Act of Sederunt (Child Care and Maintenance Rules) 1997

Rule 3.40(1)

FORM 57 S APPLICATION TO VARY OR RECALL AN EXCLUSION ORDER

Section 79(3) of the Children (Scotland) Act 1995

Case No

Date lodged

Application to Sheriff at

to vary or recall an Exclusion Order under section 79(3) of the Children (Scotland) Act 1995

Part 1. DETAILS OF APPLICANT AND OTHER PERSONS WHO THE APPLICANT BELIEVES SHOULD RECEIVE NOTICE OF THE APPLICATION

APPLICANT	[insert name, address, telephone DX and fax numbers, and details of the capacityof the person making the application]
CHILD	[insert name, address, gender and date of birth] *
THE NAMED PERSON	If not applicant [insert name and address of person excluded]
SAFEGUARDER	[insert name, address, telephone DX and fax numbers (if known) of any safeguarder appointed by a children’s hearing or court in respect of the child]
APPROPRIATE PERSON(S)	If not applicant [insert name, address and the basis for the person being an appropriate person within the meaning of section 76(2)(c) of the Act]
THE PRINCIPAL REPORTER	[insert name, address, telephone DX and fax numbers]
ANY OTHER PERSON WHO SHOULD RECEIVE NOTICE OF THE APPLICATION	[insert name, address and telephone numbers of person and provide details of their interest in the application and/or child]

*Note: Information to be provided in Part 3 where applicant does not wish to disclose the address or whereabouts of the child or any other person to persons receiving notice of the application

Part 2. INFORMATION ABOUT THE APPLICATION AND ORDERS SOUGHT

On[date of order] the Sheriff made an Exclusion Order in the following terms[insert full details of order and conditions attaching to it] [Copy original order to be attached].

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]

SUPPORTING EVIDENCE

The following supporting evidence is produced –

[list reports, statements, affidavits or other evidence including financial information produced]

Part 3. Details of Order sought and any terms, conditions or directions

ORDER SOUGHT: The applicant requests the Sheriff to[insert details of the variation or recall sought and any terms and conditions to be attached to the order] in respect of the child[insert name]

[Insert here details and grounds for any order sought in relation

(a) to non-disclosure of address or whereabouts of child; or

(b) service of restricted documents on child.]

Part 4. DETAILS OF FIRST ORDER SOUGHT FROM THE SHERIFF

The applicant requests the sheriff to:

a. Fix a hearing.

*b. Order the applicant to forthwith serve a copy of the application on,

i. The Principal Reporter

ii. The Local Authority

iii. The named person, together with a notice in Form 37; and

iv. The child, together with a notice in form 29;

v. The persons listed in part 1 of this application, together with a notice in Form 37.

*delete as appropriate

*c. Dispense with service on the child or any other person for the following reasons[insert details]

*d. Grant the following ancillary order. [specify order sought]

*e. Grant a power of arrest.

*delete as appropriate

SIGNED.................... DATE....................

[name designation and address telephone, DX and fax numbers]