Applicant or protected person application for leave to vary, revoke or extend a personal safety intervention order

This form must be used if:

• you are not the person needing protection;
• you are not the protected person on a personal safety intervention order;
• you are applying on behalf of of a protected person or a person; or
• you are a child above the age of 14 years.

You are required to seek leave (permission) of the court to lodge a personal safety intervention order application or an application to vary, extend or revoke a personal safety intervention order.

If the applicant is the protected person and does not require leave, they can proceed to lodging the application to extend and/or vary or revoke.

This form is the first form you are required to complete in the process.