Magistrates Court (Civil Jurisdiction) Rules 2004—Form 79
(see ss 308 (1), 313 (1) and 331 (2))

Application for instalment order

To the Registrar

This application is for—
* an instalment order
* the variation of an instalment order
* the revocation of an instalment order

DETAILS OF APPLICANT:
I...........................................……….	*the judgment debtor/creditor or 
(name of judgment creditor/debtor)	solicitor for the judgment debtor/creditor 
of .....................................................	Telephone numbers:
.........................................................	................................. (business)
.....................................................…	................................. (private)
	(address)

NATURE OF ORDER SOUGHT:
[To be completed unless application is made for revocation of an instalment order.]
Please specify
(a)	the amount of each instalment to be paid:		$ ......................
(b)	time when instalments are to be paid:
	(eg weekly/fortnightly/monthly):			........................…...
(c)	date of first instalment:				.....…/.…...../..…....
(d)	person to whom instalments are to be paid:	……………….…..
(e)	address where instalments are to be paid	................................
							................................

REASONS FOR APPLICATION:
[If application is being made for the variation or revocation of an instalment order, it will be necessary to state what circumstances have changed or were withheld since the last instalment order and, if so, the details and particulars relating to those circumstances.]

[If more space is required, please attach further statements.]

OTHER RELEVANT DETAILS:

						.............................................
						Signature of applicant
*Delete if not applicable
Note	If the application is made by the judgment debtor, a statement of property and financial circumstances must be filed with this application.

IMPORTANT

IF YOU DO NOT UNDERSTAND THIS DOCUMENT, YOU SHOULD OBTAIN LEGAL ADVICE IMMEDIATELY. YOU MAY ALSO NEED TO OBTAIN FINANCIAL COUNSELLING.

Endnotes
1	This form was originally in the Magistrates Court (Civil Jurisdiction) Act 1982 (the authorising Act), schedule 1.  Under amendments made by the Legislation (Consequential Amendments) Act 2001, the form was omitted from the authorising Act and became a form approved under section 471 of that Act (see amdt 1.2791, amdt 1.2793).
2	Under the Court Procedures Act 2004 A2004-59, pt 8, this form became a form approved under that Act.
3	This republication includes amendments made under the Legislation Act, part 11.3 (Editorial changes).

©  Australian Capital Territory 2005