Other notes
Other notes Other notes
Terms of the order
Order made
Date order made
Time order made
Registrar
Date
Court copy
Prostitution Act 2000Prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
❒ Other ______________
Location
Restrained person
Family name
Date of birth
Other names
Home street
address suburb postcode
Work street
Address suburb postcode
Phone nos. work home
Terms of the order
Order made
Date
Time
Registrar
Signature
Date
Court copy
Prostitution Act 2000Prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
❒ Other ______________
Location
Restrained person
Family name
Date of birth
Other names
Home street
address suburb postcode
Work street
Address suburb postcode
Phone nos. work home
Terms of the order
Order made
Date
Time
Registrar
Signature
Date
Restrained person’s copy
IMPORTANT INFORMATION
Prostitution restraining order
A restraining order has been made against you on the terms set out on the front of this order. It will take effect when it is served on you and it will remain in force until it expires or is varied or cancelled by a court. You must comply with this order at all times while it is in force.
If there is a duration specified in the order, the order expires at the end of the specified period. If there is no duration specified in the order, it expires 1 year after it was served on you.
If, in the future, there is a substantial change in the circumstances which led to the order being made you may apply to the court for leave to apply to have the order varied or cancelled. If you would like more information about doing this you should consult your lawyer or the registrar of the court.
Penalty It is an offence to breach this restraining order. If you do, you may be arrested and will face a penalty of up to $5 000.
Back of restrained person’s copy
Prostitution Act 2000Prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
❒ Other ______________
Location
Restrained person
Family name
Date of birth
Other names
Home street
address suburb postcode
Work street
Address suburb postcode
Phone nos. work home
Terms of the order
Order made
Date
Time
Registrar
Signature
Date
Police copy
Certificate of service
Officer serving order
Name
Regimental no.
Police station/division
Service
Method of service ❒ personal ❒ oral ❒ substituted
Place where order served
Date of service
Time of service
Person served
(If possible to obtain)
Name
Address street
Suburb postcode
Signature
Certificate
I certify that on the day and at the time and place set out above
❒ I personally served this order on the restrained person
❒ I orally served this order on the restrained person
❒ I took the steps directed by the court to effect substituted service of this order on the restrained person
in accordance with the Prostitution (Restraining Orders) Regulations 2000, and in the case of oral service I also certify that the restrained person appeared to understand what was said.
Signature
Date
Back of police copy
Prostitution Act 2000Prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
❒ Other ______________
Location
Restrained person
Family name
Date of birth
Other names
Home street
address suburb postcode
Work street
Address suburb postcode
Phone nos. work home
Terms of the order
Order made
Date
Time
Registrar
Signature
Date
Proof of service copy
Certificate of service
Officer serving order
Name
Regimental no.
Police station/division
Service
Method of service ❒ personal ❒ oral ❒ substituted
Place where order served
Date of service
Time of service
Person served
(If possible to obtain)
Name
Address street
Suburb postcode
Signature
Certificate
I certify that on the day and at the time and place set out above
❒ I personally served this order on the restrained person
❒ I orally served this order on the restrained person
❒ I took the steps directed by the court to effect substituted service of this order on the restrained person
in accordance with the Prostitution (Restraining Orders) Regulations 2000, and in the case of oral service I also certify that the restrained person appeared to understand what was said.
Signature
Date
Back of proof of service copy
Prostitution Act 2000Application for leave
to apply to vary or cancel
a prostitution restraining
order
Number
Jurisdiction ❒ Court of Petty Sessions
❒ Children’s Court
Location
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Date order was made
Restraining Order no.
Substantial changes
What circumstances have substantially changed since the order was made?
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order varied or cancelled?
Person applying for leave
Signature
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Court copy
Record of Proceedings
Date
Attendance
Representation
Adjournments
Applicant
Person to be restrained
Applicant
Person to be restrained
Orders
____________________________ _________________ __________________
Judicial Officer Date Time
Clerk’s record
Back of court copy
Prostitution Act 2000Application for leave to apply to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Court of Petty Sessions
❒ Children’s Court
Location
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Date order was made
Restraining Order no.
Substantial changes
What circumstances have substantially changed since the order was made?
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order varied or cancelled?
Person applying for leave
Signature
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Restrained person’s copy
IMPORTANT INFORMATION
Application for leave to apply to vary or cancel
As the restrained person, before you are allowed to apply to vary or cancel the restraining order you must apply for leave to make that application.
When you file your application for leave you must also file an affidavit setting out all the facts that you know about that are material to the application — this includes all the facts that may go against your application as well as the ones that support it. If you do not do this the court may reject your application.
At the hearing of the application for leave you must convince the court that there has been a substantial change in the relevant circumstances since the restraining order was made. If the court is not satisfied that there has been a substantial change of circumstances your application for leave will be dismissed
If the court is satisfied that there has been a substantial change of circumstances it will order you to serve a copy of this application on the person who originally applied for the restraining order (this will usually be the Commissioner of Police). That person will then be able to attend court to oppose your application for leave if he or she wishes to do so.
If the court grants you leave, you must then lodge an application to vary or cancel the restraining order.
If you do not attend the hearing of your application for leave, your application may be dismissed.
Back of restrained person’s copy
This form must not be served until service is ordered by the Court
Prostitution Act 2000Application for leave to apply to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Court of Petty Sessions
❒ Children’s Court
Location
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Date order was made
Restraining Order no.
Substantial changes
What circumstances have substantially changed since the order was made?
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order varied or cancelled?
Person applying for leave
Signature
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Respondent’s copy
This form must not be lodged until application has been served on the Respondent
Prostitution Act 2000Application for leave to apply to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Court of Petty Sessions
❒ Children’s Court
Location
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Date order was made
Restraining Order no.
Substantial changes
What circumstances have substantially changed since the order was made?
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order varied or cancelled?
Person applying for leave
Signature
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Proof of service copy
Certificate of service
Person serving application
Name
Home street
address suburb postcode
Service
Method of service ❒ personal ❒ by post
Place where order served
Date of service
Time of service
Person served
(If possible to obtain)
Name
Regimental no.
Police station/division
Signature
Certificate
I certify that on the day and at the time and place set out above
❒ I personally served this application on the person named above
❒ I sent this application by prepaid registered post to the person named above at the police station/division referred to above
in accordance with the Prostitution (Restraining Orders) Regulations 2000.
Signature
Date
Back of proof of service copy
Prostitution Act 2000Affidavit in support of application for leave to apply to vary or cancel a prostitution restraining order
Number
Jurisdiction
❒ Magistrates Court
❒ Children’s Court
Location
Person making affidavit
Family name
Date of birth
Other names
Home street
address suburb postcode
Affidavit
NOTE You must set out ALL the relevant circumstances — this includes things that may go against your application as well as those that support it.
(Add extra pages if required)
I make oath and swear that since the restraining order was made the relevant circumstances have changed as follows —
1.
2.
3.
4.
5.
6.
Sworn before a Justice of the Peace
Signature
Date
Justice of the Peace
Signature
Name
Prostitution Act 2000Application to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
Location
Applicant
❒ Police officer nominated by the Commissioner of Police
Name
Regimental no.
Police station/division
Phone no.
❒ Restrained person
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Leave
Date order was made
Restraining Order no.
Date leave to apply to vary was granted (if application is by restrained person)
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order to be varied or cancelled?
Signature of applicant
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Court copy
Record of Proceedings
Date
Attendance
Representation
Adjournments
Applicant
Person to be restrained
Applicant
Person to be restrained
Orders
____________________________ _________________ __________________
Judicial Officer Date Time
Clerk’s record
Back of court copy
Prostitution Act 2000Application to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
Location
Applicant
❒ Police officer nominated by the Commissioner of Police
Name
Regimental no.
Police station/division
Phone no.
❒ Restrained person
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Leave
Date order was made
Restraining Order no.
Date leave to apply to vary was granted (if application is by restrained person)
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order to be varied or cancelled?
Signature of applicant
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Copy for person applying to vary or cancel
Prostitution Act 2000Application to vary or cancel a prostitution restraining order
Number
Jurisdiction ❒ Magistrates Court
❒ Children’s Court
Location
Applicant
❒ Police officer nominated by the Commissioner of Police
Name
Regimental no.
Police station/division
Phone no.
❒ Restrained person
Restrained person
Family name
Other names
Address street
Suburb postcode
Phone nos. work home
Restraining order
Leave
Date order was made
Restraining Order no.
Date leave to apply to vary was granted (if application is by restrained person)
Variation or cancellation
Do you want the order to be ❒ cancelled ❒ varied
If varied, what do you want changed?
Grounds for variation or cancellation
Why do you want the restraining order to be varied or cancelled?
Signature of applicant
Date
Hearing
(To be filled in by the court)
Court
Date
Time
Signature of registrar
Other party’s copy
[Schedule 1 amended: Gazette 31 Jul 2007 p. 3799.]
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