Respondent: 1. I, [name OR of authorised person name of person authorised by body am the authorised specified in order to provide counselling] representative of [name OR person of counselling organisation] specified in the order. 2. On the Family Violence Court Division at made an order requiring the respondent to attend counselling provided by [name of person or body specified in the order] at [time] on [date] at [place]. 3. *[delete if not applicable] On the Family Violence Court Division at varied the order and directed the respondent to attend counselling at [time] on [date] at [place]. 4. *[delete if not applicable] On [name gave the of person or body providing the counselling] respondent reasonable written notice of the time and place at which each subsequent counselling session would be conducted. 5. The subsequent counselling sessions were to take place at [place] on [dates] and [times]. 6. The respondent failed to attend counselling at [time] on [date] at [place] as directed. Signed— [name] Date— Form 4 ENDNOTES General Information
Respondent: 1. I, [name of authorised person OR name of person authorised by body specified in order to provide counselling] am the authorised representative of [name of counselling organisation] OR person specified in the order. 2. On the Family Violence Court Division at made an order requiring the respondent to attend counselling provided by [name of person or body specified in the order] at [time] on [date] at [place]. 3. *[delete if not applicable] On the Family Violence Court Division at varied the order and directed the respondent to attend counselling at [time] on [date] at [place]. 4. *[delete if not applicable] On [name of person or body providing the counselling] gave the respondent reasonable written notice of the time and place at which each subsequent counselling session would be conducted. 5. The subsequent counselling sessions were to take place at [place] on [dates] and [times]. 6. The respondent failed to attend counselling at [time] on [date] at [place] as directed. Signed— [name] Date— Form 4 ENDNOTES General Information
08-153sr002.docx