Approved form AF2001-163

made under the
Domestic Violence Act 1986

Domestic Violence Act 1986—Form 3
(see s 19)

AUSTRALIAN CAPITAL TERRITORY
Domestic Violence Act 1986
Order varying protection order or interim protection order

IN THE MAGISTRATES
COURT AT CANBERRA					No    of 19
The Court, having heard an application made by [name of applicant] under the Domestic Violence Act 1986 in respect of the conduct [or threatened conduct] of [name of respondent] towards [name of person to be protected], and having on [date of original order] ordered that, for [period]:
1.	[name of respondent] not engage in the following conduct:
*2.	[name of respondent] not engage in conduct that constitutes any domestic violence offence.
3.	[name of respondent] comply with the following prohibitions and conditions:
[specify prohibitions  and conditions and any other period or periods for which they are imposed] 
Now the Court, on the application of [name of applicant], this day orders that the Protection Order [or Interim Protection Order] be varied as follows:
[specify details of variation]
Dated				19    .
	[Signature]
	Registrar of the Magistrates Court
*  Delete for variation of interim protection order.

Endnote
1	The form under the Domestic Violence Act 1986 (the authorising Act) was originally in schedule 2 to that Act.  Under an amendment made by the Legislation (Consequential Amendments) Act 2001, the form became a form approved under the authorising Act, section 35 (see amdt 1.1174).

©  Australian Capital Territory 2004