Statement to Prevent a Parent from Relocating with a Child - Word & PDF Template Form

CASE NUMBER:

TBC

IN THE FAMILY COURT SITTING AT ________

IN THE MATTER OF THE CHILDREN ACT 1989

AND IN THE MATTER OF THE CHILD:

BETWEEN:

________

Applicant

and

________

Respondent

__________________________________________________________________

WITNESS STATEMENT OF THE APPLICANT ________

IN SUPPORT OF AN APPLICATION

FOR ORDERS UNDER S.8 OF THE CHILDREN ACT 1989

___________________________________________________________________

1. I, ________ (DOB: ________) of ________ (Occupation: ________) make this statement in support of my application for a court order in relation to my child.

Background

2. I am the mother of

3. The respondent to my application is ________. The respondent is mother.

My relationship with respondent

4. The respondent and I married on ________. We separated on ________. We are currently going through divorce proceedings which are before the Family Court.

5. The main reason for our separation was:

________

Arrangements for during our relationship

6. Whilst the respondent and I were together, I was the main carer for. Specifically:

________

7. The respondent played the following role in the care arrangements:

________

8. The arrangements for the care of worked this way because:

________

Arrangements since separation

9. The living arrangements for the respondent and I are now as follows:

________

10. Since our separation, there have been some difficulties in relation to the arrangements for. The issues have been:

________

11. The living and contact arrangements for have now been agreed and are set out (and attached at the exhibit marked "________- CHILD ARRANGEMENTS") in: ________.

12. In summary, it can be seen from the attached agreement that with me. The respondent spends time with as follows:

________

13. The area within which is: ________.

14. This child arrangements have worked this way since my separation from the respondent separated because:

________

Education

Involvement with children's social care

15. Our family has had a social work involvement in relation to. The details of this are as follows:

(a) The name of the Local Authority is: ________.

(b) The name of the social worker is: ________.

(c) The involvement of the Local Authority started in: ________.

(d) The Local Authority is still involved. The purpose of this is because:

________

(e) The view of the social worker in relation of this application is:

________

(f) I attach at the exhibit marked "________ - INFORMATION ABOUT SOCIAL CARE INVOLVEMENT", the following:

________

My application

16. I am making this application because the respondent has removed from my care.

17. I am aware that the respondent has now relocated with to:

________

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________

19. As the primary carer, I am very worried about this. I am particularly worried about:

________

20. I attach at "________ - EVIDENCE OF REMOVAL":

(a) evidence in the form of:

________

(b) this evidence shows that:

________

Other relevant evidence

21. I attach at the exhibit marked "________ - ADDITIONAL EVIDENCE":

(a) evidence in the form of:

________

(b) this evidence shows that:

________

Urgency of my application

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23. I believe that this level of urgency is justifiable because:

________

24. The respondent can be served with/notified of my application and this statement via:

Email:

(a) The email address for service is: ________.

(b) I know that the respondent can be reached on this email address because:

________

Via post or personally through a court officer:

(a) At the address: ________.

(b) I know that the respondent can be served with information at this address because:

________

Telephone/SMS service:

(a) The telephone number is: ________.

(b) I know that the respondent can be reached on this number because:

________

Orders sought

25. In view of the information which I set out above, I am requesting that the Court urgently makes a Specific Issue Order directing that the respondent must return home to the address of

________

26. I am also requesting that the Court makes a Prohibited Steps Order to prohibit the respondent from:

(a) removing from my care and control save in circumstances where it is agreed in writing that contact shall take place.

(b) removing from the care and control of any person whom I have entrusted to care for or from any place of education.

(c) registering or enrolling the at any new or different place of education without my consent.

Statement of Truth 27. I believe that the facts stated in this witness statement are true. I understand that proceedings for contempt of court may be brought against anyone who makes, or causes to be made, a false statement in a document verified by a statement of truth without an honest belief in its truth.

Signed: ____________________________

________

Dated: _____________________________

CASE NUMBER:

TBC

IN THE FAMILY COURT SITTING AT ________

IN THE MATTER OF THE CHILDREN ACT 1989

AND IN THE MATTER OF THE CHILD:

BETWEEN:

________

Applicant

and

________

Respondent

__________________________________________________________________

THIS IS THE EXHIBIT MARKED

"________ - CHILD ARRANGEMENTS"

___________________________________________________________________

Page to attach relevant information which evidences the agreement about the child arrangements:

CASE NUMBER:

TBC

IN THE FAMILY COURT SITTING AT ________

IN THE MATTER OF THE CHILDREN ACT 1989

AND IN THE MATTER OF THE CHILD:

BETWEEN:

________

Applicant

and

________

Respondent

___________________________________________________________________

THIS IS THE EXHIBIT MARKED

"________- INFORMATION ABOUT SOCIAL CARE INVOLVEMENT"

___________________________________________________________________

Page to attach relevant information about the involvement of children's social work services:

CASE NUMBER:

TBC

IN THE FAMILY COURT SITTING AT ________

IN THE MATTER OF THE CHILDREN ACT 1989

AND IN THE MATTER OF THE CHILD:

BETWEEN:

________

Applicant

and

________

Respondent

_________________________________________________________________

THIS IS THE EXHIBIT MARKED

" ________- EVIDENCE OF REMOVAL"

________________________________________________________________

Page to attach relevant evidence which evidences the details of the respondent's removal of the :

CASE NUMBER:

TBC

IN THE FAMILY COURT SITTING AT ________

IN THE MATTER OF THE CHILDREN ACT 1989

AND IN THE MATTER OF THE CHILD:

BETWEEN:

________

Applicant

and

________

Respondent

_________________________________________________________________

THIS IS THE EXHIBIT MARKED

"________- ADDITIONAL CONCERNS"

_________________________________________________________________

Page to attach relevant information which evidences the details of the applicant's additional concerns: