Act of Sederunt (Child Care and Maintenance Rules) 1997

Rule 2.38(1)

FORM 16 S APPLICATION FOR A PARENTAL RESPONSIBILITIES ORDER

Section 86 of the Children (Scotland) Act 1995

Case No

Date lodged

Application to Sheriff Court at

for a Parental Responsibilities Order under section 86 of the Children (Scotland) Act 1995

APPLICANT	[insert name, address, telephone and fax numbers, and details of the capacity of the person making the application on behalf of the local authority, e.g. solicitor for local authority, social worker]
CHILD	[insert name, address, gender and date of birth exactly as given in birth certificate]
RELEVANT PERSON(S)	[insert name, address and the basis for the person being a relevant person within the meaning of section 86(4) of the Act]
REPORTING OFFICER	[insert name and address and details of appointment of Reporting Officer appointed prior to the application in terms of rules 2.7 or 2.25]
ANY OTHER PERSON WHO SHOULD RECEIVE NOTICE OF THE APPLICATION	[insert name, address of person and provide details of their interest in the application and/or child]

2.  GROUNDS FOR MAKING APPLICATION S

The Applicant asks the Court to make a Parental Responsibilities Order for the following reasons:—

[applicant to provide details of grounds for making the application]

OTHER APPLICATIONS AND ORDERS WHICH AFFECT THE CHILD

[insert details of any other applications or orders made which affect or are relevant to the child who is the subject of this application including any details of a supervision requirement of a Children’s Hearing]

3.  REQUEST FOR ORDER S

1.  The applicants request the court to make a Parental Responsibilities Order transferring the appro- priate parental rights and responsibilities to them. S

2.  The petitioners request the court to dispense with the agreement of S

on the ground that

[in terms of section 86(2)(b)]

4.  REPORTS/DOCUMENTARY EVIDENCE ETC S

The following documents are produced with this petition:—

(a) An extract of the entry in the Register of Births relating to the child

(b) *Agreement of relevant persons within the meaning of Section 86(4) of the Act

(c) *Any other document founded upon by the petitioner in support of the terms of the petition

*delete as appropriate

5.  OTHER ORDERS S

*In terms of section 88(3) of the Act the sheriff is requested to make the following directions as to contact with the child by[insert name and address of person and his or her relationship with child the child ][insert details of any directions sought as to contact with the child]

*[insert details of any other orders craved e.g. Crave for warrant for delivery of the child and warrant to open shut and lockfast places].

*delete as appropriate

6.  DETAILS OF FIRST ORDER SOUGHT FROM THE SHERIFF S

The applicant requests the sheriff to appointa curatoradlitem anda Reporting Officer to the child for the purpose of investigating and reporting to the court within 4 weeks and on receipt of the reports by the curatorad litem and reporting officer to fix a hearing

SIGNED

DATE

[insert Name, Address, telephone, DX and Fax number]