuant to section 14(1) of the State Sector Amendment Act 2003 (2003 No 41).

Form FP 51 Charging order

Section 259, Child Support Act 1991; Section 118, Family Proceedings Act 1980

(General heading—Form G 2)

By a maintenance order made (or maintenance agreement registered) on [date] (and subsequently varied), the respondent was ordered (or agreed) to pay maintenance as follows: [set out terms of order (or agreement) and any variations].

The court is satisfied that the respondent is entitled to the following property: [describe property to be charged and, if the order binds the Crown, particulars required by section 120 of the Family Proceedings Act 1980].

The court orders that the money payable or to become payable under the maintenance order (or agreement) must be a charge on the property described above and, subject in the case of any real property described above and, subject in the case of any real property to registration of a duplicate or copy of this order under the seal of the court against the appropriate title to the land [or as the case may require] the property is charged in favour of [full name], to whom for the time being and from time to time the money is or becomes payable.

.
Registrar
.
Date

Form FP 52 Receiving order

Section 259, Child Support Act 1991; Section 121, Family Proceedings Act 1980

(General heading—Form G 2)

On [date], an order was made that money payable or to become payable under the maintenance order (or agreement) must be a charge on the following property to which the respondent is entitled: [describe the property charged.]

That charge is in favour of [full name], being the person to whom for the time being and from time to time the money is or becomes payable.

The court is satisfied that payments due under the maintenance order (or agreement) are in arrears and unpaid and that there is due and payable the sum of $[specify]—

*and is satisfied that a copy of the charging order has been registered against the appropriate title to the land described above [or as the case may be].

†and is satisfied that a copy of the charging order has been served on the respondent.

‡and that the proposed receiver has entered into and filed a bond to the satisfaction of the Registrar for the due administration of his or her receivership.

The court orders that [full name and description of receiver] are the receivers of [describe terms of order].

Subject to the provisions of the Family Proceedings Act 1980, all money received by the receiver in the exercise of his or her powers must, after payment of all expenses incurred by him or her and of the remuneration (if any) that may be allowed by the court (or if Public Trust is receiver, as provided by or under the Public Trust Act 2001) be held by the receiver in trust—

(a)

to pay and satisfy all money from time to time accruing due under the maintenance order (or agreement):

(b)

to hold the residue of the money so received until the charging order or this receiving order is discharged, or the court sooner directs, and when that happens, to pay it to the person who would be entitled to the money if no such charging or receiving order was in force.

.
Registrar
.
Date

*Delete if charging order does not include a charge over any real property.

†Delete if order is not made on ex parte application.

‡Delete if the receiver is Public Trust, the Māori Trustee, or a trustee company within the meaning of the Trustee Companies Act 1967.

Schedule 6 form FP 52: amended, on 1 July 2009, pursuant to section 30(2)(a) of the Māori Trustee Amendment Act 2009 (2009 No 12).

Schedule 7 Forms for proceedings under Family Protection Act 1955 and Law Reform (Testamentary Promises) Act 1949

r 378

FP and TP 1	Notice of application to respondent
FP and TP 2	Notice of application to respondent residing outside New Zealand

Form FP and TP 1 Notice of application to respondent

(General heading—Form G 2)

*To [name of respondent]

*Repeat if more than 1 respondent.

Notification of application for order

[Full name], the applicant, has filed an application in this court.

A copy of the application is attached. The order or orders sought by the applicant are specified in the application.

Notice of defence or notice of intention to appear

If you wish to defend the application, you must, within 21 days after the date on which you receive this notice,—

(a)

file a notice of defence in this office of the court; and

(b)

serve a copy of the notice of defence on the other party (or parties) to the proceedings. The copy may be delivered to the address for service given by the applicant (or other parties).

If, instead of filing a notice of defence, you wish to appear at the hearing of the application to either support or oppose the application, you must, within 21 days after the date on which you receive this notice,—

(a)

file a notice of intention to appear in this office of the court; and

(b)

serve a copy of the notice of intention to appear on the applicant (or other parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or other parties).

At the same time as serving a copy of the notice of intention to appear, you may also serve affidavits in support of any matters referred to in the notice.

Whether or not you file and serve a notice of defence or a notice of intention to appear, you may attend the court when the application is heard to defend the application. However, if you have not filed and served a notice of defence or a notice of intention to appear, you may be liable to pay the costs incurred because of that failure.

Address for service

If you do not wish to defend the application but you do wish to know what is happening, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the applicant (or other parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or other parties).

Assistance

A lawyer will prepare a notice of defence or notice of intention to appear for you. If you want a lawyer but think you cannot afford one, contact an office of the Family Court immediately. You may also see a specimen form of a notice of defence and notice of intention to appear at any office of the Family Court.

Liability as witness

Even if you take no action, the court may summon you as a witness to help it deal with the application.

Copies of orders

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm Mondays to Fridays inclusive.

.
Registrar
.
Date

Form FP and TP 2 Notice of application to respondent residing outside New Zealand

(General heading—Form G 2)

To [name of respondent]

Notification of application for order

[Full name], the applicant, has filed an application in this court.

A copy of the application is attached. The order(s) sought by the applicant is (or are) specified in the application.

Jurisdiction of court

The court may make an order for [specify] if [set out the bases for jurisdiction in respect of the order(s) sought, following closely the relevant provisions in the Law Reform (Testamentary Promises) Act 1949 or the Family Protection Act 1955 or both].

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on the applicant (or other parties) to the proceedings. That copy may be delivered to the address for service given by the applicant (or other parties).

Copies of orders

Advice

If you need help, consult a lawyer in the place where you are immediately.

If you intend to employ a lawyer in New Zealand, ask about your eligibility for legal aid in this country.

Respondents served in Australia under Trans-Tasman Proceedings Act 2010

respond to the application by taking steps yourself or by using an Australian lawyer (rather than by instructing a New Zealand lawyer to act for you); and
respond within a period that is at least 30 working days after the day on which you were served; and
give an address for service that is an address of a place in Australia or New Zealand.

.
Registrar
.
Date

Schedule 7 form FP and TP 2: amended, on 11 October 2013, by rule 21 of the Family Courts (Trans-Tasman Proceedings Act 2010) Amendment Rules 2013 (SR 2013/347).

Schedule 8 Forms for proceedings under Property (Relationships) Act 1976

r 389

P(R) 1	Affidavit of assets and liabilities
P(R) 2	Notice to respondent of application
P(R) 3	Order to attend for examination
P(R) 4	Warrant to arrest respondent for examination
P(R) 5	Summons to witness to attend examination
P(R) 6	Warrant to arrest witness for attendance at examination

Form P(R) 1 Affidavit of assets and liabilities

r 398

(Front page—Form G 1)

I, [full name, address, occupation], swear/affirm* that—

1

My assets and liabilities are as described in paragraphs 4 to 9.

2

I am aware that making a false statement in this affidavit could result in any order of the court being set aside and criminal proceedings being brought against me.

*Select one.

Assets

3

I have no interest in any assets other than the assets described in paragraph 4.

4

My assets are as follows:

(a)

Family home or homestead

Location:

LINZ title reference:

All names on title:

My legal and beneficial interest in the property:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

(b)

Land and buildings

Location:

LINZ title reference:

All names on title:

My legal and beneficial interest in the property:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

Money in bank accounts

Bank:

Name of account:

Account No:

Nobody else has an interest in this account/Another person has or other persons have an interest in this account*

*Select one.

Share of this account owned by me:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If this account is claimed as your separate property, explain why]

(g)

Cash in excess of $300

Location:

Currency held in:

Amount:

Nobody else has an interest in this cash/Another person has or other persons have an interest in this cash*

*Select one.

Share of this cash owned by me:

[If this cash is claimed as your separate property, explain why]

(h)

Details of any money owed to me

Name and address of borrower:

Amount borrowed:

Balance outstanding at end of marriage, civil union, or de facto relationship:

Balance outstanding at date of affidavit:

Nobody else has an interest in this amount/Another person has or other persons have an interest in this amount*

*Select one.

Share of this amount owed to me:

[If this amount is claimed as your separate property, explain why]

(i)

Government stock, debentures, or bonds

Name of investment:

Type of investment:

Size of holding:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

Name of any other account holder (if applicable):

Value of my interest at date of affidavit:

Value of my interest at end of marriage, civil union, or de facto relationship:

[If this investment is claimed as your separate property, explain why]

(j)

Company shares, debentures, or bonds

Name of investment:

Type of investment:

Size of holding:

Current value:

Name of any other account holder (if applicable):

Value of my interest at end of marriage, civil union, or de facto relationship:

Value of my interest at date of affidavit:

[If this investment is claimed as your separate property, explain why]

(k)

Plant and machinery

Description:

Share owned by me:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If this is claimed as your separate property, explain why]

(l)

Livestock

Description:

Share owned by me:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If livestock is claimed as your separate property, explain why]

(m)

Interest in business, partnership, stock-in-trade, or venture

Name of business/partnership/venture:

Nature of the business and principal sources of income for the venture and for me: [briefly describe]

I am a [specify whether you are a sole trader, partner, or shareholder].

Extent of my interest in the business: [specify interest if a partner or shareholder].

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

Date at which next annual financial statements for the business, partnership, or venture will be available:

[If this interest is claimed as your separate property, explain why]

(n)

Motor vehicles

Description:

Registered owner:

Share owned by me:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If motor vehicle is claimed as your separate property, explain why]

(o)

Life insurance policy

Owner of policy:

Life assured:

Insurance company:

Policy number:

Share owned by me:

Value at start of marriage, civil union, or de facto relationship:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

Proportion of value claimed as relationship property and proportion of value claimed as separate property:

How proportion was calculated:

(p)

Insurance claims outstanding for events that occurred during relationship

Owner of policy:

Item/property insured:

Insurance company:

Policy number:

Amount of claim:

Date and amount of payment of claim:

Share owned by me:

Proportion of value claimed as relationship property and proportion of value claimed as separate property:

How proportion was calculated:

(q)

Claims for compensation or damages outstanding for events that occurred during relationship

Description:

Amount of claim:

Date and amount of payment of claim:

Share owned by me:

Proportion of value claimed as relationship property and proportion of value claimed as separate property:

How proportion was calculated:

(r)

Interest in estate

Description (including whether the interest is a legal or beneficial interest):

My share:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If claimed as your separate property, explain why]

(s)

Interest in trust

Description (including whether the interest is a legal or beneficial interest):

My share:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If claimed as your separate property, explain why]

(t)

Accumulated benefits due to me as an employee or customer

Description:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If claimed as your separate property, explain why]

(u)

Tax refund due to me at end of relationship

Amount due:

Date and amount paid or credited:

(v)

Any other property or asset not specified above that is, or could be, the subject of an order in the proceedings

Description:

Share owned by me:

Value at end of marriage, civil union, or de facto relationship:

Value at date of affidavit:

[If claimed as your separate property, explain why]

5

Valuations of items described in paragraph 4(a), (b), (c), (d), (k), (l), and (n) are attached and marked A, B, C, D, E, F, and G respectively.

6

The proof of deposits or holdings of items in paragraph 4(e), (f), (h), (i), and (j) are attached and marked H, I, J, K, and L respectively.

7

The most recent annual financial statements for the items described in paragraph 4(m) are attached and marked M.

8

Copies of the trust deeds for items in paragraph 4(s) are attached and marked N.

Liabilities

9

My liabilities are as follows:

(a)

Mortgages secured over family home

Mortgagee:

Mortgagor:

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

(b)

Mortgages secured over any other land or buildings

Property:

Mortgagee:

Mortgagor:

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

Credit card debt

Name of account:

Bank:

Account No:

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

(g)

Other loans

Lender:

Borrower:

Reference number (if any):

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

(h)

Money owed to Inland Revenue Department

Type of tax owed:

Person liable:

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

(i)

Unsecured debts

Lender:

Evidence of debt (if any):

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

(j)

Any other liabilities not falling within any of the preceding paragraphs

Nature of liability:

Evidence of liability (if any):

To whom owing:

Amount owing at end of marriage, civil union, or de facto relationship:

Amount owing at date of affidavit:

10

Statements verifying balances are attached and marked [insert numbers for each attachment].

Income

11

Since the end of my marriage, civil union, or de facto relationship, I have not earned or received any income other than as set out below from an asset described in paragraph 4 or from other sources:

Source:

Amount:

Capital payments

12

Since the end of my marriage, civil union, or de facto relationship, I have made the following capital payments to an asset described in paragraph 4:

Asset:

Amount paid:

Assets disposed of

13

Since the end of my marriage, civil union, or de facto relationship, I have not sold or otherwise disposed of (or agreed to sell or dispose of) any asset in which I had an interest at the date on which my marriage, civil union, or de facto relationship ended, other than the following:

Asset:

Date:

Amount received or to be received:

Disposition of amount:

Assets acquired

14

Since the end of my marriage, civil union, or de facto relationship, I have not acquired or agreed to acquire any assets using relationship property, other than the following:

Asset:

Mode of acquisition:

Amount paid or to be paid:

Value at date of affidavit:

Signature of deponent:

Sworn/Affirmed* at [place, date]

*Select one.

Before me: [name, signature]

(a solicitor of the High Court/Registrar/Justice of the Peace*)

*Select one.

Schedule 8 form P(R) 1: replaced, on 31 March 2014, by rule 45 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form P(R) 2 Notice to respondent of application

rr 32(2)(b), 389

(General heading—Form G 2)

[Full name], the applicant, has filed an application in this court. A copy of the application is attached. The order(s) or declaration(s) sought by the applicant is (or are) specified in the application.

Notice of defence

If you wish to defend the application, you must, within 21 days after the date on which you receive this notice—

(a)

file a notice of defence in this office of the Family Court; and

(b)

serve a copy of the notice of defence on the applicant.

Affidavit in support

A copy of an affidavit filed by the applicant in support of his (or her) application is also attached.

You must, within 20 working days of the date on which you receive the attached application, file an affidavit in support of the facts you rely on. See rule 392(3) of the Family Court Rules 2002.

Your affidavit in support must have a front page (in form G 1) and include information about any of the following matters that are relevant to your case—

(a)

when the marriage or civil union or relationship began, and the duration of the marriage or civil union or relationship:

(b)

the parties and their property:

(c)

children of the marriage or civil union or relationship:

(d)

proposed arrangements for the division of property:

(e)

if the application is one that relates to the estate of a deceased spouse or partner,—

(i)

whether the deceased died testate or intestate; and

(ii)

whether the survivor of the deceased spouse or partner has chosen option A or option B:

(f)

matters in issue between the applicant and you.

Your affidavit in support may have annexed to it a copy of any document you rely on. See rule 392(4)(b).

You must, within 20 working days of the date on which you receive the attached application, serve a copy of your affidavit in support on the applicant.

Affidavit disclosing assets and liabilities

*An affidavit of assets and liabilities filed by the applicant is also attached. You must, within 20 working days (or [specify number of days specified by Judge, Family Court Associate, or Registrar]) of receiving the applicant’s affidavit of assets and liabilities, file an affidavit of your assets and liabilities (in form P(R) 1).

*In the 20 working days (or [specify number of days specified by Judge, Family Court Associate, or Registrar]) following [specify date on which application was filed] the applicant must file an affidavit of assets and liabilities. You must, within 20 working days (or [specify number of days specified by Judge, Family Court Associate, or Registrar]) of receiving the applicant’s affidavit of assets and liabilities, file an affidavit of your assets and liabilities (in form P(R) 1).

*Delete if inapplicable.

You must, within 20 working days of receiving the applicant’s affidavit of assets and liabilities, serve a copy of your affidavit of assets and liabilities on the applicant.

How case will proceed

The date set out on the foot of the application is the date when a Registrar will monitor compliance with the Family Court Rules 2002 and make directions about how the case will proceed. It is not necessary for you or your lawyer to attend on that date, but if you oppose the application and have filed a notice of defence, you may advise the court of any directions that you seek on that date.

Address for service

If you have not already filed in this office of the Family Court an address in New Zealand at which documents may be left for you, you must include an address for service in your affidavit of assets and liabilities.

If you do not file an address for service, the case may proceed without further notice to you.

Copies of orders

You will receive a copy of any order made against you. However, any order will probably be in force from the time it is made. The fact that you have not got a copy of the order will not be an excuse for not obeying it.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Schedule 8 form P(R) 2: amended, on 2 May 2024, by rule 138(1) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 8 form P(R) 2: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 8 form P(R) 2: amended, on 26 April 2005, by section 8(1) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Schedule 8 form P(R) 2: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form P(R) 3 Order to attend for examination

r 400(4)

(General heading—Form G 2)

To the respondent

*You have failed to file an affidavit of assets and liabilities as required by rule 398 of the Family Court Rules 2002.

*You have failed to file a sufficient affidavit of assets and liabilities as required by rule 398 of the Family Court Rules 2002.

You are ordered to attend for examination by the Family Court as to any or all of the matters required to be disclosed in an affidavit of assets and liabilities under the Family Court Rules 2002.

You are ordered to appear at [time] on [date] at the Family Court at [place].

If you file a sufficient affidavit of assets and liabilities before the above date, you need not appear for examination.

*You are ordered to bring to the examination any books or documents relating to your property.

*Delete if inapplicable.

.
Registrar
.
Date

Note

Representation by a lawyer

You may, if you wish, be represented at the examination by a lawyer.

Failure to appear

If you fail to appear in answer to this order, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Schedule 8 form P(R) 3: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form P(R) 4 Warrant to arrest respondent for examination

r 401(1)

(General heading—Form G 2)

To every constable

An order was made on [date] requiring the respondent, [full name], to appear on [date] at the Family Court at [place] to be examined as to any or all of the matters required to be disclosed in an affidavit of assets and liabilities under the Family Court Rules 2002.

*The examination was adjourned to [date].

*Delete if inapplicable.

The order could not be served (or The respondent did not appear).

I direct you to arrest the respondent and bring the respondent before the Family Court as soon as possible.

If you believe the respondent cannot be brought before the Family Court within 72 hours after the arrest of the respondent, you need not execute the warrant immediately.

This warrant ceases to have effect if a sufficient affidavit of assets and liabilities is filed by the respondent.

.
Judge (or Family Court Associate)
.
Date

Schedule 8 form P(R) 4 heading: amended, on 2 May 2024, by rule 138(2) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 8 form P(R) 4: amended, on 2 May 2024, by rule 138(3) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 8 form P(R) 4: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Form P(R) 5 Summons to witness to attend examination

r 402(1)

(General heading—Form G 2)

[Full name] has been ordered to attend for examination as to any or all of the matters required to be disclosed in an affidavit of assets and liabilities under the Family Court Rules 2002.

I believe—

*that you have possession of books, papers, or documents relating to the affairs or property of the respondent.

*that you are capable of giving information concerning the respondent’s property or the respondent’s liabilities.

You are summoned to appear as a witness at the examination at [time] on [date] at the Family Court at [place].

*You are required to bring with you and produce [set out details of the book, paper, or document].

*Delete if inapplicable.

.
Judge (or Family Court Associate or Registrar)
.
Date

Notes

Travelling expenses

If you are required to travel more than 20 kilometres to attend the examination, you are entitled to a sum for expenses.

Failure to appear

If you fail to appear in answer to this order, a warrant may be issued for your arrest.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Schedule 8 form P(R) 5: amended, on 2 May 2024, by rule 138(4) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 8 form P(R) 5: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 8 form P(R) 5: amended, on 3 August 2009, by rule 16 of the Family Courts Amendment Rules 2009 (SR 2009/185).

Form P(R) 6 Warrant to arrest witness for attendance at examination

r 402(4)

(General heading—Form G 2)

To every constable

[Full name], of [address], [occupation], was summoned to appear on [date] at [place] as a witness at an examination of the respondent as to any or all of the matters required to be disclosed in an affidavit of assets and liabilities under the Family Court Rules 2002.

The witness failed to appear.

I am satisfied—

(a)

that the summons was duly served on the witness; and

(b)

that the witness was not required to travel more than 20 kilometres to attend the examination (or that expenses in accordance with the prescribed scale were tendered to the witness).

I direct you to arrest the witness, [full name], and bring him (or her) before the Family Court as soon as possible.

If you believe that the witness cannot be brought before the Family Court within 72 hours after the arrest of the witness, you need not execute the warrant immediately.

This warrant ceases to have effect if a sufficient affidavit of assets and liabilities is filed by the respondent.

.
Judge (or Family Court Associate)
.
Date

Schedule 8 form P(R) 6: amended, on 2 May 2024, by rule 138(5) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 8 form P(R) 6: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 9 Forms for proceedings under Protection of Personal and Property Rights Act 1988

PPPR 1	Front page for documents filed in court under Protection of Personal and Property Rights Act 1988
PPPR 2	Heading of documents issued by court or Registrar under Protection of Personal and Property Rights Act 1988
PPPR 3	Application for personal order in respect of applicant
PPPR 4	Application for personal order
PPPR 5	Application for order to administer property of applicant
PPPR 6	Application for order to administer property
PPPR 7	Application for appointment of welfare guardian for applicant
PPPR 8	Application for appointment of welfare guardian
PPPR 9	Application for appointment of welfare guardian to ensure compliance with personal order
PPPR 10	Application for property order in respect of applicant’s property
PPPR 11	Application for property order
PPPR 12	Application for appointment of welfare guardian and manager in respect of applicant
PPPR 13	Application for appointment of welfare guardian and manager
PPPR 14	Information sheet to accompany applications under Protection of Personal and Property Rights Act 1988
PPPR 15	Notice to respondent of application under Protection of Personal and Property Rights Act 1988
PPPR 16	Statement of consent to appointment as welfare guardian
PPPR 17	Statement of consent to appointment as manager
PPPR 18	Summons to party to attend pre-hearing conference
PPPR 19	Personal order
PPPR 20	Order to administer property
PPPR 21	Order for appointment of welfare guardian
PPPR 22	Order for appointment of manager
PPPR 23	Application by attorney for directions
PPPR 24	Application for exercise of court’s jurisdiction in respect of enduring power of attorney
PPPR 25	Application for review of attorney’s decision

Form PPPR 1 Front page for documents filed in court under Protection of Personal and Property Rights Act 1988

rr 72(1)(a), 406

In the Family Court
at [place]

PPPR No:.

[full name, address, and occupation of applicant]

Applicant

[full name, address, and occupation of person in respect of whom this application is made]

Person the application is about

[set out full description of document (including whether it is made with or without notice), its date, and, in the case of an affidavit or affirmation, the name of the deponent and in whose support it is filed]

This document is filed by [name and address for service, and, if filed by lawyers, the name and telephone number of the acting lawyer].

Form PPPR 2 Heading of documents issued by court or Registrar under Protection of Personal and Property Rights Act 1988

rr 73(1)(a), 406

In the Family Court
at [place]

PPPR No:.

[full name, address, and occupation of applicant]

Applicant

*[full name, address, and occupation of person in respect of whom this application is made]

Person the application is about

*Delete if the person in respect of whom the application is made is the applicant.

Form PPPR 3 Application for personal order in respect of applicant

Section 10, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks, in respect of himself or herself, a personal order of one of the kinds listed below.]

(Front page—Form PPPR 1)

I, [full name], apply for the following order(s) in respect of myself:

*(a)

an order that I receive appropriate remuneration for work performed or to be performed by me:

*(b)

an order that my parent, [full name], make suitable arrangements for my personal care after his (or her) death:

*(c)

an order that the arrangements made by my parent, [full name], for my personal care after his (or her) death be observed (or be varied) as follows: [set out the way in which you wish the arrangements to be observed or varied]:

*(d)

an order that I must enter, attend at, or leave the following institution: [name of institution]:

*(e)

an order that I be provided with living arrangements of the following kind: [specify the kind of living arrangements with which you wish to be provided]:

*(f)

an order that I be provided with medical advice of the following kinds: [specify the kind(s) of medical advice you wish to receive]:

*(g)

an order that I be provided with educational, rehabilitative, therapeutic, or other services of the following kind(s): [specify the kind(s) of service you wish to receive]:

*(h)

an order that I must not leave New Zealand without the court’s permission (or only on the following conditions): [specify the conditions on which you should, in your opinion, be able to leave New Zealand]:

*(i)

an order appointing [full name] as next friend (or guardian ad litem) for me for the purposes of the following District Court proceedings: [specify the nature of the proceedings, and the District Court in which they are to be held].

*Delete if inapplicable.

This application is made on the following ground:

either

*I wholly (or partly) lack the capacity to understand the nature, and to foresee the consequences, of decisions relating to my personal care and welfare.

*I have the capacity to understand the nature, and to foresee the consequences, of decisions in respect of matters relating to my personal care and welfare, but I wholly lack the capacity to communicate decisions in respect of those matters.

I say:

*1

I am of or over the age of 18 years.

*1

I am under the age of 18 years and I am (or have been) married or in a civil union.

2

[Set out sufficient information to inform the court of the facts relied on to support the application. If you have any medical, psychiatric, or other reports that you wish the court to consider, attach them to this application.]

*Delete if inapplicable.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Schedule 9 form PPPR 3: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 3: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 4 Application for personal order

Section 10, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks in respect of some other person a personal order of one of the kinds listed below.]

(Front page—Form PPPR 1)

I, [full name], apply for the following order(s) in respect of [name of person in respect of whom the application is made]:

*(a)

an order that the person receive appropriate remuneration for work performed or to be performed by that person:

*(b)

an order that the person’s parent, [full name], make suitable arrangements for the person’s care after that parent’s death:

*(c)

an order that the arrangements made by that person’s parent, [full name], for the person’s personal care after that parent’s death be observed (or be varied) as follows: [set out the way in which you wish the arrangements to be observed or varied]:

*(d)

an order that the person must enter, attend at, or leave the following institution: [name of institution]:

*(e)

an order that the person be provided with living arrangements of the following kind: [specify the kind of living arrangements with which you wish the person to be provided]:

*(f)

an order that the person be provided with medical advice of the following kind(s): [specify the kind(s) of medical advice you wish the person to receive]:

*(g)

an order that the person be provided with educational, rehabilitative, therapeutic, or other services of the following kind(s): [specify the kind(s) of service you wish the person to receive]:

*(h)

an order that the person must not leave New Zealand without the court’s permission (or only on the following conditions: [specify the conditions on which the person should, in your opinion, be able to leave New Zealand]):

*(i)

an order appointing [full name] as next friend (or guardian ad litem) for the person for the purposes of the following District Court proceedings: [specify the nature of the proceedings, and the District Court in which they are to be held].

*Delete if inapplicable.

I make this application in my capacity as—

*(a)

a [specified relative] of [name of the person in respect of whom the application is made]:

*(b)

the attorney of [name of the person in respect of whom the application is made]:

*(c)

a social worker within the meaning of the Protection of Personal and Property Rights Act 1988:

*(d)

a medical practitioner:

*(e)

a representative of [name of group], being a group that is engaged, otherwise than for commercial gain, in the provision of services and facilities for the welfare of persons in relation to whom the court has jurisdiction in accordance with section 6 of the Act:

*(f)

the superintendent (or licensee or supervisor or other person in charge) of [name of institution], being the hospital (or home or other institution) in which [name of the person in respect of whom the application is made] is a patient (or resident):

*(g)

the manager of the property of [name of the person in respect of whom the application is made]:

*(h)

a person granted leave of the court to make this application.

I say:

*1

[Name of the person in respect of whom the application is made] is of or over the age of 18 years.

*1

[Name of the person in respect of whom the application is made] is under the age of 18 years and is (or has been) married or in a civil union.

2

[Here set out sufficient information to inform the court of the facts relied on to support the application. If you have any medical, psychiatric, or other reports that you wish the court to consider, attach them to this application.]

*Delete if inapplicable.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Schedule 9 form PPPR 4: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 4: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 5 Application for order to administer property of applicant

Section 11, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of himself or herself.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing a person to administer, on my behalf, the following property (or income or benefit) belonging to me (or to which I may become entitled):

[specify the property, income, or benefit that you wish to have administered].

This application is made on the following ground:

either

*I wholly (or partly) lack the capacity to understand the nature, and to foresee the consequences, of decisions relating to my personal care and welfare.

I say:

*1

I am of or over the age of 18 years.

*1

I am under the age of 18 years and I am (or have been) married or in a civil union.

2

I am not subject to a property order.

3

No item of property in respect of which an order is sought exceeds $25,000 in value.

4

No income or benefit in respect of which an order is sought exceeds, in any 1 year, the amount prescribed for the purposes of section 11(2)(b) of the Protection of Personal and Property Rights Act 1988.

†5

The proposed appointee is [full name], of [address], [occupation].

†6

The proposed appointee is of or over the age of 20 years (or a trustee corporation).

†7

The proposed appointee is not the superintendent, licensee, supervisor, or other person in charge of a hospital, home, or other institution in which I am a patient or resident.

8

*Delete if inapplicable.

†Delete if the proposed appointee is not named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Schedule 9 form PPPR 5: amended, on 3 October 2024, by rule 4(1) of the Family Court Amendment Rules (No 2) 2024 (SL 2024/187).

Schedule 9 form PPPR 5: amended, on 3 October 2024, by rule 4(2) of the Family Court Amendment Rules (No 2) 2024 (SL 2024/187).

Schedule 9 form PPPR 5: amended, on 7 August 2008, by rule 26 of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 5: amended, on 1 August 2007, by rule 4(2)(a) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 5: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 6 Application for order to administer property

Section 11, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of some other person.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing a person to administer, on behalf of [name of the person in respect of whom the application is made], the following property (or income or benefit) belonging to [name of the person in respect of whom the application is made] (or to which that person may become entitled):

[specify the property, income, or benefit that you wish to have administered].

This application is made on the following grounds:

*[Name of the person in respect of whom the application is made] wholly (or partly) lacks the capacity to understand the nature, and to foresee the consequences, of decisions relating to his (or her) personal care and welfare.

*[Name of the person in respect of whom the application is made] has the capacity to understand the nature, and to foresee the consequences, of decisions in respect of matters relating to his (or her) personal care and welfare, but wholly lacks the capacity to communicate decisions in respect of those matters.

I make this application in my capacity as—

*(a)

a [specified relative] of [name of the person in respect of whom the application is made].

*(b)

the attorney of [name of the person in respect of whom the application is made].

*(c)

a social worker within the meaning of the Protection of Personal and Property Rights Act 1988.

*(d)

a medical practitioner.

*(e)

*(f)

*(g)

a person granted leave of the court to make this application.

I say:

*1

[Name of the person in respect of whom the application is made] is of or over the age of 18 years.

*1

[Name of the person in respect of whom the application is made] is under the age of 18 years and is (or has been) married or in a civil union.

2

[Name of the person in respect of whom the application is made] is not subject to a property order.

3

No item of property in respect of which an order is sought exceeds $25,000 in value.

4 †5

The proposed appointee is [full name], of [address], [occupation].

†6

The proposed appointee is of or over the age of 20 years (or a trustee corporation).

†7

The proposed appointee is not the superintendent, licensee, supervisor, or other person in charge of a hospital, home, or other institution in which [name of the person in respect of whom the application is made] is a patient (or resident).

8

*Delete if inapplicable.

†Delete if the proposed appointee is not named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Schedule 9 form PPPR 6: amended, on 3 October 2024, by rule 4(3) of the Family Court Amendment Rules (No 2) 2024 (SL 2024/187).

Schedule 9 form PPPR 6: amended, on 3 October 2024, by rule 4(4) of the Family Court Amendment Rules (No 2) 2024 (SL 2024/187).

Schedule 9 form PPPR 6: amended, on 1 August 2007, by rule 4(3)(a) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 6: amended, on 1 July 2005, by rule 38 of the Family Courts Amendment Rules 2005 (SR 2005/101).

Schedule 9 form PPPR 6: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 7 Application for appointment of welfare guardian for applicant

Section 12, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of himself or herself.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing a welfare guardian for me in relation to the following aspect(s) of my personal care and welfare:

[specify each aspect of your personal care and welfare for which you seek the assistance of a welfare guardian].

This application is made on the grounds that—

(a)

I wholly lack the capacity to make or to communicate decisions relating to the aspects of my personal care and welfare specified above; and

(b)

the appointment of a welfare guardian is the only satisfactory way to ensure that appropriate decisions are made relating to the aspects of my personal care and welfare specified above.

I say:

*1

I am of or over the age of 18 years.

*1

I am under the age of 18 years and I am (or have been) married or in a civil union.

*1

I am under the age of 18 years, I have never been married or in a civil union, and I have no parent or guardian living (or in regular contact) with me.

†2

The proposed appointee is [full name] of [address], [occupation].

†3

The proposed appointee is of or over the age of 20 years.

4

*Delete if inapplicable.

†Delete if no proposed appointee is named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Number of welfare guardians

The court must not appoint more than 1 welfare guardian for any person unless the court is satisfied that it would be in the best interests of the person to do so.

If the court appoints more than 1 welfare guardian for the same person, those welfare guardians must regularly consult each other.

Wishes of the person in respect of whom the application is made

So far as is practicable in the circumstances, the court must ascertain the wishes of the person in respect of whom the application is made when determining whom to appoint as welfare guardian.

Periodic review of order

If the court makes an order, it will be required to specify in it a date by which the welfare guardian must apply to the court for a review of the order. That date cannot be later than 3 years after the date of the order.

Schedule 9 form PPPR 7: amended, on 29 October 2019, by rule 5(1) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 7: amended, on 29 October 2019, by rule 5(2) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 7: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 9 form PPPR 7: amended, on 7 August 2008, by rule 27 of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 7: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 7: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 8 Application for appointment of welfare guardian

Section 12, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of some other person.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing a welfare guardian for [name of the person in respect of whom the application is made] in relation to the following aspect(s) of his (or her) personal care and welfare:

[specify each aspect of that person’s personal care and welfare for which you seek the appointment of a welfare guardian].

This application is made on the grounds that—

(a)

[name of the person in respect of whom the application is made] wholly lacks the capacity to make or to communicate decisions relating to the aspects of his (or her) personal care and welfare specified above; and

(b)

the appointment of a welfare guardian is the only satisfactory way to ensure that appropriate decisions are made relating to the aspects of his (or her) personal care and welfare specified above.

I make this application in my capacity as—

*(a)

a [specified relative] of [name of the person in respect of whom the application is made].

*(b)

the attorney of [name of the person in respect of whom the application is made].

*(c)

a social worker employed by the department for the time being responsible for the administration of the Oranga Tamariki Act 1989.

*(d)

a medical practitioner.

*(e)

*(f)

*(g)

the manager of the property of [name of the person in respect of whom the application is made].

*(h)

a person granted leave of the court to make this application.

I say:

†Delete if no proposed appointee is named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Number of welfare guardians

The court must not appoint more than 1 welfare guardian for any person unless the court is satisfied that it would be in the best interests of the person to do so.

If the court appoints more than 1 welfare guardian for the same person, those welfare guardians must regularly consult each other.

Wishes of the person in respect of whom the application is made

So far as is practicable in the circumstances, the court must ascertain the wishes of the person in respect of whom the application is made when determining whom to appoint as welfare guardian.

Periodic review of order

Schedule 9 form PPPR 8: amended, on 29 October 2019, by rule 5(1) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 8: amended, on 29 October 2019, by rule 5(2) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 8: amended, on 1 July 2019, by rule 74 of the Family Court (Family Violence and Other Matters) Amendment Rules 2019 (LI 2019/94).

Schedule 9 form PPPR 8: amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 9 form PPPR 8: amended, on 7 August 2008, by rule 28 of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 8: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 8: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 9 Application for appointment of welfare guardian to ensure compliance with personal order

Section 23, Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

[Note: This form is to be used only if the applicant seeks an appointment of a welfare guardian under section 23 of the Act to ensure compliance with a personal order.]

I, [full name], apply under section 23 of the Protection of Personal and Property Rights Act 1988 for an order appointing a welfare guardian.

The function of that guardian must be to take all reasonable steps to ensure compliance by [full name] with a personal order made by the court. A copy of that order is attached to this application.

I say:

*1

I was a party to the proceedings in which the personal order was made.

*1

I am the person in respect of whom the personal order was made.

2

[Full name] has failed to comply with the following requirements of the personal order: [specify the requirements that have not been complied with].

3

[Give the facts that show, in your opinion, that the requirements specified have not been complied with.]

†4

The proposed appointee is [full name], of [address], [occupation].

†5

The proposed appointee is of or over the age of 20 years.

*Delete if inapplicable.

†Delete if no proposed appointee is named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Expiration of order

If the court appoints a welfare guardian under section 23 of the Protection of Personal and Property Rights Act 1988, it will specify in the order the date on which the welfare guardian must cease to act, and on that date the order must expire.

Form PPPR 10 Application for property order in respect of applicant’s property

Section 31, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of himself or herself.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing 1 or more suitable persons (whether or not the person or persons proposed in this application) to act as the manager of my property (or as the manager of the following property of mine:

[specify the property you wish to be managed]).

This application is made on the ground that I wholly (or partly) lack the competence to manage my own affairs in relation to my property.

I say:

*1

I am domiciled (or ordinarily resident) in New Zealand.

*1

I am neither domiciled nor ordinarily resident in New Zealand, but all of the property in respect of which I seek the order is situated in New Zealand.

†2

The proposed appointee is [full name], of [address], [occupation]. The proposed appointee is of or over the age of 20 years (or a trustee corporation).

†2

The proposed appointees are [full name and the address and occupation of each of the proposed appointees. State, in respect of each of the proposed appointees, either that the proposed appointee is of or over the age of 20 years or that the proposed appointee is a trustee corporation].

†3

The proposed appointee is not (or None of the proposed appointees is) the superintendent, licensee, supervisor, or other person in charge of a hospital, home, or other institution in which I am a patient or resident.

4

*Delete if inapplicable.

†Delete if no proposed appointee is named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Two or more managers

If the court appoints 2 or more managers, their responsibility must be jointly held unless the court orders otherwise.

Periodic review of order

If the court makes an order, it will be required to specify a date by which the manager or managers must apply to the court for a review of the order. That date cannot be later than 3 years after the date of the order.

Schedule 9 form PPPR 10: amended, on 29 October 2019, by rule 6 of the Family Court Amendment Rules 2019 (LI 2019/230).

Form PPPR 11 Application for property order

Section 31, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of some other person.]

(Front page—Form PPPR 1)

I, [full name], apply for an order appointing 1 or more suitable persons (whether or not the person or persons proposed in this application) to act as the manager of the property of [full name of the person in respect of whom the application is made] (or as the manager of the following property of [full name of person in respect of whom the application is made]:

[specify the property in respect of which you seek the appointment of a manager]).

This application is made on the ground that [name of the person in respect of whom the application is made] wholly (or partly) lacks the competence to manage his (or her) own affairs in relation to the property.

I make this application in my capacity as—

*(a)

a [specified relative] of [name of the person in respect of whom the application is made].

*(b)

the attorney of [name of the person in respect of whom the application is made].

*(c)

a social worker employed by the department for the time being responsible for the administration of the Oranga Tamariki Act 1989.

*(d)

a medical practitioner.

*(e)

a trustee corporation.

*(f)

*(g)

*(h)

the welfare guardian for [name of person in respect of whom the application is made].

*(i)

a person granted leave of the court to make this application.

*Delete if inapplicable.

I say:

*1

[Name of the person in respect of whom the application is made] is domiciled (or ordinarily resident) in New Zealand.

*1

[Name of the person in respect of whom the application is made] is neither domiciled nor ordinarily resident in New Zealand, but all of the property in respect of which the order is sought is situated in New Zealand.

*2

The proposed appointee is [full name], of [address], [occupation]. The proposed appointee is of or over the age of 20 years (or a trustee corporation).

*2

†3

4

*Delete if inapplicable.

†Delete if no proposed appointee is named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Two or more managers

If the court appoints 2 or more managers, their responsibility must be jointly held unless the court orders otherwise.

Periodic review of order

Schedule 9 form PPPR 11: amended, on 29 October 2019, by rule 6 of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 11: amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 9 form PPPR 11: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 12 Application for appointment of welfare guardian and manager in respect of applicant

Sections 12 and 31, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of himself or herself.]

(Front page—Form PPPR 1)

I, [full name], apply—

(a)

for an order appointing a welfare guardian for me in relation to the following aspect(s) of my personal care and welfare:

[specify each aspect of your personal care and welfare for which you seek the assistance of a welfare guardian]; and

(b)

an order appointing 1 or more suitable persons (whether or not the person or persons proposed in this application) to act as manager of my property (or as the manager of the following property of mine:

[specify the property that you wish to have managed]).

This application is made on the grounds that—

(a)

I wholly lack the capacity to make or to communicate decisions relating to the aspects of my personal care and welfare specified above; and

(b)

the appointment of a welfare guardian is the only satisfactory way to ensure that appropriate decisions are made relating to the aspects of my personal care and welfare specified above; and

(c)

†5

The proposed appointee as manager is not (or None of the proposed appointees as managers is) the superintendent, licensee, supervisor, or other person in charge of a hospital, home, or other institution in which I am a patient or resident.

†6

*Delete if inapplicable.

†Delete if the proposed appointee is not named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Number of welfare guardians

The court must not appoint more than 1 welfare guardian for any person unless the court is satisfied that it would be in the best interests of the person to do so.

If the court appoints more than 1 welfare guardian for the same person, those welfare guardians must regularly consult each other.

Two or more managers

If the court appoints 2 or more managers, their responsibility is jointly held unless the court orders otherwise.

Periodic review of order

If the court makes an order, it will be required to specify a date by which the welfare guardian or the manager (or managers or the welfare guardian and the manager(s)) must apply to the court for a review of the order. That date cannot be later than 3 years after the date of the order.

Schedule 9 form PPPR 12: amended, on 29 October 2019, by rule 7(1) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 12: amended, on 29 October 2019, by rule 7(2) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 12: amended, on 7 August 2008, by rule 29(1) of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 12: amended, on 7 August 2008, by rule 29(2) of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 12: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 12: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 13 Application for appointment of welfare guardian and manager

Sections 12 and 31, Protection of Personal and Property Rights Act 1988

[Note: This form may be used only if the applicant seeks the order in respect of some other person.]

(Front page—Form PPPR 1)

I, [full name], apply—

(a)

for an order appointing a welfare guardian for [name of the person in respect of whom the application is made] in relation to the following aspect(s) of his (or her) personal care and welfare:

[specify each aspect of that person’s personal care and welfare for which you seek the appointment of a welfare guardian]; and

(b)

for an order appointing 1 or more suitable persons (whether or not the person or persons proposed in this application) to act as manager of the property of [name of the person in respect of whom the application is made] (or to act as the manager of the following property belonging to him (or her):

[specify the property in respect of which you seek the appointment of a manager]).

This application is made on the following grounds:

(a)

(b)

that the appointment of a welfare guardian is the only satisfactory way to ensure that appropriate decisions are made relating to the aspects of the personal care and welfare of [name of the person in respect of whom the application is made]; and

(c)

[name of the person in respect of whom the application is made] wholly (or partly) lacks the competence to manage his (or her) affairs in relation to his (or her) property.

I make this application in my capacity as—

*(a)

a [specified relative] of [name of the person in respect of whom the application is made].

*(b)

the attorney of [name of the person in respect of whom the application is made].

*(c)

a social worker employed by the department for the time being responsible for the administration of the Oranga Tamariki Act 1989.

*(d)

a medical practitioner.

*(e)

*(f)

*(g)

a person granted leave of the court to make this application.

†5

6

*Delete if inapplicable.

†Delete if the proposed appointee is not named in the application.

.
Signature of applicant
.
Date

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Number of welfare guardians

The court must not appoint more than 1 welfare guardian for any person unless the court is satisfied that it would be in the best interests of the person to do so.

If the court appoints more than 1 welfare guardian for the same person, those welfare guardians must regularly consult each other.

Two or more managers

If the court appoints 2 or more managers, their responsibility must be jointly held unless the court orders otherwise.

Periodic review of order

If the court makes an order, it will be required to specify a date by which the welfare guardian or the manager(s) (or the welfare guardian and the manager(s)) must apply to the court for a review of the order. That date cannot be later than 3 years after the date of the order.

Schedule 9 form PPPR 13: amended, on 29 October 2019, by rule 7(1) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 13: amended, on 29 October 2019, by rule 7(2) of the Family Court Amendment Rules 2019 (LI 2019/230).

Schedule 9 form PPPR 13: amended, on 14 July 2017, by section 149 of the Children, Young Persons, and Their Families (Oranga Tamariki) Legislation Act 2017 (2017 No 31).

Schedule 9 form PPPR 13: amended, on 7 August 2008, by rule 30(1) of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 13: amended, on 7 August 2008, by rule 30(2) of the Family Courts Amendment Rules 2008 (SR 2008/207).

Schedule 9 form PPPR 13: amended, on 1 August 2007, by rule 4(1) of the Family Courts Amendment Rules 2007 (SR 2007/197).

Schedule 9 form PPPR 13: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 14 Information sheet to accompany applications under Protection of Personal and Property Rights Act 1988

rr 20(1)(b), 406

In the Family Court
at [place]

PPPR No:.

This information sheet accompanies application(s) in respect of [full name of person in respect of whom application is made], [occupation].

Home address:

Work address:

Contact telephone number(s):

.[home] .[work]

Age: .

Date of birth:

Gender:

Country of residence:

Ethnic group: [please mark the space or spaces which apply]

□
New Zealand European
□
Maori
□
Samoan
□
Cook Island Maori
□
Tongan
□
Niuean
□
Chinese
□
Indian
□
Other [Dutch, Japanese, Tokelauan, etc]
Please state: .

Interpreter required: Yes/No

If yes, specify language:

Name and address of the lawyer of the person in respect of whom the application is made:

Nature of applications

The applications are:

1

2 Particulars of applicant

The applicant is [full name], [occupation].

Home address:

Work address:

Contact telephone number(s):

.[home] .[work]

Country of residence: .

Capacity in which the application is made (as set out in the application):

Particulars of other persons or organisations affected

The following person(s) or organisation(s) may be affected by this application:

Full name:

Address:

Occupation:

Relationship or status in relation to the person in respect of whom the application is made (eg, spouse or civil union partner or de facto partner or parent or guardian or person with whom that person is living or proposed welfare guardian or proposed manager or welfare guardian or manager): [specify].

Address for service

The accompanying applications are filed by [full name], whose address for service¹ is [address].

¹This address must be a place in New Zealand where any document may be left for the applicant. It may not be the address of a Post Office box, document exchange, or rural delivery.

Previous applications: [give the file number of any previous applications relating to the person in respect of whom the application is made, and the courts where those applications were filed].

For court use: Date stamp:

Schedule 9 form PPPR 14: amended, on 26 April 2005, by section 8(2) of the Relationships (Statutory References) Act 2005 (2005 No 3).

Form PPPR 15 Notice to respondent of application under Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

An application has been filed in this court by [full name].

A copy of the application is attached. The order (or orders) sought by the applicant is (or are) specified in the application.

*The lawyer appointed by the court to represent the person in respect of whom the application is made is [full name], of [address].

*The lawyer retained by the person in respect of whom the application is made is [full name], of [address].

*Delete if inapplicable.

If you wish to appear either to support or to oppose the application, you must, within 21 days after the service of this notice on you, file a notice of intention to appear in this office of the court.

If you file a notice of intention to appear, you must serve a copy of the notice—

(a)

on the applicant; and

(b)

on any lawyer appointed by the court to represent the person in respect of whom the application is made or retained by that person.

The copy may, in the case of the applicant, be delivered to the address for service given by the applicant and, in the case of any lawyer, be delivered to the address specified in this notice or the address of that lawyer.

[In the case of the person in respect of whom the application is made.] Whether or not you file and serve a notice of intention to appear, you must attend the court when the application is heard unless the court directs that you be excused from attending.

[In the case of any other person.] Whether or not you file and serve a notice of intention to appear, you may attend the court when the application is heard to support or oppose the application.

If you do not wish to appear either to support or to oppose the application but you do wish to be kept informed of what is happening in respect of the application, you must—

(a)

file in this office of the court a notice giving the address of a place in New Zealand at which documents may be left for you; and

(b)

serve a copy of the notice on each of the other parties to the proceedings. That copy may be delivered to the address for service given by the other party.

Assistance

Pre-hearing conference

You will be given notice of the time and place at which the pre-hearing conference will be held. You will be requested to attend that conference.

Copies of orders

You will get copies of any orders made under this application.

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

.
Registrar
.
Date

Form PPPR 16 Statement of consent to appointment as welfare guardian

r 410(1)

Section 12(5)(d), Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

I, [full name of the proposed welfare guardian], of [address], [occupation], consent to be appointed under section 12 of the Protection of Personal and Property Rights Act 1988 as a welfare guardian for [full name of the person in respect of whom the application is made], in relation to the aspect (or aspects) of the personal care and welfare of that person that the court specifies in the order.

Dated [date].

.
Signed by the above-named, [full name of the proposed welfare guardian], in the presence of—

Signature of witness:

Address:

Occupation:

Form PPPR 17 Statement of consent to appointment as manager

r 410(2)

Section 31(5)(c), Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

I, [full name of the proposed manager], of [address], [occupation], consent to be appointed to be manager of certain property belonging to [full name of the person in respect of whom the application is made].

Dated [date].

.
Signed by the above-named, [full name of the proposed manager], in the presence of—

Signature of witness:

Address:

Occupation:

Form PPPR 18 Summons to party to attend pre-hearing conference

Section 71, Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

You have failed to comply with a letter sent to you by post requesting you to attend a pre-hearing conference at [time] on [date] at [place].

You are summoned to attend a pre-hearing conference at [time] on [date] at [place].

*You are required to bring with you and produce [specify what is to be produced].

*Delete if inapplicable.

If, without sufficient cause, you refuse or neglect to attend or to produce anything that you are required to produce, you may be prosecuted and fined.

.
Judge
.
Date

Form PPPR 19 Personal order

Section 10, Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

On application made to it, the court makes an order that—

*(a)

[name of the person in respect of whom the order is made] receive appropriate remuneration for work performed or to be performed by him (or her):

*(b)

[full name], a parent of [full name of the person in respect of whom the order is made], make suitable arrangements for the care of [full name of the person in respect of whom the order is made] after that parent’s death:

*(c)

the arrangements made by [full name], a parent of [full name of the person in respect of whom the order is made], for the personal care of [full name of the person in respect of whom the order is made] after that parent’s death be observed (or be varied) as follows: [set out the way in which the arrangements are to be observed or varied]:

*(d)

[full name of the person in respect of whom the order is made] must enter (or attend at or leave) [name of institution]:

*(e)

[full name of the person in respect of whom the order is made] be provided with living arrangements of the following kind: [specify the kind of living arrangements with which the person is to be provided]:

*(f)

[full name of the person in respect of whom the order is made] be provided with medical advice of the following kind(s): [specify the kind(s) of medical advice the person is to receive]:

*(g)

[full name of the person in respect of whom the order is made] be provided with educational, rehabilitative, therapeutic, or other services of the following kind(s): [specify the kind(s) of service the person is to receive]:

*(h)

[full name of the person in respect of whom the order is made] must not leave New Zealand without the court’s permission (or only on the following conditions: [specify the conditions (if any) on which the person may leave New Zealand]):

*(i)

appointing [full name] as next friend (or guardian ad litem) for [full name of the person in respect of whom the order is made] for the purposes of the following District Court proceedings: [specify the nature of the proceedings, and the District Court in which they are to be held].

This order is made under section 10(1) [specify paragraph of section 10(1) of the Act under which the order is made] of the Protection of Personal and Property Rights Act 1988.

*This order is made with the consent of each party to the proceedings, and the court is satisfied that [full name of the person in respect of whom the order is made] understands the nature and foresees the consequences of the order and consents to it.

*This order must expire with the close of [date].

*[Full name], of [address], [occupation], must apply to the court for a review of this order before [date]. This order expires on that date unless, on a review of the order, the court decides that it must continue beyond that date.

*This order is an interim order. It continues in force until the close of [date, being not more than 6 months after the date on which the order is made.]

*Delete if inapplicable.

.
Registrar
.
Date

Form PPPR 20 Order to administer property

Section 11, Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

On application made to it, the court makes an order appointing [name of the appointee], of [address], [occupation], to administer, on behalf of [name of the person in respect of whom the order is made], of [address], [occupation], the following property (or income or benefit), being property belonging to that person (or to which that person may become entitled): [specify the property, income, or benefit to be administered].

[Name of the appointee] is required to administer the property (or income or benefit) in a way that enables or encourages [name of the person in respect of whom the order is made] to exercise and develop the capacity that person has to the greatest extent possible.

This order is made under sections 10(1)(j) and 11 of the Protection of Personal and Property Rights Act 1988.

*This order is made with the consent of each party to the proceedings, the court being satisfied that [full name of the person in respect of whom the order is made] understands the nature and foresees the consequences of the order and consents to it.

*[Name of appointee] must apply to the court for a review of this order not later than [a date not later than 3 years after the date of the order]. This order must expire on that date unless, on a review of the order, the court decides that it must continue beyond that date.

*This order is an interim order. It is made pending the final determination of the application. It expires with the close of [date, being not more than 6 months after the date on which the order is made].

*Delete if inapplicable.

.
Registrar
.
Date

Form PPPR 21 Order for appointment of welfare guardian

Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

On application made to it, the court makes an order appointing [name of the appointee], of [address], [occupation], to be a welfare guardian for [name of the person in respect of whom the order is made], of [address], [occupation].

*This order is made with the consent of each party to the proceedings, the court being satisfied that the person in respect of whom the application was made understands and foresees the consequences of the order and consents to it.

either

[If the order is made under section 12 of the Act.]

This order is made under section 12 of the Protection of Personal and Property Rights Act 1988.

The welfare guardian is appointed in relation to the following aspect(s) of the personal care and welfare of [name of the person in respect of whom the order is made]:

[specify each aspect of the person’s personal care and welfare in relation to which the welfare guardian is appointed].

*The welfare guardian must apply to this court for a review of this order not later than [a date not later than 3 years after the date of the order]. This order expires on that date unless, on a review of the order, the court decides that it must continue beyond that date.

[If the order is made under section 14 of the Act.]

*This order is an interim order. It continues in force until the close of [date, being not more than 6 months after the date on which the order is made].

[If the order is made under section 23 of the Act.]

This order is made under section 23 of the Protection of Personal and Property Rights Act 1988.

The function of the welfare guardian is to take all reasonable steps to ensure that [full name of the person who has so far failed to comply with the order] complies with the order of this court dated [date].

The welfare guardian must cease to act on the day [date], and on that date this order expires.

*Delete if inapplicable.

.
Registrar
.
Date

Form PPPR 22 Order for appointment of manager

Section 31, Protection of Personal and Property Rights Act 1988

(Heading—Form PPPR 2)

On application made to it, the court makes an order appointing [full name of appointee], of [address], [occupation], to act as manager of property belonging to [full name of the person in respect of whom the order is made], of [address], [occupation].

This order applies to all the property of [full name of the person in respect of whom the order is made].

This order applies only to the following property belonging to [full name of the person in respect of whom the order is made]:

[specify the property in respect of which the appointee is appointed manager].

The manager has all the powers specified in Schedule 1 of the Act.

The manager has, in respect of the property to which this order relates, the following rights and powers, all of which are specified in clause 1 of Schedule 1 of the Protection of Personal and Property Rights Act 1988:

[specify rights and powers of manager].

*The manager also has, in respect of the property to which this order relates, the following additional rights and powers:

[specify additional rights and powers of manager].

*The manager’s rights and powers are subject to the following restrictions:

[specify restrictions on rights and powers of manager].

*The manager must apply to this court for a review of this order not later than [a date not later than 3 years after the date of the order]. This order expires on that date unless, on a review of the order, the court decides that it must continue beyond that date.

*This order is a temporary order. It expires with the close of [date, being not more than 3 months after the date on which the order is made].

*Delete if inapplicable.

.
Registrar
.
Date

Form PPPR 23 Application by attorney for directions

Section 101, Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

I, [full name, address, occupation of attorney], apply for directions relating to the exercise of my powers under an enduring power of attorney.

I say—

1

For this paragraph select the statement that applies.

Statement A

On [date] [name of donor] granted to me an enduring power of attorney to act in relation to his/her* personal care and welfare.

*Select one.

Statement B

On [date] [name of donor] granted to me an enduring power of attorney to act in relation to his/her* property.

*Select one.

Statement C

On [date] [name of donor] granted to me an enduring power of attorney to act in relation to his/her* personal care and welfare and his/her* property.

*Select one.

2

For this paragraph select the statements that apply.

Statement A

The enduring power of attorney authorises me to act in relation to the personal care and welfare of [name of donor] generally.

Statement B

The enduring power of attorney authorises me to act in relation to the personal care and welfare of [name of donor] regarding the following specific matters: [state matters].

Statement C

The enduring power of attorney authorises me to act generally in relation to all of the property of [name of donor].

Statement D

The enduring power of attorney authorises me to act generally in relation to the following property of [name of donor]: [describe property].

Statement E

The enduring power of attorney authorises me to do the following specific things in relation to the property of [name of donor]: [specify things].

3

For this paragraph select the statement that applies.

Statement A

The enduring power of attorney is not subject to any conditions or restrictions.

Statement B

The enduring power of attorney is subject to the following conditions and restrictions: [specify].

4

Include this paragraph if the attorney is—

•

acting in respect of a significant matter relating to the donor’s personal care and welfare; or

•

authorised to act in relation to the donor’s property only if the donor becomes mentally incapable.

For this paragraph select the statement that applies.

Statement A

A relevant health practitioner has certified that [name of donor] is mentally incapable and a copy of that certificate is attached.

Statement B

The court has determined that [name of donor] is mentally incapable and a copy of the court order is attached.

5

Include this paragraph if the enduring power of attorney is in relation to the donor’s personal care and welfare and the attorney is acting in respect of a matter other than a significant matter.

I have reasonable grounds to believe that [name of donor] is mentally incapable. Those grounds are: [specify].

6

I seek directions relating to the exercise of my powers in respect of [state the directions sought and sufficient information to inform the court of the need for those directions].

Date:

Signature of applicant:

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relevant health practitioner

The term relevant health practitioner means a person who is, or is deemed to be, registered with a registration authority appointed by or under the Health Practitioners Competence Assurance Act 2003 as a practitioner of a particular health profession, or a medical practitioner registered by a competent overseas authority,—

(a)

whose scope of practice includes the assessment of a person’s mental capacity; or

(b)

whose scope of practice—

(i)

includes the assessment of a person’s mental capacity; and

(ii)

is specified in the enduring power of attorney.

Copy of enduring power of attorney

When filing this application you must lodge in the office of the court, unless the Registrar otherwise directs, a copy of the enduring power of attorney.

Schedule 9 form PPPR 23: inserted, on 26 September 2008, by rule 4 of the Family Courts Amendment Rules (No 2) 2008 (SR 2008/316).

Form PPPR 24 Application for exercise of court’s jurisdiction in respect of enduring power of attorney

Sections 102 and 102A, Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

I, [full name, address, occupation], apply for the exercise of the court’s jurisdiction in respect of [state matter in respect of which the court’s jurisdiction is sought].

I say—

1

For this paragraph select the statement that applies.

Statement A

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* personal care and welfare.

*Select one.

Statement B

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* property.

*Select one.

Statement C

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* personal care and welfare and my/his/her* property.

*Select one.

2

For this paragraph select the statements that apply.

Statement A

The enduring power of attorney authorises [name of attorney] to act in relation to my/the donor’s* personal care and welfare generally.

*Select one.

Statement B

The enduring power of attorney authorises [name of attorney] to act in relation to my/the donor’s* personal care and welfare regarding the following specific matters: [state matters].

*Select one.

Statement C

The enduring power of attorney authorises [name of attorney] to act generally in relation to all of my/the donor’s* property.

*Select one.

Statement D

The enduring power of attorney authorises [name of attorney] to act generally in relation to the following of my/the donor’s* property: [describe property].

*Select one.

Statement E

The enduring power of attorney authorises [name of attorney] to do the following specific things in relation to my/the donor’s* property: [specify things].

*Select one.

3

For this paragraph select the statement that applies.

Statement A

The enduring power of attorney is not subject to any conditions or restrictions.

Statement B

The enduring power of attorney is subject to the following conditions and restrictions: [specify].

4

For this paragraph select the statement that applies.

Statement A

I apply to the court to determine whether the instrument executed by me/[name of donor]* is an enduring power of attorney.

*Select one.

Statement B

I apply to the court to determine whether or not [name of donor] is mentally incapable.

Statement C

I apply to the court for the following order/direction* in respect of the enduring power of attorney: [state order sought from court and reasons].

*Select one.

5

Include this paragraph if an application is being made to the court for an order or direction in respect of an enduring power of attorney, and select the statement that applies.

Statement A

[Name of attorney] believes on the following reasonable grounds that [name of donor] is mentally incapable: [state grounds].

Statement B

A relevant health practitioner has certified that [name of donor] is mentally incapable and a copy of that certificate is attached.

Statement C

The court has determined that [name of donor] is mentally incapable and a copy of the court order is attached.

6

I am:

*the donor of the enduring power of attorney

*a relative of the donor

*an attorney of the donor (not being the attorney acting under the enduring power of attorney)

*a social worker

*a medical practitioner

*a trustee corporation

*the principal manager of [name of place] providing hospital care/rest home care/residential disability care* to the donor

*a welfare guardian appointed for the donor

*a person authorised by a body or organisation contracted by the Government to provide elder abuse and neglect prevention services

*a person granted leave by the court to make this application.

*Select one.

Date:

Signature of applicant:

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Meaning of the term relevant health practitioner

(a)

whose scope of practice includes the assessment of a person’s mental capacity; or

(b)

whose scope of practice—

(i)

includes the assessment of a person’s mental capacity; and

(ii)

is specified in the enduring power of attorney.

Copy of enduring power of attorney

When filing this application you must, if possible, lodge in the office of the court a copy of the enduring power of attorney.

Schedule 9 form PPPR 24: inserted, on 26 September 2008, by rule 4 of the Family Courts Amendment Rules (No 2) 2008 (SR 2008/316).

Form PPPR 25 Application for review of attorney’s decision

Section 103, Protection of Personal and Property Rights Act 1988

(Front page—Form PPPR 1)

I, [full name, address, occupation], apply for a review of the following decision made by [full name of attorney] acting under an enduring power of attorney granted by me/[name of donor]*: [state decision sought to be reviewed].

*Select one.

I say—

1

For this paragraph select the statement that applies.

Statement A

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* personal care and welfare.

*Select one.

Statement B

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* property.

*Select one.

Statement C

On [date] I/[name of donor]* granted to [name of attorney] an enduring power of attorney to act in relation to my/his/her* personal care and welfare and my/his/her* property.

*Select one.

2

For this paragraph select the statements that apply.

Statement A

The enduring power of attorney authorises [name of attorney] to act in relation to my/the donor’s* personal care and welfare generally.

*Select one.

Statement B

The enduring power of attorney authorises [name of attorney] to act in relation to my/the donor’s* personal care and welfare regarding the following specific matters: [state matters].

*Select one.

Statement C

The enduring power of attorney authorises [name of attorney] to act generally in relation to all of my/the donor’s* property.

*Select one.

Statement D

The enduring power of attorney authorises [name of attorney] to act generally in relation to the following of my/the donor’s* property: [describe property].

*Select one.

Statement E

The enduring power of attorney authorises [name of attorney] to do the following specific things in relation to my/the donor’s* property: [specify things].

*Select one.

3

For this paragraph select the statement that applies.

Statement A

The enduring power of attorney is not subject to any conditions or restrictions.

Statement B

The enduring power of attorney is subject to the following conditions and restrictions: [specify].

4

At a time when I/the donor* was mentally incapable [full name of attorney] made the following decision/decisions*: [state decision(s)].

*Select one.

5

This decision needs/These decisions* need review because: [state reasons].

*Select one.

6

I am—

*the donor of the enduring power of attorney

*a relative of the donor

*an attorney of the donor (not being the attorney acting under the enduring power of attorney)

*a social worker

*a medical practitioner

*a trustee corporation

*the principal manager of [name of place] providing hospital care/rest-home care/residential disability care* to the donor

*a welfare guardian appointed for the donor

*a person authorised by a body or organisation contracted by the Government to provide elder abuse and neglect prevention services

*a person granted leave by the court to make this application.

*Select one.

Date:

Signature of applicant:

Notes

Advice

If you need help, consult a lawyer or contact a Family Court office immediately.

Office hours

The office of the Family Court is open from 8.30 am to 5 pm on Mondays to Fridays inclusive.

Information sheet

A duly completed information sheet (in form PPPR 14) must accompany this application.

Meaning of the term relative

The term relative, in relation to any person, means—

(a)

the spouse, civil union partner, or de facto partner of that person; and

(b)

a parent or grandparent of that person, or of the spouse or other person referred to in paragraph (a); and

(c)

a child or grandchild of that person, or of the spouse or other person referred to in paragraph (a); and

(d)

a brother or sister of that person, or of the spouse or other person referred to in paragraph (a), whether of full-blood or of half-blood; and

(e)

an aunt or uncle of that person, or of the spouse or other person referred to in paragraph (a); and

(f)

a nephew or niece of that person, or of the spouse or other person referred to in paragraph (a).

Copy of enduring power of attorney

When filing this application you must, if possible, lodge in the office of the court a copy of the enduring power of attorney.

Schedule 9 form PPPR 25: inserted, on 26 September 2008, by rule 4 of the Family Courts Amendment Rules (No 2) 2008 (SR 2008/316).

Schedule 10 Forms for proceedings under Care of Children Act 2004

Schedule 10: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

COC 1	Notice to respondent of application under Care of Children Act 2004
COC 2	Notice to respondent residing outside New Zealand of application under Care of Children Act 2004
COC 3	Warrant to enforce role of providing day-to-day care for, or order for contact with, child
COC 4	Warrant to take child to prevent removal from New Zealand
COC 5	Parenting order(s)
COC 6	Interim parenting order(s)
COC 7	Bond to ensure compliance with parenting order

Form COC 1 Notice to respondent of application under Care of Children Act 2004

rr 416E, 416I

(General heading—Form G 2)

To [name of respondent]

An application (see the attached copy) has been filed in this court by [full name]. The order or orders sought by the applicant are specified in the application.

Even if you take no action, the court may summon you as a witness to help it deal with the application.

Copies of orders

You will get a copy of any orders made by the court. Orders are normally in force from the time they are made. However, even if you do not receive a copy of an order you will still be required to obey it.

Advice

If you need help, consult a lawyer, check the Ministry of Justice website, call the Ministry of Justice call centre, or contact an office of the Family Court immediately.

Ministry of Justice website: http://www.justice.govt.nz

Ministry of Justice call centre: 0800 268 787

Date:

Signature:

(Registrar)

Schedule 10 form COC 1: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 10 form COC 1: amended, on 2 May 2024, by rule 139(1) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 10 form COC 1: amended, on 2 May 2024, by rule 139(2) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 10 form COC 1: amended, on 1 July 2020, by rule 12(1) of the Family Court Amendment Rules 2020 (LI 2020/135).

Form COC 2 Notice to respondent residing outside New Zealand of application under Care of Children Act 2004

rr 416E, 416I

(General heading—Form G 2)

To [name of respondent]

An application (see the attached copy) has been filed in this court by [full name]. The order or orders sought by the applicant are described in the application.

Jurisdiction of court

The court may make an order if [set out bases for jurisdiction in respect of each order sought, following closely the relevant provisions of the Care of Children Act 2004].

Advice

If you need help, consult a lawyer immediately in the place where you are and check the Ministry of Justice website. If you intend to employ a lawyer in New Zealand, you should ask about your eligibility for legal aid in this country.

Ministry of Justice website: http://www.justice.govt.nz

Date:

Signature:

(Registrar)

Schedule 10 form COC 2: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 10 form COC 2: amended, on 2 May 2024, by rule 139(3) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 10 form COC 2: amended, on 2 May 2024, by rule 139(4) of the Family Court Amendment Rules 2024 (SL 2024/35).

Schedule 10 form COC 2: amended, on 1 July 2020, by rule 12(2) of the Family Court Amendment Rules 2020 (LI 2020/135).

Form COC 3 Warrant to enforce role of providing day-to-day care for, or order for contact with, child

Sections 72 and 73, Care of Children Act 2004

(General heading—Form G 2)

To every constable (or social worker) (or [full name of person])

1

I am satisfied, on the application of [full name, address, occupation], that the applicant, in respect of [full name], a child aged [specify] years,—

*has the role of providing day-to-day care for the child

*is entitled under a parenting order or other order specified in section 73(1) of the Care of Children Act 2004 to have direct contact with the child.

*Omit if inapplicable.

2

I direct you to take the child (using reasonable force if necessary) and to deliver the child to [full name of applicant or of other person or authority to whom child is to be delivered on behalf of applicant], and to report to this court when you have done so.

3

4

You are required to have this warrant with you when executing it and to produce it on initial entry and, if requested, at any later time.

5

You must also comply with any other applicable requirements of section 75(2) of the Care of Children Act 2004.

Date:

Signature:

(Judge)

Notes

Arrest of person resisting execution of warrant

Under section 79 of the Care of Children Act 2004, it is an offence to—

knowingly resist or obstruct a person executing this warrant; or
knowingly fail or refuse to afford immediate entrance to premises to a person executing this warrant.

The offence is punishable by a fine not exceeding $2,500 or imprisonment for a term not exceeding 3 months.

Under section 315 of the Crimes Act 1961, a constable (and anyone he or she calls to assist) may arrest and take into custody any person whom he or she has good cause to suspect has committed an offence punishable by imprisonment.

Use of faxed copy of warrant

(a)

the fact that a faxed copy of the warrant may be used for the purposes of executing the warrant; and

(b)

the date and time at which the authorisation expires, which must be the close of the third day after the day on which the authorisation is granted.

Schedule 10 form COC 3: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form COC 4 Warrant to take child to prevent removal from New Zealand

Section 77, Care of Children Act 2004

(General heading—Form G 2)

To every constable (or social worker)

1

I have reason to believe that [full name], a child aged [specify] years, may be taken out of New Zealand with intent to, or in circumstances where the taking of the child would be likely to,—

Select the statement that applies.

defeat the claim of [full name, address, occupation], who has applied for/is about to apply for* the role of providing day-to-day care for, or an order for contact with, the child.

*Select one.

prevent an order made in the [court] at [place, date]/registered under section 81 of the Care of Children Act 2004* about the role of providing day-to-day care for, or about contact with, the child, from being complied with.

*Select one.

2

The child is said to be in the care of [full name, address].

3

There being no High Court Judge or District Court Judge or Family Court Judge available,* I direct you to take the child (using reasonable force if necessary) and place the child in the care of some suitable person pending the order or further order of the court having jurisdiction in the case.

*Omit this phrase if it does not apply.

4

When you have executed this warrant in accordance with the direction, you must advise this court immediately of the name and address of the person with whom you have placed the child.

Date:

Signature:

Judge/Family Court Associate/Registrar (not being a constable)*

*Select one.

Notes

Arrest of person resisting execution of warrant

Under section 79 of the Care of Children Act 2004, it is an offence to—

knowingly resist or obstruct a person executing this warrant; or
knowingly fail or refuse to afford immediate entrance to premises to a person executing this warrant.

The offence is punishable by a fine not exceeding $2,500 or imprisonment for a term not exceeding 3 months.

Use of faxed copy of warrant

(a)

the fact that a faxed copy of the warrant may be used for the purposes of executing the warrant; and

(b)

the date and time at which the authorisation expires, which must be the close of the third day after the day on which the authorisation is granted.

Schedule 10 form COC 4: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 10 form COC 4: amended, on 2 May 2024, by rule 139(5) of the Family Court Amendment Rules 2024 (SL 2024/35).

Form COC 5 Parenting order(s)

Sections 40(3), 48, 55, and 70, Care of Children Act 2004

(General heading—Form G 2)

On application made to it, the court orders that—

(a)

the following person has/people have* the role of providing day-to-day care of the child(ren) listed below, during the times stated:

*Select one.

Full name of child and date of birth		Full name of person		Times when person has role of providing day-to-day care
[state]		[state]		[specify]

(b)

the following person has/people have* contact with the child(ren) listed below, during the times and in the ways stated:

*Select one.

Full name of child and date of birth		Full name of person		Times, location, and nature of contact
[state]		[state]		[specify, eg, face-to-face contact, letters, telephone, email, supervised by a person other than an approved provider]

Effect of parenting order

The role of providing day-to-day care for a child continues until the child turns 16.

While exercising the role of providing day-to-day care for a child, you have exclusive responsibility for the child’s day-to-day living arrangements, subject to any court order and the following conditions (if any). [State any conditions imposed under section 48(5) of the Care of Children Act 2004, including which party and child(ren) the conditions affect.]

If you are a guardian, unless your role or another guardian’s role is modified by a court order, you must act jointly (eg, consulting whenever practicable with the aim of reaching agreement) when making guardianship decisions for a child.

*Monitoring and review

See also the information sheet accompanying this order.

*Omit this paragraph if it does not apply.

Variation or discharge of this order

Any person affected by this order, or a person acting for a child who is the subject of this order, may apply to the court to vary or discharge this order. Leave (permission) of the court is required if the application is substantially similar to previous proceedings and the order was made less than two years ago.

Consequences of non-compliance

*Omit this paragraph if it does not apply.

*Bond

This order requires [full name of person required to enter into the bond] to enter into a bond for the purpose of [state purpose of the bond].

[Full name of person required to enter into the bond] is required to deposit the sum of $[specify] with the Family Court at [place] by [date for payment of bond].

The bond may be forfeited to the Crown if [full name of person required to enter into the bond] does not meet the purpose of the bond or if the following circumstances apply: [specify circumstances that may result in forfeiture of the bond].

*Omit this section if it does not apply.

Date:

Signature:

(Registrar)

Note

This order may include terms of an agreement between parents or guardians of a child relating to any 1 or more of the following:

(a)

the role of providing day-to-day care for the child:

(b)

contact with the child:

(c)

the upbringing of the child.

See section 40 of the Care of Children Act 2004 for the circumstances in which agreement terms may be included.

General information to accompany parenting orders (as required by section 55(1) of the Care of Children Act 2004)

See above information about—

the effect of a parenting order; and
the processes for the monitoring and review of the order; and
the means by which the order can be varied or discharged; and
the consequences that may follow if the order is not complied with.

Schedule 10 form COC 5: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Form COC 6 Interim parenting order(s)

Sections 40(3), 48, 55, and 70, Care of Children Act 2004

(General heading—Form G 2)

On application made to it, the court orders that—

(a)

the following person has/people have* the role of providing day-to-day care of the child(ren) listed below, during the times stated:

*Select one.

Full name of child and date of birth		Full name of person		Times when person has role of providing day-to-day care
[state]		[state]		[specify]

(b)

the following person has/people have* contact with the child(ren) listed below, during the times and in the ways stated:

*Select one.

Full name of child and date of birth		Full name of person		Times, location, and nature of contact
[state]		[state]		[specify, eg, face-to-face contact, letters, telephone, email, supervised by a person other than an approved provider]

Effect of interim parenting order

The role of providing day-to-day care for a child continues until the child turns 16.

While exercising the role of providing day-to-day care for a child, you have exclusive responsibility for the child’s day-to-day living arrangements, subject to any court order and the following conditions (if any). [State any conditions imposed under section 48(5) of the Care of Children Act 2004, including which party and child(ren) the conditions affect.]

Duration of interim parenting order

Select the statement that applies

This order continues in effect until [state specific date or specific event] or until it is replaced by another interim order or final order, as the case may be.

The court has directed that this order is to become a final parenting order on [date] unless, before that date,—

you notify the court that you wish to be heard; or
if a lawyer has been appointed to represent the child/children*, that lawyer has notified the court that he or she wishes to be heard.

*Select one.

If a parent has neither the role of providing day-to-day care nor contact

Select the statement that applies

I appoint [date within 3 months] at [time] at the Family Court at [place] for this hearing.

I will advise you of that date, time, and place of the hearing as soon as practicable.

Application to vary or discharge

If the order was made on an application without notice to you, you may make an application to the court to vary or discharge this order.

*Monitoring and review

See also the information sheet accompanying this order.

*Omit this paragraph if it does not apply.

Variation or discharge of this order

Any person affected by this order, or a person acting for a child who is the subject of this order, may apply to the court to vary or discharge this order.

Consequences of non-compliance

*Omit this paragraph if it does not apply.

*Bond

This order requires [full name of person required to enter into the bond] to enter into a bond for the purpose of [state purpose of the bond].

[Full name of person required to enter into the bond] is required to deposit the sum of $[specify] with the Family Court at [place] by [date for payment of bond].

*Omit this section if it does not apply.

Date:

Signature:

(Registrar)

Note

This order may include terms of an agreement between parents or guardians of a child relating to 1 or more of the following:

(a)

the role of providing day-to-day care for the child:

(b)

contact with the child:

(c)

the upbringing of the child.

See section 40 of the Care of Children Act 2004 for the circumstances in which agreement terms may be included.

General information to accompany parenting orders (as required by section 55(1)(b) of the Care of Children Act 2004)

See above information about—

the effect of a parenting order; and
the processes for the monitoring and review of the order; and
the means by which the order can be varied or discharged; and
the consequences that may follow if the order is not complied with.

Schedule 10 form COC 6: inserted, on 31 March 2014, by rule 46 of the Family Courts Amendment Rules (No 2) 2014 (LI 2014/4).

Schedule 10 form COC 6: amended, on 1 July 2014, by rule 36 of the Family Courts Amendment Rules (No 4) 2014 (LI 2014/180).

Form COC 7 Bond to ensure compliance with parenting order