Details of the original order (not details of any subsequent variation or extension) The Children's Court at (venue) on (date) made the following order— *a supervision order *a custody to third party order *a supervised custody order *a custody to Secretary order *an interim protection order *The Secretary has directed that on (date) the child return to the sole or joint custody of a parent or parents and accordingly, pursuant to section 286(1)(c) of the Act, the supervised custody order has been deemed to be a supervision order. Details of this application This application is— *to vary the order (specify the condition(s) to be varied) *to revoke the order The grounds for the application are— (set out grounds) This application is made by— * the child * a parent of the child * a person with whom the child is living * a person who has been granted custody of the child * the Secretary Applicant's name— Address—
Details of the original order (not details of any subsequent variation or extension) The Children's Court at (venue) on (date) made the following order— *a supervision order *a custody to third party order *a supervised custody order *a custody to Secretary order *an interim protection order *The Secretary has directed that on (date) the child return to the sole or joint custody of a parent or parents and accordingly, pursuant to section 286(1)(c) of the Act, the supervised custody order has been deemed to be a supervision order. Details of this application This application is— *to vary the order (specify the condition(s) to be varied) *to revoke the order The grounds for the application are— (set out grounds) This application is made by— * the child * a parent of the child * a person with whom the child is living * a person who has been granted custody of the child * the Secretary Applicant's name— Address—
07-24sr003.docx