Application for leave to apply for an intervention order on behalf of an affected family member or applicant

The form must be used if:

• you are not the person experiencing family violence;
• you are not the protected person listed on a family violence intervention order;
• you are applying on behalf of a protected person or a person experiencing family violence; or
• you are a child above the age of 14 years.

This form is the first form you must complete in the family violence intervention order process.

In completing the form you are seeking permission from the court to apply for a family violence intervention order or an application to vary, extend or revoke a family violence intervention order. This is called seeking leave.