Rule 3.37(2)
Section 76 of the Children (Scotland) Act 1995
Case No
IN THE SHERIFF COURT
at
on
In the application by the Local Authority for an exclusion order in terms of section 76 of the Act the sheriff orders that[insert name and address of named person] shall be excluded from[insert address of child’s family home] * forthwith/from[insert date] until[insert date when order shall cease to have effect].
*From the effective date the rights of occupancy of [insert name] from the said address are suspended
*delete as appropriate
ANCILLARY ORDERS
In terms of section 77 the sheriff makes the following ancillary orders:
[insert details of the orders granted and any terms and conditions or directions made by the sheriff or power of arrest attached to any interdict]
For the purpose of enforcing this order warrant is granted for all lawful execution, including warrant to open shut and lockfast places.
Signed....................
Sheriff at....................