CHILDREN AND YOUNG PERSONS (CHILDREN'S COURT) REGULATIONS 2001 S.R. No. 88/2001 Version incorporating amendments as at 5 September 2006 $$A $$T Children and Young Persons (Children's Court) Regulations 2001 - TABLE OF PROVISIONS $$T $$NTABLE Regulation Page 1. Objectives 2. Authorising provision 3. Revocation 4. Definition 5. Supply of information by registrars and police 6. Remand in custody-prescribed regions 7. Placement of child 8. Youth supervision orders 9. Prescribed forms 10. Application for time to pay fine, for instalment order or for variation of instalment order 11. Advice in other languages 12. Specified agencies under section 260B. 13. Enforcement agencies 14. Revoked 15. Infringement notice 16-19. Revoked 20. Minimum registrable amount 21. CAYPINS forms __________________ SCHEDULE 1-Regulations Revoked SCHEDULE 2-Prescribed Regions of the State SCHEDULE 3-Prescribed Regions of the State SCHEDULE 4-Prescribed Regions of the State SCHEDULE 5-Forms Form 1-Order to Bring a Child Before the Court Prior to the Adjourned Date Form 2-Children's Court Search Warrant (Safe Custody) Form 3-Notice of Protection Application Form 4-Irreconcilable Difference Application Form 5-Interim Accommodation Order Form 6-Statutory Declaration Form 7-Notice of Application to Vary an Interim Accommodation Order or for a New Order Form 8-Application to Revoke an Interim Accommodation Order Form 9-Non-accountable Undertaking Form 10-Accountable Undertaking Form 11-Notice to Appear Before the Court-Criminal Division Form 12-Good Behaviour Bond Form 13-Probation Order Form 14-Application to Vary or Revoke a Sentencing Order Form 15-Youth Supervision Order Form 16-Youth Attendance Order Form 17-Warrant of Detention (Not for Unpaid Fines) Form 18-Order to Bring a Person Before a Court or Coroner's Inquest Form 19-Advice in Other Languages Form 20-Revoked Form 21-Witness Summons Form 22-Warrant to Arrest Form 23-Children's Court Remand Warrant Form 24-Application for a Permanent Care Order Form 25-Permanent Care Order Form 26-Application to Vary or Revoke a Permanent Care Order Form 27-Application to Restrict Access to a Protection Report Form 28-Application to Vary or Revoke a Protection Order or Interim Protection Order Form 29-Notice to Appear Before the Children's Court-Family Division Form 30-Undertaking-Children's Court Family Division Form 31-Supervision Order Form 32-Custody to Third Party Order Form 33-Supervised Custody Order Form 34-Custody to Secretary Order Form 35-Guardianship to Secretary Order Form 36-Application for an Extension or Additional Extension of a Custody to Secretary Order or a Guardianship to Secretary Order Form 37-Application to Revoke a Guardianship to Secretary Order Form 38-Interim Protection Order 6, 7-Revoked SCHEDULE 8-CAYPINS Forms Form 1-Infringement Penalty for Registration Form 2-Certificate for Registration of Infringement Penalty Form 3-Cancellation of an Infringement Penalty Form 4-Application for Order that Payment of Registered Amount Not be Enforced Form 5-Notice of Enforcement Order --------------- ENDNOTES 1. General Information 2. Table of Amendments 3. Explanatory Details $$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 1 Objectives $$T $$NSECT
	1.	Objectives

     The objective of these Regulations is to prescribe-

			(a)	forms for use in the Children's Court; and

			(b)	the manner of supplying certain information for the purposes of section 35(2) of the Children and Young Persons Act 1989;

			(c)	regions for the purposes of sections 129(4)(b), 130 and 163(2)(a) of the Act; and

			(d)	various other matters required or authorised to be prescribed for the purposes of the Act.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 2 Authorising provision $$T $$NSECT
	2.	Authorising provision

     These Regulations are made under section 280 of the Children and Young Persons Act 1989.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 3 Revocation $$T $$NSECT
	3.	Revocation

     The Regulations listed in Schedule 1 are revoked.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 4 Definition $$T $$NSECT
	4.	Definition

     In these Regulations, ''the Act" means the Children and Young Persons Act 1989.



$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 5 Supply of information by registrars and police $$T $$NSECT
	5.	Supply of information by registrars and police

     For the purposes of section 35(2) of the Act, the prescribed manner of supplying information to the Secretary or a probation officer nominated by the Secretary is personal service or electronic or facsimile transmission or orally or by post.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 6 Remand in custody-prescribed regions $$T $$NSECT
	6.	Remand in custody-prescribed regions

     For the purposes of section 129(4)(b) of the Act, the municipal districts of the councils referred to in Schedule 2 are prescribed regions of the State.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 7 Placement of child $$T $$NSECT
	7.	Placement of child

     
		(1)	For the purposes of section 130 of the Act, the municipal districts of the councils referred to in Schedule 3 are prescribed regions of the State.

		(2)	For the purposes of section 130(1) of the Act, in those regions, a child may by order be placed in a police gaol if the period of remand is not more than 2 working days.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 8 Youth supervision orders $$T $$NSECT
	8.	Youth supervision orders

     For the purposes of section 163(2)(a) of the Act the municipal districts of the councils referred to in Schedule 4 are prescribed regions of the State.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 9 Prescribed forms $$T $$NSECT
	9.	Prescribed forms

     The forms to be used for or with respect to proceedings in the Court are set out in Schedule 5.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 10 Application for time to pay fine, for instalment order or for variation of instalment order $$T $$NSECT
	10.	Application for time to pay fine, for instalment order or for variation of instalment order

     An application under section 154 of the Act is made in the prescribed manner by the child notifying the appropriate registrar of the Court orally or in writing of the details of the application.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 11 Advice in other languages $$T $$NSECT
	11.	Advice in other languages

     
		(1)	In a proceeding, a notice of advice in the form of Form 19 must be included with and served with any originating process served on a child or parent of a child and any process served on a witness.

		(1A)	A notice of advice in the form of Form 19 must be included 	with and served with any document that is caused to be 	given or sent to a child by the registrar or the Court in 	accordance with-

			(a)	clause 6(1) of Schedule 2A to the Act; or

			(b)	clause 9(1) of Schedule 2A to the Act; or



			(c)	clause 10(3) of Schedule 2A to the Act.



		(2)	The notice must be printed in the English, Arabic, Cambodian, Chinese, Croation, Greek, Italian, Macedonian, Polish, Spanish, Turkish and Vietnamese languages.

		(3)	The notice forms part of any originating process or other process with which it is served.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 12 Specified agencies under section 260B $$T $$NSECT
	12.	Specified agencies under section 260B

     For the purposes of section 260B of the Act, a person or body listed in Schedule 2 to the Infringements (General) Regulations 20061 is a specified agency.

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 13 Enforcement agencies $$T $$NSECT
	13.	Enforcement agencies

     For the purposes of paragraph (c) of the definition of "enforcement agency" in clause 2 of Schedule 2A to the Act, a person, body, class of person or body, described or specified in Schedule 1 to the Infringements (General) Regulations 2006 is prescribed as an enforcement agency in relation to an infringement notice under a relevant provision prescribed by regulation 15 or an infringement penalty in such a notice.
	*	*	*	*	*



$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 15 Infringement notice $$T $$NSECT
	15.	Infringement notice

     For the purpose of the definition of "infringement notice" in clause 2 of Schedule 2A to the Act, the following provisions are prescribed-

			(a)	the provisions specified in Schedule 3 to the Infringements (General) Regulations 2006;

			(b)	the provisions specified in regulation 1203 of the Magistrates' Court General Regulations 2000 as in force immediately before 1 July 2006.

	*	*	*	*	*


	*	*	*	*	*



	*	*	*	*	*



	*	*	*	*	*



$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 20 Minimum registrable amount $$T $$NSECT
	20.	Minimum registrable amount

     The amount specified for the purposes of clause 4(3) of Schedule 2A to the Act is $10.00.


$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SECT 21 CAYPINS forms $$T $$NSECT
	21.	CAYPINS forms

     

		(1)	For the purposes of clause 3(1)(a)of Schedule 2A to the Act, a document must be in the form of and contain the details required by Form 1 of Schedule 8.

		(2)	For the purposes of clause 3(1)(b) of Schedule 2A to the Act, a certificate must be in Form 2 of Schedule 8.


		(3)	For the purposes of clause 5(1) of Schedule 2A to the Act, a notice must be in Form 3 of Schedule 8.


		(4)	For the purposes of clause 6(4) of Schedule 2A to the Act, the prescribed form is Form 4 of Schedule 8.


		(5)	For the purposes of clause 9(1) of Schedule 2A to the Act, a notice of enforcement order must be in Form 5 of Schedule 8.

__________________

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 1 $$T $$NSCHEDULE

Regulation 3
REGULATIONS REVOKED
S.R. No
Title
165/1991
Children and Young Persons (Children's Court) Regulations 1991
4/1992
Children and Young Persons (Children's Court) (Amendment) Regulations 1992
52/1992
Children and Young Persons (Children's Court) (Further Amendment) Regulations 1992
165/1992
Children and Young Persons (Children's Court) (Forms) Regulations 1992
32/1995
Children and Young Persons (Children's Court) (Amendment) Regulations 1995
26/2000
Children and Young Persons (Children's Court) (Amendment) Regulations 2000
__________________

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 2 $$T $$NSCHEDULE

										Regulation 6
PRESCRIBED REGIONS OF THE STATE
Alpine Shire Council
Loddon Shire Council
Ararat Rural City Council
Macedon Ranges Shire Council
Ballarat City Council
Mansfield Shire Council
Bass Coast Shire Council
Mildura Rural City Council
Baw Baw Shire Council
Mitchell Shire Council
Benalla Rural City Council
Moira Shire Council
Borough of Queenscliffe
Moorabool Shire Council
Buloke Shire Council
Mount Alexander Shire Council
Campaspe Shire Council
Moyne Shire Council
Central Goldfields Shire Council
Murrindindi Shire Council
Colac-Otway Shire Council
Northern Grampians Shire Council
Corangamite Shire Council
Pyrenees Shire Council
East Gippsland Shire Council
South Gippsland Shire Council
Gannawarra Shire Council
Southern Grampians Shire Council
Glenelg Shire Council
Strathbogie Shire Council
Golden Plains Shire Council
Surf Coast Shire Council
Greater Bendigo City Council
Swan Hill Rural City Council
Greater Geelong City Council
Towong Shire Council
Greater Shepparton City Council
Wangaratta Rural City Council
Hepburn Shire Council
Warrnambool City Council
Hindmarsh Shire Council
Wellington Shire Council
Horsham Rural City Council
West Wimmera Shire Council
Indigo Shire Council
Wodonga City Council
Latrobe City Council
Yarriambiack Shire Council
__________________

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 3 $$T $$NSCHEDULE

										Regulation 7
PRESCRIBED REGIONS OF THE STATE
Alpine Shire Council
Loddon Shire Council
Ararat Rural City Council
Macedon Ranges Shire Council
Ballarat City Council
Mansfield Shire Council
Bass Coast Shire Council
Mildura Rural City Council
Baw Baw Shire Council
Mitchell Shire Council
Benalla Rural City Council
Moira Shire Council
Borough of Queenscliffe
Moorabool Shire Council
Buloke Shire Council
Mount Alexander Shire Council
Campaspe Shire Council
Moyne Shire Council
Central Goldfields Shire Council
Murrindindi Shire Council
Colac-Otway Shire Council
Northern Grampians Shire Council
Corangamite Shire Council
Pyrenees Shire Council
East Gippsland Shire Council
South Gippsland Shire Council
Gannawarra Shire Council
Southern Grampians Shire Council
Glenelg Shire Council
Strathbogie Shire Council
Golden Plains Shire Council
Surf Coast Shire Council
Greater Bendigo City Council
Swan Hill Rural City Council
Greater Geelong City Council
Towong Shire Council
Greater Shepparton City Council
Wangaratta Rural City Council
Hepburn Shire Council
Warrnambool City Council
Hindmarsh Shire Council
Wellington Shire Council
Horsham Rural City Council
West Wimmera Shire Council
Indigo Shire Council
Wodonga City Council
Latrobe City Council
Yarriambiack Shire Council
__________________

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 4 $$T $$NSCHEDULE

Regulation 8
PRESCRIBED REGIONS OF THE STATE
Alpine Shire Council
Ararat Rural City Council
Ballarat City Council
Banyule City Council
Bass Coast Shire Council
Brimbank City Council
Campaspe Shire Council
Central Goldfields Shire Council
Colac-Otway Shire Council
Darebin City Council
East Gippsland Shire Council
Frankston City Council
Gannawarra Shire Council
Glenelg Shire Council
Greater Bendigo City Council
Greater Dandenong City Council
Greater Geelong City Council
Greater Shepparton City Council
Hindmarsh Shire Council
Horsham Rural City Council
Hume City Council
La Trobe Shire Council
Macedon Ranges Shire Council
Maroondah City Council
Melbourne City Council
Mildura Rural City Council
Mitchell Shire Council
Moira Shire Council
Moonee Valley City Council
Moorabool Shire Council
Mornington Peninsula Shire Council
Mount Alexander Shire Council
Northern Grampians Shire Council
Southern Grampians Shire Council
Swan Hill Rural City Council
Towong Shire Council
Wangaratta Rural City Council
Warrnambool City Council
Wellington Shire Council
Wodonga Rural City Council
Wyndham City Council
Yarriambiack Shire Council
__________________
$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 5 $$T $$NSCHEDULE

FORMS
FORM 1
Children and Young Persons Act 1989
(section 25(4))
ORDER TO BRING A CHILD BEFORE THE COURT PRIOR TO THE ADJOURNED DATE
		Court Ref-
Name of Child-		*Male/*Female
			Date of Birth-
To-
the Secretary to the Department of Human Services
the Officer in charge at (insert name of place where child has been remanded in custody or name of secure welfare service where child has been placed)
all members of the police force of Victoria.

 I order that the child is to be brought to the Children's Court at (name and address of Children's Court or name and address of place where facilities exist to enable the child to appear by audio visual link within the meaning of Part IIA of the Evidence Act 1958)
at (time) am/pm on (date)
 The child is to answer the charges written below.
What is the charge? (brief description)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................


The charges were filed by-
Name-
Agency and address-
The charge is filed at the Children's Court at-

OR

  The child is to be brought before the Court on:
	  a Protection Application
	  an Irreconcilable Difference Application
	  other (give details)

Signed at-
Date-
							*Judge/*Magistrate
*delete if not applicable
__________________
FORM 2
Children and Young Persons Act 1989
(sections 69, 70, 79, 80, 80A, 95, 98, 110, 111, 265)
CHILDREN'S COURT SEARCH WARRANT
(SAFE CUSTODY)
				Court Ref-
Name or description of Child		*Male/*Female
[and address if applicable]			Date of Birth-
		
AUTHORITY AND DIRECTIONS
To all members of the police force or
You are authorised to:
break enter and search any place where the child named or described in this warrant is suspected to be; and take into safe custody the child named or described in this warrant;
AND if the warrant is issued under section 69 or 70 of the Act, to
bring the child before the Court for the hearing of an application for an interim accommodation order as soon as practicable and, in any event, within one working day after the child was taken into safe custody. Unless the child is brought before the Court within 24 hours after the child was taken into safe custody, he or she must (unless the child is of tender years) be brought before a bail justice as soon as possible within that period of 24 hours for the hearing of an application for an interim accommodation order.
release the child on an interim accommodation order of the type referred to in section 73(3)(a) or (b) of the Act in accordance with the endorsement below.
OR  if the warrant is issued under section 79, 80, 80A, 95, 98, 110 or 111 of the Act, to
bring the child before the Court or a bail justice as soon as possible after being taken into safe custody and in any event within 24 hours after that event. Unless the child is brought before the Court within 24 hours after the child was taken into safe custody, he or she must (unless the child is of tender years) be brought before a bail justice as soon as possible within that period of 24 hours for the hearing of an application for an interim accommodation order.
OR if the warrant is issued under section 265 of the Act,
the member of the police force who executed this warrant must take the child to the place specified in this warrant or, if no place is specified, to a place determined by the Secretary or, in the absence of a determination, to a place referred to in section 124 of the Act.

Place specified:
......................................................................................................................
......................................................................................................................
ENDORSEMENT

The child may be released on an interim accommodation order to appear at the Children's Court at
at	am/pm on

Applicant's name-
Agency and address-
Phone-

Issued at-
Date-

	*Registrar/*Judge/*Magistrate/*Authorised Bail Justice

*delete if not applicable
__________________
FORM 3
Children and Young Persons Act 1989
(sections 68(1)(b), 68(2), 70)
NOTICE OF PROTECTION APPLICATION
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Grounds for the application
*(a)	The child has been abandoned by his or her parents and after 	reasonable enquiries-
	(i)	the parents cannot be found; and
	(ii)	no other suitable person can be found who is willing and able to care for the child.
*(b)	The child's parents are dead or incapacitated and there is no other suitable person willing and able to care for the child.
*(c)	The child has suffered, or is likely to suffer, significant harm as a result of physical injury and the child's parents have not protected, or are unlikely to protect, the child from harm of that type.
*(d)	The child has suffered, or is likely to suffer, significant harm as a result of sexual abuse and the child's parents have not protected, or are unlikely to protect, the child from harm of that type.
*(e)	The child has suffered, or is likely to suffer, emotional or psychological harm of such a kind that the child's emotional or intellectual development is, or is likely to be, significantly damaged and the child's parents have not protected, or are unlikely to protect, the child from harm of that type.
*(f)	The child's physical development or health has been, or is likely to be, significantly harmed and the child's parents have not provided, arranged or allowed the provision of, or are unlikely to provide, arrange or allow the provision of, basic care or effective medical, surgical or other remedial care.


Applicant's name-
Agency and address-
Phone-
Date-
		(Signature)

Notice to Parents and child
To the child:	You must come to the hearing of this application.
To the Parent(s):	If your child is in your custody-the child must appear or be produced before the Court for the hearing of this application.
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-
Registrar

*delete if not applicable
(Reverse)
Affidavit/Declaration of Service of Notice of Protection Application 
(*delete if not applicable)

I (full name)	of (address)

(occupation)

*swear/declare that I served a true copy of this notice on:

(name of person served) who is the (capacity e.g. parent/child)
on (date) at 	am/pm

by
delivering it to him/her personally at	(address)
leaving it for him/her at (address)		being that person's last known place of *residence/*business with a person who apparently resided or worked there and who apparently was not less than 16 years of age.
posting it by prepaid ordinary post at (address of posting) 	in an envelope addressed to that person at his or her last known place of *residence/*business.  I obtained this address from

AND on (name of person served) who is the (capacity e.g. parent/child)
on (date) at	am/pm
by
*delivering it to *him/her personally at	(address)
*leaving it for *him/her at (address)		being that person's last known place of *residence/business with a person who apparently resided or worked there and who apparently was not less than 16 years of age.
*posting it by prepaid ordinary post at (address of posting) 	in an envelope addressed to that person at his or her last known place of *residence/business.  I obtained this address from

AND on (name of person served) who is the (capacity e.g. parent/child)
on (date) at 	am/pm
by
*delivering it to *him/her personally at	(address)
*leaving it for *him/her at (address)		being that person's last known place of *residence/business with a person who apparently resided or worked there and who apparently was not less than 16 years of age.
*posting it by prepaid ordinary post at (address of posting) 	in an envelope addressed to that person at his or her last known place of *residence/business.  I obtained this address from



*Sworn at                                             in the State of Victoria 

on (date)		(Signature of person making affidavit)

Before-

(Name and address in legible writing, typing or stamp)

OR
*I acknowledge that this declaration is true and correct and make it in the belief that a person making a false declaration is liable to the penalties of perjury.

Declared at	in the State of Victoria

on (date)		(Signature of person making declaration)

Before-

(Name and address in legible writing, typing or stamp)

*delete if not applicable
__________________
FORM 4
Children and Young Persons Act 1989
(sections 71, 72)
IRRECONCILABLE DIFFERENCE APPLICATION
		Court Ref-
Name of Child-		*Male/*Female
			Date of Birth-
Address-

Details of the application
Name of parent or custodian

Address-

Relationship to child		*Mother/*Father/*Relative (state relationship)/*Custodian

Grounds for the application

When the applicant is a person who has custody of the child
The person who has custody of the child believes that there is a substantial and presently irreconcilable difference between himself or herself and the child to such an extent that the care and control of the child are likely to be seriously disrupted.

When the applicant is the child
The child believes that there is a substantial and presently irreconcilable difference between himself or herself and the person who has custody of him or her to such an extent that the care and control of the child are likely to be seriously disrupted.

Applicant's name-
Agency and address-
Phone-
Date-
		(Signature)

Notice to custodian or child

To the child: You must come to the hearing of this application.

To the person who has custody of the child: You should come to the hearing of this application.
(If you do not attend, the Court may proceed to hear and determine the application in your absence.)

Details of the hearing

A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-

Registrar

*delete if not applicable
__________________
FORM 5
Children and Young Persons Act 1989
(section 73)
INTERIM ACCOMMODATION ORDER
		Court Ref-
Name of Child-		*Male/*Female
			Date of Birth-
Address-

Applicant's name-
Agency and address-
Phone-

Details of the application (Insert grounds-refer to reverse for correct wording.)
......................................................................................................................
......................................................................................................................
......................................................................................................................
A hearing in this case will take place at                  am/pm on                 at the Children's Court at

Interim Accommodation Order

Until the date of the next Court hearing I order that the child is to be:
*released on the signing by the child of an undertaking to appear on the hearing of the relevant proceeding.
*released into the care of 	               who is his or her parent pending the hearing on the entering (whether orally or in writing) by that parent into an undertaking to produce the child before the Court for the hearing of the relevant proceeding.
*placed with (name of person(s)) who is (are) a suitable person(s) pending that hearing on the entering (whether orally or in writing) by that person or those persons into an undertaking to produce the child before the Court for the hearing of the relevant proceeding and following a report (whether oral or written) from the Secretary on that person's or those persons' suitability.
*placed in a community service pending that hearing.
*placed in a secure welfare service pending that hearing as there is a substantial and immediate risk of harm to the child.

The following conditions apply to this Interim Accommodation Order.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
UNDERTAKING

I undertake to *appear/*produce the child before the Court for the hearing of the proceeding.

(Signature)


Order made by-

					*Judge/*Magistrate/*Bail Justice
at (Place)-
Date-



(Reverse)

Grounds for the making of an Interim Accommodation Order under
section 73(1) of the Children and Young Persons Act 1989 are-
• the child has been taken into safe custody by a protective intervener under Part 3 of the Act;
• a protection application is filed with the appropriate registrar;
• an irreconcilable difference application is filed with the appropriate registrar;
• an application for conciliation counselling is lodged with the Secretary under section 72 of the Act;
• the hearing by the Court of a proceeding in the Family Division (including a proceeding under section 73 of the Act) is adjourned;
• an application for an extension or further extension of the period of an interim accommodation order has been made to the Court under section 78 of the Act;
• an application for variation of an interim accommodation order has been made to the Court under section 79(1) of the Act;
• an interim accommodation order or any condition attached to an interim accommodation order (state the condition that has not been complied with) has not been complied with;
• an application for a new interim accommodation order has been made to the Court under section 80A(1) of the Act;
• the child has been taken into safe custody on a warrant issued under Part 3 of the Act; or
• an appeal has been instituted under Part 3 of the Act to the Supreme Court or the County Court against an order made by the Court under Part 3 of the Act.

*delete if not applicable
__________________
FORM 6
Children and Young Persons Act 1989
(section 74(2))
STATUTORY DECLARATION

I, (full name)	of (address)	(occupation)

declare that I undertake to produce the child named (full name)              born (date of birth) 	
before the Children's Court at (venue)		on (date)	 at (time) 	for the hearing, or the resumption of the hearing, of the following proceeding (state type of proceeding)

I acknowledge that this declaration is true and correct and I make it in the belief that a person making a false declaration is liable to the penalties of perjury.

Declared at (place)
in the State of Victoria on (date)

Before:

(name and address in legible writing, typing or stamp below signature)

a person authorised under section 107A(1) of the Evidence Act 1958 to witness the signing of a statutory declaration.
__________________
FORM 7
Children and Young Persons Act 1989
(sections 78, 80, 80A)
NOTICE OF APPLICATION TO VARY AN INTERIM ACCOMMODATION ORDER OR FOR A NEW ORDER
		Court Ref-
Name of Child-		*Male/*Female
			Date of Birth-
Address-

Details of the Interim Accommodation Order

The Interim Accommodation Order was made by the Children's Court at 
on	

The original Order was applied for by-                                   (Full name)
Agency and address-
Phone-

Details of this application

This application is 
*to vary the order.
*for a new interim accommodation order.



The grounds for the application are:
......................................................................................................................
......................................................................................................................
......................................................................................................................

Applicant's name-
Agency and address-
Phone-
Date-

(Signature)

NOTE: The applicant must give notice of this application to: 
the person who applied for the interim accommodation order; and 
any other party to the proceeding in which that order was made; and 
any person with whom the child is living.

Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 8
Children and Young Persons Act 1989
(section 8 0)
APPLICATION TO REVOKE AN INTERIM ACCOMMODATION ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-

Details of the Interim Accommodation Order
The Interim Accommodation Order was made by the Children's Court at 
on	

The original Order was applied for by- 	                              (Full name)
Agency and address-
Phone-

Details of this application
The grounds for the application are: 
(Provide details of any condition which has not been, or is not being, complied with.)
......................................................................................................................
......................................................................................................................
......................................................................................................................


Applicant's name-
Agency and address-
Phone-
Date-

		(Signature)

Details of the hearing

A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 9
Children and Young Persons Act 1989
(section 140)
NON-ACCOUNTABLE UNDERTAKING
		Court Ref-
To-                                (name)		*Male/*Female
		Date of Birth-
Address-

The Children's Court at                                           on                   found you guilty of



You have not been convicted of these offences.

Details of the Order

The Court made the following Order:
That the charge(s) against you be dismissed
AND
That you give the following undertaking:



That your parent (insert name) give the following undertaking:

NOTE: An undertaking is a promise to the Court that you will or will not do the things specified in the undertaking.


I agree to comply with this undertaking.

	Signature			Signature
	(child)			(parent)


Date-

*Judge/*Magistrate

*delete if not applicable
__________________
FORM 10
Children and Young Persons Act 1989
(section 142)
ACCOUNTABLE UNDERTAKING
		Court Ref-
To-                                (name)		*Male/*Female
		Date of Birth-
Address-

The Children's Court at                                           on                   found you guilty of

You have not been convicted of these offences.

Details of the Order

The Court made the following Order:
That the charge(s) against you be dismissed.
AND
That you give the following undertaking:


and that if you breach the undertaking you be made accountable and dealt with for the breach.

That your parent (insert name) give the following undertaking:


NOTE:	An undertaking is a promise to the Court that you will or will not do the things specified in the undertaking. If you fail to comply with this undertaking the Court may direct that you be brought back before the Court.

I agree to comply with this undertaking.


	Signature			Signature
	(child)			(parent)



Date-

*Judge/*Magistrate

*delete if not applicable
__________________

FORM 11
Children and Young Persons Act 1989
(sections 143, 146, 148, 155, l60, l65, l84)
NOTICE TO APPEAR BEFORE THE COURT-CRIMINAL DIVISION
	Court Ref-
To-        (name)	*Male/*Female
				Date of Birth-
Address-
Details of the Sentencing Order
The order was made by the Children's Court at       (location)
on       (date)
The charges were filed by-	(Full name of informant)
	Agency and address-
	Phone-
The sentencing order was: 
*an Accountable Undertaking	*a Good Behaviour Bond
*a Fine	*Probation
*a Youth Supervision Order		*a Youth Attendance Order
	The *probation/*youth supervision order was made pursuant to section 155(1)(d) of the Act.
Details of this notice
Reasons for service of this notice
Applicant's name-
Agency and address-
Phone-
Date-
(Signature)

Details of the hearing
A hearing of this case will be held at                   a.m./p.m. on             at the Children's Court at
YOU MUST APPEAR BEFORE THE COURT AT THE HEARING
IF THE ORDER WAS MADE AGAINST YOU, AND YOU FAIL TO APPEAR BEFORE THE COURT, THE COURT MAY ORDER THAT A WARRANT TO ARREST YOU BE ISSUED
Issued at-
Date-
by Order of the Court
Registrar
*delete if not applicable
__________________
FORM 12
Children and Young Persons Act 1989
(section 144)
GOOD BEHAVIOUR BOND
		Court Ref-
To-                                (name)		*Male/*Female
		Date of Birth-
Address-

The Children's Court at                                           on                   found you guilty of-
(list offences)


You have not been convicted of these offences.

Details of the Order

The Court made the following Order:
That the proceeding be adjourned for (period) until (end date) 	on condition that you enter into a Good Behaviour Bond.

The amount of your Bond is $

The following conditions apply to your Good Behaviour Bond
That you appear, if so required by the Court, at the time to which the proceeding has been adjourned. (You will receive a notice if you have to come to Court).
That you appear before the Court, if required to do so, during the period of the adjournment. (You will receive a notice if you have to come to Court).
That you are of good behaviour during the period of the adjournment.
That you observe any special conditions imposed by the Court.

Special Conditions:




I agree to enter into this Good Behaviour Bond, to appear before the Court if required, and to observe any special conditions imposed by the Court.

		(Signature of child)



Date-
*Judge/*Magistrate

*delete if not applicable
__________________

FORM 13
Children and Young Persons Act 1989
(sections 155, 158, 159)
PROBATION ORDER
				Court Ref-
To-           (name)	*Male/*Female
		Date of Birth-
Address-
The Children's Court at             (location)             on        (date)       has found you guilty of:
You *were/*were not convicted.


Details of the Order

The Court orders that you be placed on probation 
for         (period)       until            (end date).
*The order was made pursuant to section 155(1)(d) of the Act.
*This probation order is *concurrent/*cumulative/*partly cumulative upon other probation order(s) as follows: 
The following conditions apply to your probation order
1.	You must report to the Secretary to the Department of Human Services within 2 working days after this order is made. 
2.	You must report, during the period of the probation order, to your assigned probation officer as required by the probation officer.
3.	You must not re-offend during the period of the probation order.
4.	You must not leave the State without the written permission of the Secretary to the Department of Human Services.
5.	You must notify your assigned probation officer of any change of residence, school or employment within 48 hours after the change.
6.	You must obey the reasonable and lawful instructions of your assigned probation officer.
*You must comply with the following special condition(s):
I consent to this order being made.

(Signature of child)
Date-
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 14
Children and Young Persons Act 1989
(sections 159(5), 164(4), 185, 195)
APPLICATION TO VARY OR REVOKE A SENTENCING ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Details of the Sentencing Order

The order was made by the Children's Court at
on	 (date)

The charges were filed by-                                 (Full name of informant)

Agency and address-
Phone-


The sentencing order was-
*a probation order/*a youth supervision order/*a youth attendance order

Details of this application
This application is to *vary the order/*revoke the order.


The grounds for the application are-


Applicant's name-
Agency and address-
Phone-
Date-
(Signature)

Details of the hearing

A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-
Registrar

*delete if not applicable
__________________

FORM 15
Children and Young Persons Act 1989
(sections 155, 163, 164)
YOUTH SUPERVISION ORDER
		Court Ref-
To-         (name)	*Male/*Female
		Date of Birth-
Address-
The Children's Court at        (location)        on              (date) has found you guilty of:
You *were/*were not convicted.
Details of the Order

The Court orders that you be placed on a youth supervision order 
for       (period)         until             (end date).
*The order was made pursuant to section 155(1)(d) of the Act.
*This youth supervision order is *concurrent/*cumulative/
*partly cumulative upon other youth supervision order(s) as follows: 
The following conditions apply to your youth supervision order
1.	You must report to the Secretary to the Department of Human Services within 2 working days after this order is made.
2.	You must report, during the period of the youth supervision order, to the Secretary to the Department of Human Services as required by the Secretary.
3.	You must not re-offend during the period of the youth supervision order.
4.		You must not leave the State without the written permission of the Secretary to the Department of Human Services.
5.	You must notify the Secretary to the Department of Human Services of any change of residence, school or employment within 48 hours after the change.
6.	You must attend a youth supervision unit or any other place specified in the youth supervision order.
7.	You must participate in a community service program or any other program, if so directed by the Secretary to the Department of Human Services.
8.	You must obey the reasonable and lawful instructions of the Secretary to the Department of Human Services.
NOTE:	Any reference to the Secretary to the Department of Human Services is to be taken as a reference to one of his or her delegated officers 
*You must comply with the following special condition(s):
I consent to this order being made.

		(Signature of child)
Date-
*Judge/*Magistrate
*delete if not applicable
__________________

FORM 16
Children and Young Persons Act 1989
(sections 170, 172)
YOUTH ATTENDANCE ORDER
		Court Ref-
To-                  (name)	*Male/*Female
		Date of Birth-
Address-
The Children's Court at        (location)        on             (date) has convicted you of:
and makes a youth attendance order in respect of you 
for    (period)         until                 (end date).
*This youth attendance order is *concurrent/*cumulative/
*partly cumulative upon other youth attendance order(s) as follows: 
Details of the Order
1.	You must report to the Secretary to the Department of Human Services within 2 working days after this order is made.
2.	You must not commit another offence during the period that the order is in force.
3.	You must attend at a youth supervision unit 
for           (period)        until          (end date).
4.	You must not leave the State without the written permission of the Secretary.
5.	You must notify the Secretary of any change of residence, school or employment within 48 hours after the change.
6.	You must comply with the provisions of a notice from the Secretary under section 177 of the Act requiring you to attend a youth supervision unit or a notice varying the details of your attendance.
7.	You must comply with the requirements for attendance of section 177(1)(a) and (b) of the Act.
8.	You must attend at any alternative day and time fixed by the Secretary under section 177(5) of the Act or attend for any extension of the term of the order as fixed by the Secretary under section 177(6) of the Act.
9.	You must carry out the reasonable and lawful directions of the Secretary or any person acting under the authority of the Secretary under sections 182 and 183(1) of the Act.
NOTE:	Any reference to the Secretary to the Department of Human 			Services is to be taken as a reference to one of his or her delegated 		officers.
*You must comply with the following special condition(s):
I consent to this order being made.

		(Signature of child)
Date-
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 17
Children and Young Persons Act 1989
(sections 186, 188, 193)
WARRANT OF DETENTION
(NOT FOR UNPAID FINES)
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-

The charges were filed by-
Name-
Agency-

The charges were heard in the Children's Court at

Detention order summary

Effective total term

Time spent in custody 			Taken into account              *Yes/*No

Sentences imposed in this case to be-

*cumulative on other sentences presently being served
*part concurrent with other sentences presently being served.
(the concurrent portion of sentence-	)

*cumulative on any period owed to the Youth Parole Board or the Youth Residential Board
*part concurrent with any period owed to the Youth Parole Board or Youth Residential Board    (the concurrent portion of sentence)
Date sentence imposed-

The Court also ordered:

Authority and directions

To all members of the police force, or

You are authorised to break, enter and search any place where the child named in this warrant is suspected to be and to take and safely convey the child named in this warrant to-
*a youth training centre 		*a youth residential centre 
and to deliver the child to the officer in charge of the youth training centre or youth residential centre.

To the Secretary to the Department of Human Services or any other person into whose custody the child named in this warrant is transferred: 

You are directed and authorised to receive that child into custody and safely keep that child for the period specified, or in the circumstances described, in this warrant or until that child is otherwise removed or discharged from custody by due course of law.

Issued at-
Date-

						*Registrar/*Judge/*Magistrate

*delete if not applicable
__________________
FORM 18
Children and Young Persons Act 1989
(section 258)
ORDER TO BRING A PERSON BEFORE A COURT OR CORONER'S INQUEST
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
To-
the Secretary to the Department of Human Services
the Officer in charge at (insert name of place where child has been remanded in custody or name of secure welfare service where child has been placed)
all members of the police force of Victoria.

I order that the child is to be brought to the Children's Court at (name and address of Children's Court or name and address of place where facilities exist to enable the child to appear by audio visual link within the meaning of Part IIA of the Evidence Act 1958)
at (time) am/pm on (date)
The proceeding (Describe the proceeding)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
Reason for order (Set out reasons)
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
AND the person is to remain in the custody of that member of the police force, protective services officer or other officer acting under this order until returned to the officer in charge of the place of detention or remand.

Applicant's name-
Agency and address-
Phone-
Signed at-
Date-

*Judge/*Magistrate/*Registrar/*Coroner/*Coroner's Clerk

*delete if not applicable
__________________
FORM 19
ADVICE IN OTHER LANGUAGES
IMPORTANT: DO NOT IGNORE THIS DOCUMENT
If you do not understand it, you should immediately have it interpreted and explained to you. You may then get advice from:
A Registrar of the Children's Court
Your local solicitor
Victoria Legal Aid    (Insert address and telephone number)
__________________
	*	*	*	*	*

__________________
FORM 21
Children and Young Persons Act 1989
WITNESS SUMMONS
		Court Ref-
To the Witness-		*Male/*Female
Address-
Details of the case
Name of child
Type of hearing 
  Charges (brief description)
  Protection application
  Irreconcilable difference application
  Other (specify)
Name of informant/applicant-
Agency and address-
Phone-
WHAT YOU HAVE TO DO
You must bring this summons with you and come to court to give evidence in the proceeding; come to court to give evidence and also produce at the hearing the following documents or things that are in your possession or control:
(specify documents or things)
produce at the hearing the following documents or things that are in your possession or control:
(specify documents)
You may produce this summons and the documents or things referred to above to the Registrar of the Children's Court at                              by hand or by post, in either case so that the registrar receives them not later than 2 days before the date on which you are required to attend.
If you are required to give evidence, you must attend at the hearing.

Where and when will the case be heard?
The case will be heard at the Children's Court at (venue) at
	(address)	Phone
at	am/pm on	(date)
Issued at-
Date-

*Registrar/*Judge/*Magistrate
Summons filed by-                                                       (identify party)

*delete if not applicable
__________________
FORM 22
Children and Young Persons Act 1989
(section 193)
WARRANT TO ARREST
		Court Ref-
Name of person to be arrested-		*Male/*Female
		Date of Birth-
Address-
Statement of Reasons for this Warrant
*The defendant failed to appear before the Court on (date) in answer to a charge and summons.
*The defendant failed to attend before the Court on (date) in accordance with his or her bail.
*The person failed to appear before the Court on (date) in answer to a notice to appear before the Court.
*The person was served with a witness summons and failed to attend before the Court on (date) in answer to that witness summons.
*Other-give details.
The defendant was charged with-
The charges were filed by-
Agency and address-
Phone-
Directions
To all members of the police force, or
You are authorised to:
break, enter and search, if necessary, any place where the person named or described in this warrant is suspected to be;
arrest the person named or described in this warrant;

AND TO
bring him or her before a bail justice or the Court within a reasonable time of being arrested to be dealt with according to law. If the warrant is issued in respect of a sentencing order alleged to have been breached, the child must be brought before the Court within a reasonable time of being arrested but not later than the next working day after the child is arrested and in the meantime must be placed as provided by the Children and Young Persons Act 1989;
OR
release him or her on bail in accordance with the endorsement below;
OR
discharge him or her on bail under section 10 of the Bail Act 1977.
Issued at-
Date-

					*Registrar/*Judge/*Magistrate
ENDORSEMENT FOR BAIL
A judge or magistrate has authorised the following endorsement:
The person named may be released upon entering an undertaking of bail to appear at the Children's Court at				on the following conditions:
Date-

					*Registrar/*Judge/*Magistrate

*delete if not applicable
__________________
FORM 23
Children and Young Persons Act 1989
(section 193)
CHILDREN'S COURT REMAND WARRANT
		Court Ref-
Name of defendant (or Witness)-		*Male/*Female
		Date of Birth-
Address-
The defendant (or witness) has been *remanded in custody *returned to the custody of the Secretary to the Department of Human Services
The proceeding has been adjourned and the defendant is to be brought before the Children's Court at	at 10.00 a.m. on
The defendant has been committed to stand trial.
The defendant was charged with-
The charges were filed by-
Agency and address-
Phone-
The charge is filed 
  at the Children's Court at
  with the Bail Justice making this order.
AUTHORITY AND DIRECTIONS
If a child is remanded in custody
To all members of the police force or the Secretary to the Department of Human Services or
You must take and safely convey the child named in this warrant to-
  a remand centre
  other (only in prescribed regions). Specify place where child is to be placed:
and deliver the child to the officer in charge of that facility.

If an adult is remanded in custody
To all members of the police force or all prison officers or-
You must take and safely convey the person named in this warrant to-
	*a prison        *a police gaol        *a youth training centre
and deliver the person to the officer in charge of that facility.
To the Secretary to the Department of Human Services or to the Secretary to the Department of Justice or to the Chief Commissioner of Police (as the case may be), or any other person into whose custody the person is transferred.
You must receive the person named in this warrant into custody and safely keep that person-
(i)	for the period specified, or in the circumstances described, in this 	warrant; 
or
(ii)	until that person is otherwise removed or discharged from custody 	by due course of law.
ENDORSEMENTS
The defendant did not apply for bail.
I certify that the defendant's application for bail was refused. The reasons for my refusal are:
I certify that bail was granted and the defendant is to be released from custody when he or she signs an undertaking with the conditions which are endorsed below:
The defendant was legally represented by-
Signed at-
Date-

*Registrar/*Judge/*Magistrate/*Bail Justice

*delete if not applicable
__________________
FORM 24
Children and Young Persons Act 1989
(section 112)
APPLICATION FOR A PERMANENT CARE ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Details of the application
Applicant's name-
Agency and address-
Phone-
(Signature)
Name of child's mother-
Address-
Name of child's father-
Address-
Name of proposed carer 1-
Address-
Name of proposed carer 2-
Address-
Relationship of carer(s) to child:	  Relative(s) (specify)
		  Foster parent(s) 
		  Other (specify)
The applicant applies for a permanent care order in respect of the child named above.
A statement of approval from the Secretary to the Department of Human Services or a person authorised under section 7(2) of the Act *is/*is not attached.  If not give reason.

A protection order *is/*is not in force in respect of the child. If in force give details.
An application to revoke the protection order *has/*has not been made.  It *has/*has not been determined.
There *are/*are not current proceedings under the Family Law Act 1975 of the Commonwealth with respect to the child.  If there are current proceedings give details, stating who commenced the proceeding.
Notice to parties
To the child and applicant: You must come to the hearing of this application.
To the parent(s) and authorised person: You should come to the hearing of this application. If you do not attend, the Court may proceed to hear and determine the application in your absence.
A hearing of this application will be held at                am/pm on               at the Children's Court at 
Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 25
Children and Young Persons Act 1989
(section 112)
PERMANENT CARE ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Name of child's mother-
Address-
Name of child's father-
Address-
Details of the order
The Children's Court at                                     on                             made a permanent care order in respect of the child named above.
Custody and guardianship of the child was granted to:
Name-
Address-
Name-
Address-
(if applicable) Guardianship of the child was vested in:
The Court made the following conditions with regard to access to the child by the child's parent(s):
......................................................................................................................
......................................................................................................................
......................................................................................................................


Order made at-
Date-							
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 26
Children and Young Persons Act 1989
(section 115)
APPLICATION TO VARY OR REVOKE A PERMANENT CARE ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-

Details of the Permanent Care Order
The Children's Court at                                     on                  made an order granting custody and guardianship of the child to   (Give names and addresses) 
The parents of the child are   (Give names and addresses)

Details of this application
This application is:
  to vary the permanent care order
  to revoke the permanent care order.
The grounds for the application are:

Applicant's name-
Agency and address-
Phone-
The applicant is:
  the child 
  a parent of the child

  a person granted custody and guardianship of the child under the order
  the Secretary. 

Date-
		(Applicant's signature)
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at
Issued at-
Date-


Registrar

*delete if not applicable
__________________
FORM 27
Children and Young Persons Act 1989
(section 47)
APPLICATION TO RESTRICT ACCESS TO A PROTECTION REPORT
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Details of the Order for the Protection Report
The Children's Court at		on		ordered the Secretary to the Department of Human Services Victoria to submit to the Court a protection report concerning the child named above. The report is to be considered at a hearing of the protection application on                       .
Details of this application
I apply to the Court for an order restricting access by: 
  the child who is the subject of the report 
  that child's parent 
  any other person specified by the Court namely.
Access is to be restricted to:
  the whole of the report
  a part of the report  (specify).
This application is based on the grounds that information in the report, or the part of the report, may be prejudicial to the physical or mental health of the child or a parent of the child.
Applicant's name-
Address-
Phone-
Agency or relationship to the child-

Date-
		(Applicant's signature)

Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at

Issued at-
Date-

Registrar

*delete if not applicable
__________________
FORM 28
Children and Young Persons Act 1989
(sections 90, 94, 97, 98, 104, 105, 110A)
APPLICATION TO VARY OR REVOKE A PROTECTION ORDER OR INTERIM PROTECTION ORDER
(Not for Breach of Protection Order or Interim Protection Order)
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address	Postcode
Details of the Order
On the application of   (Full name)
Agency and address-
Phone-
the Children's Court at                                     on                           made the following order:
  an Undertaking
  a Supervision Order
  a Custody to Third Party Order
  a Supervised Custody Order
  a Custody to Secretary Order
  an Interim Protection Order.

Details of this application
This application is:
  to vary the order
  to revoke the order.

The grounds for the application are:
......................................................................................................................
......................................................................................................................
This application is made: 
  by the child
  by a parent of the child
  by a person with whom the child is living
  by a person who has been granted custody of the child
  on behalf of the child 
  by the Secretary to the Department of Human Services.
Applicant's name-
Address-
Phone-
Date-
	(Signature)
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at
Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 29
Children and Young Persons Act 1989
(sections 95, 98, 111)
NOTICE TO APPEAR BEFORE THE CHILDREN'S COURT-FAMILY DIVISION
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Details of the Order
On the application of   (Full name)
Agency and address-
Phone-
the Children's Court at                               on                   made an order for:
  a Supervision Order
  a Supervised Custody Order
  an Interim Protection Order.
Details of this notice
Reason for the service of this Notice:
  There has been a failure to comply with any condition of the order.
  There has been a failure to comply with any direction given by the Secretary under section 93(2) of the Children and Young Persons Act 1989. (Not applicable for Interim Protection Orders).
  The child is living in conditions which are unsatisfactory in terms of the safety and well-being of the child.
Applicant's name-
Agency and address-


Phone-
Date-
		(Applicant's signature)

Notice to parent or child
To the child:  You must appear before the Court on the date and at the time listed below. 
To the parent(s) or other person with whom the child is living:  You must bring the child to Court on the date and at the time listed below.
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at
Issued at-
Date-
by Order of the Court
Registrar

*delete if not applicable
__________________
FORM 30
Children and Young Persons Act 1989
(section 89)
UNDERTAKING-CHILDREN'S COURT FAMILY DIVISION
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address	Postcode
The Children's Court at                                           on                   found that
the child named above is in need of protection.
there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court made the following Order:
That the child give the following undertaking:
That	gives the following undertaking:

The undertaking is to last *for (period)         *until (end date).
NOTE: 	An undertaking is a promise to the Court that you will or will not do the things specified in the undertaking.
I consent to the making of this order and agree to comply with this undertaking.

	Signature			Signature
	(child)			(*parent/*custodian)
Date-
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 31
Children and Young Persons Act 1989
(sections 91-93)
SUPERVISION ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address	Postcode
The Children's Court at                                           on                   found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that the child named above be placed on a supervision order.
This order remains in force *for (period)         *until (end date).
A supervision order gives the Secretary to the Department of Human Services responsibility for the supervision of the child.
The parent or other person with whom the child is living must permit the Secretary to visit the child at his or her place of residence and to carry out the duties of the Secretary under the order.
If the order is for a period exceeding 12 months, the Court directs the Secretary to review the operation of the order before the end of the period of 12 months after the making of the order and to notify the Court, the child, the child's parent and such other persons as the Court directs before the end of that period if he or she considers that, to ensure the safety and well-being of the child, the order should continue for the duration of the period specified in the order.



The following conditions apply to this supervision order:
Date-
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 32
Children and Young Persons Act 1989
(section 96)
CUSTODY TO THIRD PARTY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address                                               Postcode
The Children's Court at                                           on                   found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that sole or joint custody of the child named in this order be granted to:
Name-
Address-
Name-
Address-
This order remains in force *for (period)         *until (end date).
The following conditions apply to this custody to third party order:
.....................................................................................................................
.....................................................................................................................
......................................................................................................................
Date-
*Judge/*Magistrate

*delete if not applicable
__________________
FORM 33
Children and Young Persons Act 1989
(section 98)
SUPERVISED CUSTODY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
The Children's Court at                                           on                   found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court ordered that sole or joint custody of the child named in this order be granted to:
Name-
Address-
Name-
Address-
This order remains in force *for (period)         *until (end date).
The parent, or other person with whom the child is living, must permit the Secretary to the Department of Human Services to visit the child at his or her place of residence and carry out the duties of the Secretary under the order.
The Court directs the parties to take all appropriate steps to enable the re-unification of the child with his or her parent before the end of the period for which the order remains in force.



The following conditions apply to this supervised custody order-
Date-
*Judge/*Magistrate
*delete if not applicable
__________________
FORM 34
Children and Young Persons Act 1989
(sections 99-102)
CUSTODY TO SECRETARY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
The Children's Court at                                           on                   found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court granted sole custody of the child named in this order to the Secretary to the Department of Human Services.
This order remains in force *for (period)         *from (start date)         *until (end date).
*This is not an extension of an existing custody to Secretary order.
This order extends an existing custody to Secretary order. The application to extend the order is made under *section 100 *section 101 *section 102.
The following conditions apply to this custody to Secretary order
.....................................................................................................................
.....................................................................................................................
(Delete if not applicable)
The Court directs the Secretary to take steps to ensure that at the end of the period of the order a person other than the child's parent or the Secretary applies to a court for an order relating to-
(i)	the custody; or
(ii)	the custody and guardianship; or

(iii)	the custody and joint guardianship-
of the child.

Date-

*Judge/*Magistrate

*delete if not applicable
__________________
FORM 35
Children and Young Persons Act 1989
(sections 106-108)
GUARDIANSHIP TO SECRETARY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
The Children's Court at                                           on                   found that
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the Order
The Court granted custody and guardianship of the child named in this order to the Secretary to the Department of Human Services to the exclusion of all other persons.
This order remains in force *for (period) *from (start date)                  *until (end date).
This is not an extension of an existing guardianship to Secretary order.
This order extends an existing guardianship to Secretary order. The application to extend the order was made under *section 107 *sections 101 and 108 *sections 102 and 108.
If the Court has specified a period exceeding 12 months for the order to remain in force it now directs the Secretary to the Department of Human Services to review the operation of the order before the end of the period of 12 months after the making of the order and to notify the Court, the child, the child's parent and such other persons as the Court directs before the end of  that period if he or she considers that, to ensure the safety and well-being of the child, the order should continue for the duration of the period specified in the order. 

The Court directs that the following should be notified of the decision to continue the order:
Name-
Address-
Name-
Address-
(Delete if not applicable)
The Court directs the Secretary to the Department of Human Services to take steps to ensure that at the end of the period of the order a person other than the child's parent or the Secretary to the Department of Human Services applies to a court for an order relating to-
(i)	the custody; or
(ii)	the custody and guardianship; or
(iii)	the custody and joint guardianship-
of the child.

Date-

*Judge/*Magistrate

*delete if not applicable
__________________
FORM 36
Children and Young Persons Act 1989
(sections 100-102, 107, 108)
APPLICATION FOR AN EXTENSION OR ADDITIONAL EXTENSION OF A CUSTODY TO SECRETARY ORDER OR A GUARDIANSHIP TO SECRETARY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
The Children's Court at                                       on                             made
*a custody to Secretary order
*a guardianship to Secretary order
*for (period)         *until (end date).
(If the order has since been extended) The Children's Court at                       on                    last extended this order
*for (period)         *until (end date).
Details of the application
The applicant applies for:
(if the application relates to a custody to Secretary order)
*an extension of custody to Secretary order by up to 12 months under section 100 
[for orders that have been in force for 12 months or less]
*an extension of custody to Secretary order beyond 2 years under section 101 
[for orders that have been in force for more than 12 months but not more than 2 years]
*an additional extension of custody to Secretary order under section 102
[for orders that have been in force for more than 2 years]
(if the application relates to a guardianship to Secretary order)

*an extension of guardianship to Secretary order by up to 12 months under section 107
[for orders that have been in force for 12 months or less]
*an extension of guardianship to Secretary order beyond 2 years under sections 101 and 108
[for orders that have been in force for more than 12 months but not more than 2 years]
*an additional extension of guardianship to Secretary order under sections 102 and 108
[for orders that have been in force for more than 2 years]
Applicant's name-
Agency and address-
Phone-
(Signature)
Notice to parties
To the child and applicant:  You must come to the hearing of this application.
To the parent(s):  You should come to the hearing of this application. If you do not attend, the Court may proceed to hear and determine the application in your absence.
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at
Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 37
Children and Young Persons Act 1989
(section 109)
APPLICATION TO REVOKE A GUARDIANSHIP TO SECRETARY ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-
Details of the Order
On the application of   (Full name)
Agency and address-
Phone-
the Children's Court at                                      on                             made a Guardianship to Secretary order.
Details of the application
This application is made on the grounds that-
*circumstances have changed since the making of the guardianship to Secretary order and the applicant has asked the Secretary to the Department of Human Services to review the case plan and the Secretary has either refused to review the case plan or has reviewed it in a way which the applicant finds unsatisfactory.
*the Secretary to the Department of Human Services makes a notification in accordance with section 106(2) in respect of the order.
The Court *has/*has not granted any extensions of this guardianship to Secretary order. [If so, gives dates and venue of the Court.]
Applicant's name-
Agency and address-


Phone-
The applicant is *the child *a parent of the child *the Secretary to the Department of Human Services.

Date-			(Signature)
Details of the hearing
A hearing of this application will be held at                am/pm on               at the Children's Court at
Issued at-
Date-
Registrar

*delete if not applicable
__________________
FORM 38
Children and Young Persons Act 1989
(section 110)
INTERIM PROTECTION ORDER
		Court Ref-
Name of Child-		*Male/*Female
		Date of Birth-
Address-

Applicant's name-
Agency and address-
Phone-
The Children's Court at                                     on                              found that-
*the child named above is in need of protection.
*there is a substantial and irreconcilable difference between the person who has custody of the child and the child to such an extent that the care and control of the child are likely to be seriously disrupted.
Details of the order

The Court ordered that the child named in this order be placed on an interim protection order.
The Secretary to the Department of Human Services is accountable to the Court for the implementation of this order. 
The responsibility for the supervision of the child is with:
The Court directs the preparation and submission to the Court of an additional report by: (state person)
This order remains in force *for (period)         *until (end date).


The following conditions apply to this Interim Protection Order-
.....................................................................................................................
.....................................................................................................................
Details of the further hearing
.....................................................................................................................
.....................................................................................................................
A further hearing of this case will be held at                                  am/pm on                   at the Children's Court at

Date-
*Judge/*Magistrate

*delete if not applicable
__________________

	*	*	*	*	*


__________________

	*	*	*	*	*



__________________

$$A $$T Children and Young Persons (Children's Court) Regulations 2001 - SCHEDULE 8 $$T $$NSCHEDULE

CAYPINS FORMS
FORMS
FORM 1
									Regulation 21(1)
Children and Young Persons Act 1989
(Schedule 2A clause 3(1)(a))
INFRINGEMENT PENALTY FOR REGISTRATION
[Name of Enforcement Agency] seeks to have the infringement penalty, as detailed below, registered. 
DETAILS OF CHILD
Surname:					Other Names:
Date of Birth:
Address:								
Suburb:						Postcode:
DETAILS OF INFRINGEMENT NOTICE
Description of offence:								
*Act/*Statutory Rule/*Local Law/*Subordinate Instrument/ *Commonwealth Act or any Act of another State or Territory or any subordinate instrument under such an Act that applies as a law of Victoria/*Code:		
Infringement Notice No.:
Time of offence:					Date of offence:	
Place of offence:					Date of Issue of Infringement 
	Notice:
VEHICLE DETAILS (if relevant)
Registration Number:	State of Issue (Registration):
*Licence/*Permit Number:					
State of Issue (*Licence/*Permit):
Vehicle Class:

ENFORCEMENT AGENCY DETAILS
Informant's Name:	
Agency:									
Address:									
PENALTY/INSTALMENT DETAILS
The original infringement amount was:  [insert amount]
The amount that has been paid is:    [insert amount]
The amount to be registered (including $       [insert amount]     costs) is:             [insert amount]
(The amount to be registered consists of the original infringement amount minus any amount previously paid to the Agency (whether or not pursuant to a payment plan), plus any prescribed costs.)
*delete if not applicable.
NOTES: 	
* ·		this form can be replicated for each additional penalty/instalment.
__________________

FORM 2
Regulation 21(2)
Children and Young Persons Act 1989
(Schedule 2A clause 3(1)(b))
CERTIFICATE FOR REGISTRATION OF INFRINGEMENT PENALTY
I,        	[Name]      , an appropriate officer of  [Name of Enforcement Agency]	 certify that in respect of the child or each child referred to in a document provided under clause 3(1)(a) of Schedule 2A to the Children and Young Persons Act 1989 with this certificate, the penalty indicated in the document is the prescribed penalty and the following requirements and any other prescribed requirements have been satisfied-
(a)	an infringement notice has been served on the child; and
(b)	a penalty reminder notice has been served on the child after the end of the time specified in the infringement notice as the time within which the infringement penalty may be paid; and
(c)	a period of at least 28 days has passed since the penalty reminder notice was served; and
(d)	the infringement penalty and any prescribed costs had not been paid, whether in full or in part, before this certificate was issued; and
(e)	if a payment plan under the Infringements Act 2006 applies to the child in relation to the infringement penalty, the child has defaulted in making a payment under the payment plan and a specified amount still remains to be paid under that payment plan; and
(f)	if a part payment of the infringement penalty and prescribed costs has been made (otherwise than under a payment plan under the Infringements Act 2006) but no further payment has been made and a specified amount still remains to be paid; and	
(g)	the child has not, under Part 2 of the Infringements Act 2006 elected to have the matter of the infringement offence heard and determined in the Court; and
(h)	a charge in relation to the offence has not been filed; and
(i)	a charge may still be filed in relation to the offence, having regard to the time when the offence is alleged to have been committed; and

(j)	if the infringement notice was served under section 87 of the Road Safety Act 1986, the child was at the time of the alleged offence-
 (i)	the owner of the vehicle within the meaning of Part 7 of that Act; or
(ii)	the person in charge of the vehicle as shown in a statement or declaration supplied in accordance with section 86(3)(a), 86(3)(aab) or 86(3)(ab) of that Act; and
(k)	if the infringement notice was issued in respect of an offence to which section 66 of the Road Safety Act 1986 applies, the child was at the time of the alleged offence-
 (i)		the owner of the motor vehicle within the meaning of section 66 of that Act; or
(ii)	the driver of the motor vehicle as shown in a statement or declaration supplied in accordance with section 66(3)(a), 66(3)(aab) or 66(3)(ab) of that Act; and
(l)	if the infringement notice was issued in respect of an offence against section 73(1) of the Melbourne City Link Act 1995, the child was at the time of the alleged offence-
 (i)		the owner of the vehicle within the meaning of Part 4 of that Act; or
(ii)		the driver of the vehicle as shown in a statement or declaration supplied in accordance with section 87(3)(a), 87(3)(aab) or 87(3)(ab) of that Act; and
(m)	if the infringement notice was issued in respect of an offence under section 204 of the EastLink ProjectAct 2004, the child was at the time of the trip to which the alleged offence relates-
 (i)		the owner of the vehicle within the meaning of that Act; or
(ii)		the driver of the vehicle as shown in a statement supplied under section 199 or 219 of that Act.
	Signed on behalf of the Enforcement Agency by:	
	Appropriate Officer:
	Print Name:	
	Date:		
*delete if not applicable.
__________________

FORM 3
									Regulation 21(3)
Children and Young Persons Act 1989
(Schedule 2A clause 5(1))
CANCELLATION OF AN INFRINGEMENT PENALTY
								Infringement No.:
								Date:
Enforcement agency:
Child's name:
Address:

To the Registrar of the Children's Court at [venue]

The enforcement agency in this matter requests that you cancel the infringement penalty identified by this form.

Signed on behalf of the
enforcement agency by:
Name:
Date:
__________________

FORM 4
									Regulation 21(4)
Children and Young Persons Act 1989 
(Schedule 2A clause 6(4)) 
APPLICATION FOR ORDER THAT PAYMENT OF REGISTERED AMOUNT NOT BE ENFORCED
Registration No.: 
Date of registration: 
Child's name:		
Date of birth: 
Address: 
Description of offence: 
Place of offence:		
Date of offence: 
Enforcement agency: 
Registered amount: $ 
I,	 [Name of child]		, apply to the Registrar of the Children's Court of Victoria for an order that payment of the above registered amount not be enforced.
* Details of my employment, school attendance and personal and financial circumstances are as follows
OR
* I have already provided details in writing to the Registrar of my employment, school attendance and personal and financial circumstances
I am aware that a copy of this application together with any information provided under clause 6(3) of Schedule 2A to the Children and Young Persons Act 1989 will be provided to the enforcement agency that issued the infringement notice if an order is made that payment of the above registered amount not be enforced.



Signed: 
Name: 
Date: 
*delete if not applicable.
__________________

FORM 5
Regulation 21(5)
Children and Young Persons Act 1989 
(Schedule 2A clause 9(1)) 
NOTICE OF ENFORCEMENT ORDER
COURT REFERENCE NUMBER:
DATE OF REGISTRATION:
DETAILS OF CHILD
Surname:					Other Names:					
Date of Birth:
Address:								
Suburb:							Postcode:
DETAILS OF INFRINGEMENT NOTICE
Description of offence:								
*Act/*Statutory Rule/*Local Law/*Subordinate Instrument/ *Commonwealth Act or any Act of another State or Territory or any subordinate instrument under such an Act that applies as a law of Victoria/*Code:			
Infringement Notice No.:
Time of offence:					Date of offence:	
Place of offence:				Date of Issue of Infringement Notice:
ENFORCEMENT AGENCY DETAILS
Informant's Name:	
Agency:									
Address:
DETAILS OF ORDER
On 	    [date]     	, at       [venue]       	the following orders were made:
Dated:
for Registrar

Failure to make the payment required in this order or to make an application to the Registrar (see Notes) may result in further proceedings in the Children's Court.
Methods of payment (insert details)
WARNING:
DO NOT IGNORE THIS NOTICE OR MORE SERIOUS PENALTIES MAY BE IMPOSED.
Note:
(1)	You may apply to the registrar of the Children's Court at [venue] for one or more of the following-
(a)	an order that the time within which the registered amount is to be paid be extended; or
(b)	an order that the registered amount be paid by instalments; or
(c)	an order for the variation of an instalment order.
(2)	If this order requires you to make any payment, you have 28 days after the date of this notice to apply in writing to the Court for a review of the registrar's order.
(3)	If this order is that payment of the registered amount not be enforced, the enforcement agency listed on this notice has 14 days after the date of this notice to apply to the Court for a review of the registrar's order.
(4)	If this order relates to a traffic infringement within the meaning of the Road Safety Act 1986, it does not prevent the incurring of demerit points under section 25 of that Act in relation to that infringement.
*delete if not applicable.
---------------

$$A
$$T
CHILDREN AND YOUNG PERSONS (CHILDREN'S COURT) REGULATIONS 2001
 - NOTES
$$T
$$NNOTES

ENDNOTES
1. General Information
The Children and Young Persons (Children's Court) Regulations 2001, S.R. No. 88/2001 were made on 11 September 2001 by the Governor in Council under section 280 of the Children and Young Persons Act 1989, No. 56/1989 and came into operation on 11 September 2001.
The Children and Young Persons (Children's Court) Regulations 2001 will sunset 10 years after the day of making on 11 September 2011 (see section 5 of the Subordinate Legislation Act 1994).
2. Table of Amendments
This Version incorporates amendments made to the Children and Young Persons (Children's Court) Regulations 2001 by statutory rules, subordinate instruments and Acts.
-------------------------------------------------------------
Children and Young Persons (Children's Court) (Amendment) Regulations 2005, S.R. No. 139/2005
Date of Making:
15.11.05
Date of Commencement:
15.11.05
Children and Young Persons (Children's Court) (Amendment) Regulations 2006, S.R. No. 119/2006
Date of Making:
5.9.06
Date of Commencement:
5.9.06
-------------------------------------------------------------
3. Explanatory Details

1 Reg. 12: S.R. No. 76/2006.
??

??



S.R. No. 88/2001


Children and Young Persons (Children's Court) Regulations 2001