Form 5	Domestic Violence and Protection Orders Act 2001
(see s 16)
Notice of application

Australian Capital Territory

To (applicant’s name)
This application is set down for hearing on the 	day of		
20 	at 	am/pm at the Magistrates Court at	
Dated this 	day of		20	.
[Signature]
Registrar

Endnotes
This republication includes amendments made under the Legislation Act, part 11.3 (Editorial changes).

©  Australian Capital Territory 2006