District No.

In the matter of ........... a child

......... Applicant

of .....

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

of .............

WHEREAS PROCEEDINGS entitled as above, brought under section ..... of the ...... Act, ...... in respect of the above-named child, who *resides *is for the time being at ........ in the area of the ......... Health Board and in the said court district, were before this Court to-day.

AND WHEREAS it appeared to the Court that it might be appropriate for a care order or a supervision order to be made with respect to the said child and under section 20 (1) of the Child Care Act, 1991, the Court adjourned the proceedings and directed that health board to undertake an investigation of the child's circumstances.

NOW, THE COURT being satisfied that the welfare of the child so requires.

HEREBY DIRECTS under section 20 (2) of the Act (as to the care and custody of the child pending the outcome of the investigation) as follows:—

Dated this ... day of ..... 19 .....

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

Judge of the Children Court

* Delete words inapplicable