Form 11 –  Notice of Motion
Domestic Violence and Protection Orders Regulation 2009
In the Magistrates Court of the Australian Capital Territory
DV/RO/WO 09/………………

………………………………………….
Applicant

…………………………………………..

Respondent

I, (name of applicant)..........................................................................................................
Apply  for:

………………………………………………………………………………………………………

………………………………………………………………………………………………………
On the following grounds:

………………………………………………………………………………………………………

………………………………………………………………………………………………………

I rely on the following affidavits in support of my application:

1.	………………………………………. dated ………………………..

2.	………………………………………. dated ………………………..

...............................................
Applicant’s signature

Dated this ...................................... day of .......................................................... 2009.

NOTE:  This application is set down for the................ day of ........................, 2009 at..................................., at the Magistrates Court at Knowles Place, Canberra.

.............................................
Deputy Registrar