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District Court Rules

Schedule: C - Forms in civil proceedings

Form: 59.1 Summons for a safety order - Domestic Violence Act 1996, s. 2(2)

S. I. No. 286 of 2012

Schedule C

O.59, r. 4(1)


NO. 59.1

DOMESTICE VIOLENCE ACT 1996, section 2 (2)

SUMMONS FOR A SAFETY ORDER


District Court Area of

District No.

....................... Applicant

....................... Respondent

YOU ARE HEREBY REQUIRED to appear at the sitting of the District Court to be held at ............. on the ........ day of ........... 20 ....., at .....m. to answer the application of the *applicant *(or the Health Service Executive on behalf of the applicant by virtue of section 6 of the above-mentioned Act) who is

*the spouse of the respondent

*the civil partner (within the meaning of the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010) of the respondent

*not the spouse or civil partner of the respondent and is not related to the respondent within the prohibited degrees of relationship, but lived with the respondent in an intimate and committed relationship prior to this application

*a parent of the respondent and the respondent being of full age and not, in relation to the parent, a dependent person

*of full age and residing with the respondent in a relationship which is not primarily contractual

*a person who was a party to a civil partnership with the respondent that has been dissolved under the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010

*a parent of a child whose other parent is the respondent

and who resides at .............. *(in the Court District aforesaid) for a safety order directing that you shall not use or threaten to use violence against, molest or put in fear the *applicant *or any dependent person(s) *and shall not watch or beset the place where the applicant *and that dependent person(s) reside(s).

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

Signed .............

Judge of the District Court

District Court Clerk

To ..............

Of ...............

Respondent


*WARNING

IT IS AN OFFENCE under section 9 of the Family Home Protection Act 1976, as applied by section 8 of the Domestic Violence Act 1996, for a spouse to DISPOSE OF OR REMOVE ANY OF THE HOUSEHOLD CHATTELS pending the determination of the application herein, and if a safety order is made, while that order is in force (unless the other spouse consents or the Court permits it).

A spouse who contravenes that provision shall be liable on conviction to a Class D fine, being a fine not exceeding €1,000 or to imprisonment for a term not exceeding six months, or to both.

*Delete where inapplicable