Form 13	Undertaking by litigation guardian
Domestic Violence and Protection Orders Regulation 2009, s 52
In the Magistrates Court of the Australian Capital Territory

DV/RO/WO ……. /………………

APPLICANT			.........................................................................

RESPONDENT		...................................................................

I, ..........................................................................................................................................

of (address) ........................................................................................................................,

state that:

1.	To the best of my knowledge the person with a legal disability does not have a disability guardian or manager, other than myself;
2.	I have no interest in these proceedings that is adverse to the interests of the applicant/respondent;
3.	I agree to be appointed as the litigation guardian of the applicant/respondent.

Dated this ................... day of ................................................ 20……

.........................................................................
Litigation Guardian

.........................................................................
Witness
(Registrar, legal practitioner or Justice of the Peace)