Consent Orders Intake Form

    Who is making this application?

    Your details

    First Name
    Middle Name
    Family Name
    DOB
    Occupation
    Phone
    Email

    Your Residential Address

    Country
    Street
    Suburb/Town
    State
    Postcode

    Spouse's details

    First Name
    Middle Name
    Family Name
    DOB
    Occupation
    Phone
    Email

    Your Spouse's Residential Address

    Country
    Street
    Suburb/Town
    State
    Postcode
    Your Details Spouse's Details
    Do you regard Australia as your home? YesNo YesNo
    Have you lived in Australia for the last 12 months? YesNo YesNo
    Are you an Australian Citizen? YesNo YesNo
    Have you become an Australian citizen? YesNo YesNo
    Are you of Aboriginal and/or Torres Strait Islander origin? YesNo

    If so, which?
    YesNo

    If so, which?
    Are you married? YesNo YesNo
    If born overseas, in what country?

    Marriage

    Date of cohabitation
    (DD/MM/YYYY)
    Date of Marriage
    (DD/MM/YYYY)
    Date of Separation
    (DD/MM/YYYY)
    Place of Marriage
    Wife's Maiden Name
    Do you have any children under 18 years of age that are children of you and your spouse? YesNo

    Children's details

    Child 1
    First Name
    Middle Name
    Last Name
    Birthday
    Lives with:
    How is the child's health? (20-30 words)
    How is the child progressing at school/childcare(or preschoold)? (20-30 words)
    Which school do they attend? What year?
    What are the current contact arrangements? (20-30 words)
    Is there a child support arrangement? (20-30 words)
    Do you need to add another child? YesNo
    Child 2
    First Name
    Middle Name
    Last Name
    Birthday
    Lives with:
    How is the child's health? (20-30 words)
    How is the child progressing at school/childcare(or preschool)? (20-30 words)
    Which school do they attend? What year?
    What are the current contact arrangements? (20-30 words)
    Is there a child support arrangement? (20-30 words)
    Do you need to add another child? YesNo
    Child 3
    First Name
    Middle Name
    Last Name
    Birthday
    Lives with:
    How is the child's health? (20-30 words)
    How is the child progressing at school/childcare(or preschool)? (20-30 words)
    Which school do they attend? What year?
    What are the current contact arrangements? (20-30 words)
    Is there a child support arrangement? (20-30 words)
    Do you need to add another child? YesNo
    Child 4
    First Name
    Middle Name
    Last Name
    Birthday
    Lives with:
    How is the child's health? (20-30 words)
    How is the child progressing at school/childcare(or preschool)? (20-30 words)
    Which school do they attend? What year?
    What are the current contact arrangements? (20-30 words)
    Is there a child support arrangement? (20-30 words)
    Do you need to add another child? YesNo
    Child 5
    First Name
    Middle Name
    Last Name
    Birthday
    Lives with:
    How is the child's health? (20-30 words)
    How is the child progressing at school/childcare(or preschool)? (20-30 words)
    Which school do they attend? What year?
    What are the current contact arrangements? (20-30 words)
    Is there a child support arrangement? (20-30 words)
    Do you require a property settlement? YesNo
    Explain your agreement in basic language (500 words)
    Are there any pending cases in this or any other court about family law, child support, family violence or child welfare issues involving any of the parties or children listed in this application? YesNo
    If yes, describe
    Are there any existing orders, agreements, parenting plans or undertakings to a court about family law, child support, family violence or abuse in relation to a child (including orders which have applies to a child or a member of the child's family), or child welfare, concerning any of the parties or children listed in this application? YesNo
    If yes, describe

    Gross Annual Income

    You
    Your Partner

    Child Support: Applicant

    Are you paying child support? YesNo
    If yes, please provide details
    Amount paid per week
    Paid to (name)
    Are you receiving child support? YesNo
    If yes, please provide details
    Amount received each week
    Paid to you by (name)

    Child Support: Respondent

    Are they paying child support? YesNo
    If yes, please provide details
    Amount paid per week
    Is this number an estimate? YesNo
    Paid to (name)
    Are they receiving child support? YesNo
    If yes, please provide details
    Amount received each week
    Paid to you by (name)