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Rules of the Superior Courts

Appendix: II

Civil Partnership and Cohabitation : S.I. No. 348 of 2011


Forms:
No.1 ¦ No.2 ¦ No.3 ¦ No.4 ¦ No.5

Form No. 1


O. 70B, rr, 5, 16(5)

THE HIGH COURT

CIVIL PARTNERSHIP

[or, as the case may be, COHABITATION]

IN THE MATTER OF SECTION ... OF THE CIVIL PARTNERSHIP AND CERTAIN RIGHTS AND OBLIGATIONS OF COHABITANTS ACT 2010


BETWEEN/

A.B.

Applicant

and

C.D.

Respondent


AFFIDAVIT OF MEANS

I, .........., ........ [insert occupation], of........, aged 18 years and upwards MAKE OATH and say as follows:—

1. I say that I am the applicant/respondent [delete as appropriate] in the above entitled proceedings and I make this affidavit from facts within my own knowledge save where otherwise appears and where so appearing I believe the same to be true.

2. I say that I have set out in the First Schedule all the assets, property and financial resources to which I am legally or beneficially entitled and the manner in which such assets, property and financial resources are held.

3. I say that I have set out in the Second Schedule all income which I receive, including any income or benefits to which I am entitled by or under statute, and the source(s) of such income, and details of my current employment and employment prospects.

4. I say that I have set out in the Third Schedule all my debts, liabilities, financial obligations and financial responsibilities and, where relevant, the persons to whom such debts and liabilities are due.

5. I say that details of my regular outgoings have been set out in the Fourth Schedule.

6. I say that to the best of my knowledge, information and belief, all pension information known to me relevant to the within proceedings is set out in the Fifth Schedule. [Where information has been obtained from the trustees of the pension scheme concerned under the Pensions Act 1990, such information should be exhibited and where such information has not been obtained, the Deponent should depose to the reason(s) why such information has not been obtained].


FIRST SCHEDULE

[Here set out in numbered paragraphs all assets, property and financial resources whether held in the applicant’s/respondent's sole name or jointly with another, whether held legally or beneficially, the manner in which the assets are held, whether they are subject to a mortgage or other charge or lien and such further and other details as are appropriate].

SECOND SCHEDULE

[Here set out in numbered paragraphs all the deponent’s income including any income or benefits to which the deponent is entitled by or under statute, and the source(s) of all such income, and details of the deponent’s current employment, if any, and future employment prospects].

THIRD SCHEDULE

[Here set out in numbered paragraphs all debts, liabilities, obligations and responsibilities of the deponent and, where relevant, the person to whom each such debt, liability, financial obligation or financial responsibility is due].

FOURTH SCHEDULE

[Here set out full details of regular personal outings].

FIFTH SCHEDULE

[Here full details of nature of pension scheme, benefits payable thereunder, normal pensionable age and period of reckonable service should be listed to the best of the deponent's knowledge, information and belief].

SWORN etc.


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Form No. 2



O. 70B, rr, 6(6), 16(5)

THE HIGH COURT

CIVIL PARTNERSHIP

[or, as the case may be, COHABITATION]

IN THE MATTER OF PARAGRAPH (a) OF SECTION *56(1) **179(1) OF THE CIVIL PARTNERSHIP AND CERTAIN RIGHTS AND OBLIGATIONS OF COHABITANTS ACT 2010


BETWEEN/

A.B.

Applicant /Maintenance Creditor

and

C.D.

Respondent /Maintenance Debtor


STATEMENT AS TO EARNINGS

I, ......, ....... [insert occupation], of ......., aged 18 years and upwards say as follows:—

1. I am the respondent /maintenance debtor [delete as appropriate] in the above entitled proceedings.

2. I have set out in the First Schedule the name and address of every employer by whom I am employed, together with particulars enabling each such employer to identify me, and particulars of my earnings and expected earnings from each such employment and other sources, my resources and needs.


FIRST SCHEDULE

†Name and address of Employer(s) ............

(or trustee of a pension scheme under which the maintenance debtor is receiving periodical pension benefits) ............

Commencement date ............

Nature of work ................

Place of Work .................

Weekly earnings ........

Expected changes to weekly earnings .............

Employee/contractor identification number/code (if any) ..........

P.P.S. number ..........

‡Income from any other sources

Nature of income ............

Source .............

Identification/account number/code (if any) ..........

Weekly income ..............

‡Financial resources

Nature of resource ............

Location (e.g. bank account) ..........

Gross value ............

Needs

[Here set out full details of regular personal outings].

Dated: ........ 20

Signed

*For civil partnership law proceedings

**For cohabitation proceedings

†Repeat for each separate employer, pension provider, or for income as self-employed

‡ Repeat for each separate income source or, as the case may be, resource


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Form No. 3


O. 70B, rr, 6(6), 16(5)

THE HIGH COURT

CIVIL PARTNERSHIP

[or, as the case may be, COHABITATION]

IN THE MATTER OF PARAGRAPH (a) OF SECTION *56(1) **179(1) OF THE CIVIL PARTNERSHIP AND CERTAIN RIGHTS AND OBLIGATIONS OF COHABITANTS ACT 2010


BETWEEN/

A.B.

Applicant /Maintenance Creditor

and

C.D.

Respondent /Maintenance Debtor


STATEMENT AS TO EARNINGS

I, ......., ...... [insert occupation], of......, aged 18 years and upwards say as follows:—

1. I am the employer of the maintenance debtor in the above entitled proceedings (or a trustee of a pension scheme under which the maintenance debtor is receiving periodical pension benefits).

2. I certify the following particulars of the maintenance debtor:


FIRST SCHEDULE

Name and address of Employer(s) ...........

(or trustees) .............

Commencement date .........

Nature of work .........

Place of Work ........

Weekly earnings ........

Expected changes to weekly earnings .......

Employee/contractor identification number/code (if any) of the maintenance debtor ...........

P.P.S. number of the maintenance debtor ..........

Dated: ......... 20

Signed

*For civil partnership law proceedings

**For cohabitation proceedings



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Form No. 4


O. 70B, rr, 7(1), 8(3), 16(5)

THE HIGH COURT

CIVIL PARTNERSHIP

[or, as the case may be, COHABITATION]

IN THE MATTER OF SECTION ... OF THE CIVIL PARTNERSHIP AND CERTAIN RIGHTS AND OBLIGATIONS OF COHABITANTS ACT 2010


BETWEEN/

A.B.

Applicant and

C.D. Respondent


NOTICE TO TRUSTEES

TAKE NOTICE that relief has been claimed by the applicant/respondent in the above entitled proceedings pursuant to the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010 and in particular in relation to...... [here insert details of pension in respect of which relief is claimed].

AND FURTHER TAKE NOTICE that

†any representations to be made to the Court may be made by way of affidavit of representation to be filed and served on all parties herein within 28 days of the date of service of this notice upon you

†a request will be made to the court for you to provide the calculations referred to in section *126(2) **section 192 of the said Act.

Dated the ... day of ........ 20....

Signed: ...............

Solicitors for the Applicant/Respondent

To: The Trustees of the pension scheme concerned

and

To: Applicant/Respondent [or solicitors where appropriate]

†Delete where inapplicable

*For civil partnership law proceedings

**For cohabitation proceedings


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S.I. No. 16 of 2016

FORM No. 5


O. 70B, r, 5A

THE HIGH COURT

CIVIL PARTNERSHIP [or, as the case may be, COHABITATION]

IN THE MATTER OF SECTION OF THE CIVIL PARTNERSHIP AND CERTAIN RIGHTS AND OBLIGATIONS OF COHABITANTS ACT 2010


BETWEEN/

A.B. Applicant
and

C.D. Respondent


AFFIDAVIT OF WELFARE

I, [name], [occupation], ....... of [address] ...... being aged 18 years and upwards MAKE OATH and say as follows:

1 I am the *Applicant/*Respondent in the above entitled proceedings. I make this Affidavit from facts within my own knowledge save where otherwise appears and where so appearing I believe the same to be true.

2 The facts set out in the Schedule hereto are true.

[Where the Respondent does not dispute the facts as set out by the Applicant in his/her Affidavit of Welfare, the following averment shall be included, replacing paragraph 2, and the Schedule shall not be omitted by the Respondent

2. I agree with the facts as set out by the Applicant in his/her Affidavit of Welfare sworn herein


SCHEDULE

Part I --Details of Children


1. Details of dependent children of the civil partners:

Forenames .....

Surname .....

Date of Birth ............

Relationship to Applicant/Respondent .........

      Part II --Arrangements for the dependent children of the civil partners
2. Home Details:

(a) The address or addresses at which the children now live

(b) Give details of number of living rooms, bedrooms etc. at the address(es) in

(a) above

(c) Is the house rented or owned and, if so, name the tenant(s) or owner(s)?

(d) Is the rent or mortgage being regularly paid and, if so, by whom?

(e) Give names of all other persons living with the children either on a full-time or part-time basis and state their relationship to the children, if any.

(f) Will there be any change in these arrangements and, if so, give details.


Part III --Education and training details

3. Education and training details:

(a) Give names of the school, college or place of training attended by each child.

(b) Do the children have any special education needs? If so, please specify.

(c) Is the school, college or place of training fee-paying? If so, give details.


Part IV --Childcare details

4. Childcare details:

(a) Which civil partner looks after the children from day to day? If responsibility is shared, please give details.

(b) Give details of work commitments of both civil partners.

(c) Does someone look after the children when either civil partner is not there? If yes, give details.

(d) Who looks after the children during school holidays?

(e) Will there be any change in these arrangements? If yes, give details.


Part V --Maintenance

5. Maintenance:

(a) Does the Applicant/Respondent pay towards the upkeep of the children? If yes, give details. Please specify any other source of maintenance.

(b) Is the maintenance referred to in (a) above paid under court order? If yes, give details.

(c) Has maintenance for the children been agreed? If yes, give details.

(d) If not, will you be applying for a maintenance order from the court?


Part VI --Details of contact with children

6. Contact:

(a) Do the children see the Applicant/Respondent? Please give details.

(b) Do the children stay overnight and/or have holiday visits with the Applicant/Respondent? Please give details.

(c) Will there be any change to these arrangements?


Part VII --Details of Health

7. Children’s health:

(a) Are the children generally in good health? Please give details of any serious disability or chronic illness suffered by any of the children.

(b) Do the children or any of them have any special health needs? Please give details of the care needed and how it is to be provided.

(c) Are the Applicant and the Respondent generally in good health? In not, please give details.


Part VIII --Details of care and other Court Proceedings

8. Care and other Court proceedings:

(a) Are the children or any of them in the care of the Child and Family Agency or under the supervision of a Social Worker or Probation Officer? If so, please specify.

(b) Are there or have there been any proceedings in any Court involving the children or any of them? If so, please specify. Copies of all relevant Court Orders relating to the children or any of them should be annexed.

SWORN etc.


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